Background Ageing is associated with changes in body composition and due to the ageing of the populations and the lessened physical activity (PA), sarcopenia and osteopenia/osteoporosis are emerging as major health concerns. Lack of PA is a significant risk factor for sarcopenia. Vitamin D plays an important role on bone and muscle development.
Objectives A randomized controlled trial was conducted to determine the prevalence of sarcopenia and to evaluate the effectiveness of PA and vitamin D supplementation in enhancing muscle mass and strength in community-dwelling older adults with osteopenia/osteoporosis.
Methods One hundred and forty-five individuals aged 65 years and above with documented osteopenia/osteoporosis were scanned for sarcopenia (defined as a relative skeletal muscle index (appendicular skeletal muscle mass divided by height) below 5.45 kg/m2). The participants were randomly assigned to one of four groups: Group 1-PA and vitamin D (n=38), Group 2-PA (n=36), Group 3-vitamin D (n=36) or Group 4-healthy lifestyle (n=35) for 16 weeks. The PA group received a 60-minute 3-day/week exercise programme, the vitamin D group received oral cholecalciferol 2000 IU/day and the control group was provided with health education using videotaped presentations, physician talks on topics concerning bone and muscle health. Body composition was measured by dual energy X-ray absorptiometry (DEXA). Exclusion criteria included patients with severe cognitive impairment and major organ disease. Vitamin D levels were measured by Liaison immunoassay. PA was measured using the Baecke Physical Activity Questionnaire. Physical performance was assessed using upper limb grip strength, walking speed and knee extension strength. All data was collected at baseline and at 4 months.
Results At baseline the prevalence of sarcopenia in patients with osteopenia/osteoporosis was 54% and the mean vitamin D level was 22.4ng/ml. Vitamin D levels increased in Groups 1 and 3. In comparing pre- and postintervention changes in body composition and physical performance there was a significant group x time interaction in appendicular muscle mass (p=0.006), grip strength (p=0.007), walking speed (p=0.015) and knee extension strength (p=0.051). The within group analysis showed Group 1 to have significant improvement in appendicular muscle mass, grip strength, walking speed and knee extension strength compared to the other groups that was more than three times as great as in Group 4. Group 2 showed significant improvement in appendicular muscle mass and walking speed but no change in knee extension strength was seen. In Group 3, there was an improvement in walking speed only.
Conclusions The results of the current study demonstrated that muscle mass and strength improved with the combination of PA and vitamin D supplementation. The findings show that muscle mass and walking speed increased significantly in the PA group, suggesting that exercise is effective in preventing sarcopenia in older adults with osteopenia/osteoporosis. Sarcopenia screening simultaneous to BMD examinations is thus warranted to identify this vulnerable group who are most in need of PA interventions to increase muscle mass and BMD and maintain active ageing.
Disclosure of Interest None Declared
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