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Calcif Tissue Int. 2018 Jul 23. doi: 10.1007/s00223-018-0458-5. [Epub ahead of print]

Aortic Calcification is Associated with Five-Year Decline in Handgrip Strength in Older Women.

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Bone and Muscle Health Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
Bone and Muscle Health Research Group, Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, 3146, Australia.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Sir Charles Gairdner Hospital Unit, Medical School, University of Western Australia, Nedlands, WA, Australia.
Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
Bone and Muscle Health Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
Australian Institute for Musculoskeletal Science, Melbourne Medical School-Western Campus, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
Institute for Aging Research, Hebrew Senior Life, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Park Nicollet Clinic and HealthPartners Institute, HealthPartners Inc., Minneapolis, MN, USA.
Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia.


The objective of the study was to determine the association between AAC and neuromuscular function over 5 years. Participants in this study were ambulant women over 70 years old residing in Perth, Western Australia who participated in the Calcium Intake Fracture Outcomes Study, a randomised controlled trial of calcium supplementation. 1046 women (mean age = 74.9 ± 2.6 years; BMI = 27.1 ± 4.4 kg/m2) were included. Lateral spine images captured during bone density testing were scored for AAC (AAC24; 0-24) at baseline. Severe AAC (AACsev) was defined using established cut points (AAC24 ≥ 6). At baseline and follow-up, isometric grip strength was assessed using a dynamometer. Mobility was assessed by the Timed-Up-and-Go (TUG) test. Using pre-defined criteria, muscle weakness was considered as grip strength < 22 kg and poor mobility defined as TUG > 10.2 s. A subset of women had appendicular lean mass (ALM) determined by dual-energy X-ray absorptiometry at baseline and follow-up (n = 261). AACsev was evident in 193 (18.5%) women. Average decline in grip strength after 5 years was greater in those with AACsev than those without (3.6 ± 3.7 vs. 2.9 ± 4.2 kg; p = 0.034). This remained significant after adjustment for age, treatment allocation, diabetes, smoking history, renal function, medical record-derived prevalent vascular disease, BMI and physical activity (β = - 0.184; 95% confidence interval: - 0.361, - 0.008; p = 0.040). AACsev was not associated with 5-year changes in TUG or ALM in univariable or multivariable analyses (all p > 0.05). In older women, severe aortic calcification was associated with greater 5-year decline in muscle strength, but not TUG or ALM. These findings support the concept that vascular disease may have an effect on the loss of muscular strength.


Aortic calcification; Grip strength; Mobility; Older women; Physical function


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