Phase Angle and Impedance Ratio As Indicators of Physical Function and Fear of Falling in Older Adult Women: Cross-Sectional Analysis

Overview

Journal JMIR Aging

Specialty Geriatrics

Date 2024 Mar 15

PMID 38488531

Authors

Danielle A Sterner

Jeffrey R Stout

Kworweinski Lafontant

Joon-Hyuk Park

David H Fukuda

Ladda Thiamwong

Affiliations

Soon will be listed here.

Abstract

Background: Older adults experience a significant decline in muscle integrity and function with aging. Early detection of decreased muscle quality can pave the way for interventions to mitigate the progression of age-related physical declines. Phase angle (PhA) and impedance ratio (IR) are measures of muscle integrity, which can be assessed quickly via bioelectrical impedance analysis (BIA) and may be indicative of physical function.

Objective: This study aimed to characterize the relationships among handgrip strength (HGS), sit-to-stand (STS), BTrackS balance scores, fear of falling (evaluated using the Short Falls Efficacy Scale-International [Short FES-I]), and IR among community-dwelling older adult women classified as having a low or high PhA.

Methods: A cross-sectional analysis was conducted with 85 older women (mean age 75.0, SD 7.2 years; mean weight 71.0, SD 15.0 kg; mean height 162.6, SD 6.1 cm). To examine the influence of PhA on performance measures, participants were divided into 2 PhA groups: high (>4.1°; n=56) and low (≤4.1°; n=29). Data were nonnormative; hence, the Mann-Whitney U test was used to evaluate between-group differences, and Kendall τ coefficients were used to determine the partial correlations.

Results: The low PhA group had a significantly higher IR (mean 0.85, SD 0.03) than the high PhA group (mean 0.81, SD 0.03; r=.92; P<.001). The high PhA group had superior HGS (mean 21.4, SD 6.2 kg; P=.007; r=0.36), BTrackS balance scores (mean 26.6, SD 9.5 cm; P=.03; r=0.30), and STS scores (mean 16.0, SD 5.5; P<.001; r=0.49) than the low PhA group (mean HGS 17.6, SD 4.7 kg; mean BTrackS balance score 37.1, SD 21.1 cm; mean STS score 10.7, SD 6.2). Both PhA and IR were significantly correlated with HGS and BTrackS balance, STS, and Short FES-I scores (P<.05). However, on adjusting for the whole sample's age, only PhA was strongly correlated with HGS (τb=0.75; P=.003) and STS scores (τb=0.76; P=.002). Short FES-I scores were moderately correlated with IR (τb=0.46; P=.07) after controlling for age. No significant between-group differences were observed for height, weight, or BMI.

Conclusions: PhA and IR are associated with physical function and the fear of falling in older women. However, only PhA was significantly associated with physical function (HGS and STS) independent of age. Conversely, only IR was significantly associated with the fear of falling. Diminished physical function and increased IR appear to be characteristics of older women with a PhA of ≤4.1°. These findings suggest that PhA and IR measured through BIA together may serve as a valuable tool for early identification of older women at the risk of functional decline and a heightened fear of falling.

Citing Articles

Whole-Body and Segmental Phase Angles and Cognitive Function in the Older Korean Population: Cross-Sectional Analysis.

Chen J, Park J, Lin C, Lai T, Kim D, Shin M JMIR Public Health Surveill. 2024; 10:e63457.

PMID: 39692345 PMC: 11683505. DOI: 10.2196/63457.

Comparing Device-Generated and Calculated Bioimpedance Variables in Community-Dwelling Older Adults.

Lafontant K, Sterner D, Fukuda D, Stout J, Park J, Thiamwong L Sensors (Basel). 2024; 24(17).

PMID: 39275537 PMC: 11397826. DOI: 10.3390/s24175626.

References

Buckinx F, Reginster J, Dardenne N, Croisiser J, Kaux J, Beaudart C . Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry: a cross-sectional study. BMC Musculoskelet Disord. 2015; 16:60. PMC: 4369090. DOI: 10.1186/s12891-015-0510-9. View

Unterberger S, Aschauer R, Zohrer P, Draxler A, Aschauer M, Kager B . Association of Bioelectrical Impedance Phase Angle with Physical Performance and Nutrient Intake of Older Adults. Nutrients. 2023; 15(6). PMC: 10057147. DOI: 10.3390/nu15061458. View

Bellido D, Garcia-Garcia C, Talluri A, Lukaski H, Garcia-Almeida J . Future lines of research on phase angle: Strengths and limitations. Rev Endocr Metab Disord. 2023; 24(3):563-583. PMC: 10090740. DOI: 10.1007/s11154-023-09803-7. View

Oliveira R, Leao C, Silva A, Clemente F, Santamarinha C, Nobari H . Comparisons between Bioelectrical Impedance Variables, Functional Tests and Blood Markers Based on BMI in Older Women and Their Association with Phase Angle. Int J Environ Res Public Health. 2022; 19(11). PMC: 9180009. DOI: 10.3390/ijerph19116851. View

Cawthon P, Blackwell T, Cauley J, Kado D, Barrett-Connor E, Lee C . Evaluation of the Usefulness of Consensus Definitions of Sarcopenia in Older Men: Results from the Observational Osteoporotic Fractures in Men Cohort Study. J Am Geriatr Soc. 2015; 63(11):2247-59. PMC: 4739621. DOI: 10.1111/jgs.13788. View

Hubscher M, Vogt L, Schmidt K, Fink M, Banzer W . Perceived pain, fear of falling and physical function in women with osteoporosis. Gait Posture. 2010; 32(3):383-5. DOI: 10.1016/j.gaitpost.2010.06.018. View

Iwasaka C, Yamada Y, Nishida Y, Hara M, Yasukata J, Miyoshi N . Association of appendicular extracellular-to-intracellular water ratio with age, muscle strength, and physical activity in 8,018 community-dwelling middle-aged and older adults. Arch Gerontol Geriatr. 2023; 108:104931. DOI: 10.1016/j.archger.2023.104931. View

Garlini L, Alves F, Ceretta L, Perry I, Souza G, Clausell N . Phase angle and mortality: a systematic review. Eur J Clin Nutr. 2018; 73(4):495-508. DOI: 10.1038/s41430-018-0159-1. View

Brouwer B, Musselman K, Culham E . Physical function and health status among seniors with and without a fear of falling. Gerontology. 2004; 50(3):135-41. DOI: 10.1159/000076771. View

10.

Germano M, Gomes C, Guerra Azevedo I, Fernandes J, de Medeiros Freitas R, Guerra R . Relationship between phase angle and physical performance measures in community-dwelling older adults. Exp Gerontol. 2021; 152:111466. DOI: 10.1016/j.exger.2021.111466. View

11.

Ballarin G, Scalfi L, Monfrecola F, Alicante P, Bianco A, Marra M . Body Composition and Bioelectrical-Impedance-Analysis-Derived Raw Variables in Pole Dancers. Int J Environ Res Public Health. 2021; 18(23). PMC: 8656643. DOI: 10.3390/ijerph182312638. View

12.

Goble D, Baweja H . Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test. Geriatr Gerontol Int. 2018; 18(8):1225-1229. DOI: 10.1111/ggi.13452. View

13.

Sardinha L . Physiology of exercise and phase angle: another look at BIA. Eur J Clin Nutr. 2018; 72(9):1323-1327. DOI: 10.1038/s41430-018-0215-x. View

14.

Campa F, Colognesi L, Moro T, Paoli A, Casolo A, Santos L . Effect of resistance training on bioelectrical phase angle in older adults: a systematic review with Meta-analysis of randomized controlled trials. Rev Endocr Metab Disord. 2022; 24(3):439-449. PMC: 10140106. DOI: 10.1007/s11154-022-09747-4. View

15.

Kawakami W, Umehara T, Iwamoto Y, Takahashi M, Katayama N . Phase Angle Is Associated With Handgrip Strength in Older Patients With Heart Failure. Ann Rehabil Med. 2023; 47(2):129-137. PMC: 10164521. DOI: 10.5535/arm.22138. View

16.

Asano Y, Tsuji T, Kim M, Nagata K, Shibuya K, Tateoka K . Cross-sectional and longitudinal study of the relationship between phase angle and physical function in older adults. Geriatr Gerontol Int. 2023; 23(2):141-147. DOI: 10.1111/ggi.14532. View

17.

Dugan S, Pettee Gabriel K, Lange-Maia B, Karvonen-Gutierrez C . Physical Activity and Physical Function: Moving and Aging. Obstet Gynecol Clin North Am. 2018; 45(4):723-736. PMC: 6226270. DOI: 10.1016/j.ogc.2018.07.009. View

18.

Norman K, Wirth R, Neubauer M, Eckardt R, Stobaus N . The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc. 2014; 16(2):173.e17-22. DOI: 10.1016/j.jamda.2014.10.024. View

19.

Campbell A, Buchner D . Unstable disability and the fluctuations of frailty. Age Ageing. 1997; 26(4):315-8. DOI: 10.1093/ageing/26.4.315. View

20.

Cadore E, Pinto R, Bottaro M, Izquierdo M . Strength and endurance training prescription in healthy and frail elderly. Aging Dis. 2014; 5(3):183-95. PMC: 4037310. DOI: 10.14336/AD.2014.0500183. View