Risks of Muscle Atrophy in Patients with Malignant Lymphoma after Autologous Stem Cell Transplantation

Objective: Muscle atrophy is associated with autologous stem cell transplantation (ASCT)-related outcomes in patients with malignant lymphoma (ML). However, the impact of ASCT on muscle mass remains unclear in patients with ML. The aims of this study were to investigate changes in muscle mass and risk profiles for muscle atrophy after ASCT. Method: We enrolled 40 patients with refractory ML (age 58 [20-74] years, female/male 16/24, body mass index (BMI) 21.1 kg/m² [17.1-29.6]). Psoas muscle mass was assessed using the psoas muscle index (PMI) before and after ASCT. Statistical analysis used: Independent factors associated with a severe decrease rate of change in PMI were evaluated by decision-tree analysis, respectively. Results: PMI was significantly decreased after ASCT (4.61 vs. 4.55 cm²/m²; P=0.0425). According to the decision-tree analysis, the regimen was selected as the initial split. The rates of change in PMI were −5.57% and −3.97% for patients administered MCEC and LEED, respectively. In patients who were administered LEED, the second branching factor was BMI. In patients with BMI < 20.3 kg/m², the rate of change in PMI was −7.16%. On the other hand, the rate of change in PMI was 4.05% for patients with BMI ≥ 20.3 kg/m². Conclusion: We demonstrated that muscle mass decreased after ASCT in patients with ML. Patients who received MCEC and patients with low BMI were at risk for a decrease in muscle mass.     

Association Between Social Network and Physical Function in Community-Dwelling Older Adults in Japan

Objective: A poor social network and the decline of physical function are known to be critical risk factors for functional decline in older adults. The aim of this study was to investigate the relationships between social network and physical function in Japanese community-dwelling older adults. Methods: Participants were 339 adults aged 65 years or older (mean age : 73.0 years, women :70.2%), living independently in their communities. A self-reported questionnaire was used to assess social network on two different scales―the 6-item Lubben Social Network Scale (6LSNS) and frequency of contact with other people. Handgrip strength, knee extension strength, gait speed, Timed Up and Go Test (TUG) results, and 5-repetition chair stand test (CST) scores were used to determine physical function. A multiple regression analysis that adjusted for confounding factors was used to analyze the relationship between the social network scales and each physical function test. Results: According to the results of a multiple regression analysis, a high 6LSNS score was significantly associated with greater handgrip strength (B = 0.63, p = 0.03), faster CST (B = −0.23, p = 0.01), and faster TUG (B = −0.12, p = 0.03), and high frequency of contact was significantly associated with greater handgrip strength (B = 1.08, p = 0.01). Conclusions: Social network was associated with muscle strength and physical performance. Consequently, older adults with poor social networks require an assessment of physical function, since their physical functions have possibly deteriorated.     

Maximum Phonation Time is a Useful Assessment for Older Adults Requiring Long-term Care/support

Objective: The maximum phonation time (MPT) is used to assess simple respiratory functions and can be performed anywhere without special instruments. We investigated the association between MPT and respiration, considering the future utilization of simple respiratory assessments during home-based physical therapy. Method: This cross-sectional study included 140 older adults enrolled in Japanese long-term care insurance (77 men, 63 women; mean age, 77.9±8.0 years). The participants performed the MPT, followed by spirometry. We analyzed the MPT of the three age groups, relative reliability of the MPT values, and the association between MPT and respiratory function. Results: We found that the MPT of older men requiring long-term care or support was related to age. The intraclass correlation coefficient of MPT was >0.8 for all groups. Only forced vital capacity was associated with MPT in the partial correlation and multiple regression analyses. Conclusion: MPT could be an alternative assessment of respiratory function in home-based physical therapy for older adults requiring long-term care or support.