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Muscle Endurance in Elderly Nursing Home Residents Is Related to Fatigue Perception, Mobility, and Circulating Tumor Necrosis Factor-Alpha, Interleukin-6, and Heat Shock Protein 70

(See editorial comments by Drs. Hermes Florez and Bruce R. Troen, pp 558–560)

Authors

  • Ivan Bautmans PhD,

    1. From the *Department of Gerontology, Brussels, BelgiumFrailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium§Foundation for Psychogeriatrics, Brussels, Belgium
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  • Rose Njemini PhD,

    1. From the *Department of Gerontology, Brussels, BelgiumFrailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium§Foundation for Psychogeriatrics, Brussels, Belgium
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  • Heidi Predom PT,

    1. From the *Department of Gerontology, Brussels, BelgiumFrailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium§Foundation for Psychogeriatrics, Brussels, Belgium
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  • Jean-Claude Lemper MD,

    1. From the *Department of Gerontology, Brussels, BelgiumFrailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium§Foundation for Psychogeriatrics, Brussels, Belgium
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  • Tony Mets PhD

    1. From the *Department of Gerontology, Brussels, BelgiumFrailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium§Foundation for Psychogeriatrics, Brussels, Belgium
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Address correspondence to Tony Mets, PhD, Department of Geriatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. E-mail: tony.mets@uzbrussel.be

Abstract

OBJECTIVES: To explore the relationships between muscle endurance and circulating interleukin (IL)-6, tumor necrosis factor alpha (TNF-α), and heat shock protein (Hsp)70 in nursing home residents and to assess how muscle endurance relates to self-perceived fatigue and mobility.

DESIGN: Exploratory study.

SETTING: Three nursing homes of the Foundation for Psychogeriatrics (Brussels, Belgium).

PARTICIPANTS: Seventy-seven residents (53 female and 24 male, mean age 81 ± 8).

MEASUREMENTS: Participants were assessed for muscle endurance (fatigue resistance and grip work); perceived fatigue (visual analogue scale for fatigue); fatigue during daily activities (Mobility-Tiredness Scale); effect of fatigue on quality of life (World Health Organization Quality Of Life questionnaire); mobility (Tinetti Test & Elderly Mobility Scale (EMS)); and circulating IL-6, TNF-α, and Hsp70.

RESULTS: Residents with better fatigue resistance reported less self-perceived tiredness (P<.05). Similar trends were observed for fatigue during daily activities and for the extent to which fatigue bothered subjects. Higher grip work was associated with less self-perceived fatigue on all fatigue scales (P<.01). Fatigue resistance and grip work were positively related to balance and basic mobility (all P<.01; trend for relationship between fatigue resistance and EMS). Subjects with high IL-6 and Hsp70 showed significantly worse fatigue resistance (P=.007) and muscle work (P=.045) than those with high IL-6 and low Hsp70. In male residents, higher TNF-α was related to worse fatigue resistance and grip work (P<.05).

CONCLUSION: Elderly nursing home residents complaining of fatigue need to be taken seriously, because they show worse muscle endurance, which is related to poorer mobility. Inflammatory processes involving TNF-α and the interaction between IL-6 and Hsp70 are related to poorer muscle endurance in these patients.

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