Low Muscle Strength, Low Bone Mineral Density, and High Body Mass Index Among Adult Special Olympics Athletes: A Cross-Sectional Examination

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Morgan CleveringaDepartment of Kinesiology, Iowa State University, Ames, IA, USA

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E. Andrew PitchfordDepartment of Kinesiology, Iowa State University, Ames, IA, USA

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Adults with intellectual disabilities have increasing life expectancy but may be susceptible to early aging-related conditions. The purpose of this study was to examine associations between the presence of low muscle strength, low bone mineral density, and high body mass index with age and sex in adult Special Olympics athletes. Grip strength (n = 6,477; 40.9% female), chair stand time (n = 6,444; 40.5% female), body mass index (n = 7,824; 43.7% female), and bone mineral density (n = 3,091; 43.2% female) measurements were provided by Special Olympics International. Poor grip strength, chair stand time, bone mineral density, and body mass index were identified in 43.8%, 46.2%, 28.7%, and 50.3% of each sample, respectively. Increasing age was a risk factor for all conditions (odds ratio = 1.30–10.89; p < .05). High rates of adverse health conditions were observed in a sample of adults with intellectual disabilities. Increased risk was observed as early as the fourth decade of life.

Pitchford (eapitch@iastate.edu) is corresponding author, https://orcid.org/0000-0002-8945-8194

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  • Atlihan, R., Kirk, B., & Duque, G. (2021). Non-pharmacological interventions in osteosarcopenia: A systematic review. The Journal of Nutrition, Health & Aging, 25(1), 2532. https://doi.org/10.1007/s12603-020-1537-7

    • Search Google Scholar
    • Export Citation
  • Balogun, S., Winzenberg, T., Wills, K., Scott, D., Callisaya, M., Cicuttini, F., Jones, G., & Aitken, D. (2019). Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Archives of Gerontology and Geriatrics, 82, 6773. https://doi.org/10.1016/j.archger.2019.01.015

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bastiaanse, L., Mergler, S., Evenhuis, H., & Echteld, M. (2014). Bone quality in older adults with intellectual disabilities. Research in Developmental Disabilities, 35(9), 19271933. https://doi.org/10.1016/j.ridd.2014.04.018

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bastiaanse, L.P., Hilgenkamp, T.I., Echteld, M.A., & Evenhuis, H.M. (2012). Prevalence and associated factors of sarcopenia in older adults with intellectual disabilities. Research in Developmental Disabilities, 33(6), 20042012. https://doi.org/10.1016/j.ridd.2012.06.002

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Burke, É., Carroll, R., O’Dwyer, M., Walsh, J., McCallion, P., & McCarron, M. (2019). Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: A cross-sectional nationwide study. BMJ Open, 9(4), Article e026939. https://doi.org/10.1136/bmjopen-2018-026939

    • Search Google Scholar
    • Export Citation
  • Carfì, A., Liperoti, R., Fusco, D., Giovannini, S., Brandi, V., Vetrano, D., Meloni, E., Mascia, D., Villani, E., Manes Gravina, E., Bernabei, R., & Onder, G. (2017). Bone mineral density in adults with Down syndrome. Osteoporosis International, 28(10), 29292934. https://doi.org/10.1007/s00198-017-4133-x

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Carmeli, E., Imam, B., & Merrick, J. (2012). The relationship of pre-sarcopenia (low muscle mass) and sarcopenia (loss of muscle strength) with functional decline in individuals with intellectual disability (ID). Archives of Gerontology and Geriatrics, 55(1), 181185. https://doi.org/10.1016/j.archger.2011.06.032

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cawthon, P.M., Manini, T., Patel, S.M., Newman, A., Travison, T., Kiel, D.P., Santanasto, A.J., Ensrud, K.E., Xue, Q.-L., Shardell, M., Duchowny, K., Erlandson, K.M., Pencina, K.M., Fielding, R.A., Magaziner, J., Kwok, T., Karlsson, M., Ohlsson, C., Mellström, D., … Bhasin, S. (2020). Putative cut-points in sarcopenia components and incident adverse health outcomes: An SDOC analysis. Journal of the American Geriatrics Society, 68(7), 14291437. https://doi.org/10.1111/jgs.16517

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Chalhoub, D., Cawthon, P.M., Ensrud, K.E., Stefanick, M.L., Kado, D.M., Boudreau, R., Greenspan, S., Newman, A.B., Zmuda, J., Orwoll, E.S., Cauley, J.A., & The Osteoporotic Fractures in Men Study Research Group. (2015). Risk of nonspine fractures in older adults with sarcopenia, low bone mass, or both. Journal of the American Geriatrics Society, 63(9), 17331740. https://doi.org/10.1111/jgs.13605

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Chen, L.-K., Woo, J., Assantachai, P., Auyeung, T.-W., Chou, M.-Y., Iijima, K., Jang, H. C., Kang, L., Kim, M., Kim, S., Kojima, T., Kuzuya, M., Lee, J.S.W., Lee, S.Y., Lee, W.-J., Lee, Y., Liang, C.-K., Lim, J.-Y., Lim, W.S., … Arai, H. (2020). Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. Journal of the American Medical Directors Association, 21(3), 300307. https://doi.org/10.1016/j.jamda.2019.12.012

    • Search Google Scholar
    • Export Citation
  • Coelho-Junior, H.J., Villani, E.R., Calvani, R., Carfì, A., Picca, A., Landi, F., Bernabei, R., Onder, G., & Marzetti, E. (2019). Sarcopenia-related parameters in adults with Down syndrome: A cross-sectional exploratory study. Experimental Gerontology, 119, 9399. https://doi.org/10.1016/j.exger.2019.01.028

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Coppus, A.M. (2013). People with intellectual disability: What do we know about adulthood and life expectancy? Developmental Disabilities Research Reviews, 18(1), 616. https://doi.org/10.1002/ddrr.1123

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cruz-Jentoft, A., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A., Schneider, S., Sieber, C., Topinkova, E., Vandewoude, M., Visser, M., & Zamboni, M. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 1631. https://doi.org/10.1093/ageing/afy169

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cuesta-Vargas, A., & Hilgenkamp, T. (2015). Reference values of grip strength measured with a Jamar dynamometer in 1526 adults with intellectual disabilities and compared to adults without intellectual disability. PLoS One, 10(6), Article e0129585. https://doi.org/10.1371/journal.pone.0129585

    • PubMed
    • Search Google Scholar
    • Export Citation
  • de Winter, C., Bastiaanse, L., Hilgenkamp, T., Evenhuis, H., & Echteld, M. (2012a). Cardiovascular risk factors (diabetes, hypertension, hypercholesterolemia and metabolic syndrome) in older people with intellectual disability: Results of the HA-ID study. Research in Developmental Disabilities, 33(6), 17221731. https://doi.org/10.1016/j.ridd.2012.04.010

    • PubMed
    • Search Google Scholar
    • Export Citation
  • de Winter, C., Bastiaanse, L., Hilgenkamp, T., Evenhuis, H., & Echteld, M. (2012b). Overweight and obesity in older people with intellectual disability. Research in Developmental Disabilities, 33(2), 398405. https://doi.org/10.1016/j.ridd.2011.09.022

    • PubMed
    • Search Google Scholar
    • Export Citation
  • de Winter, C., Echteld, M., & Evenhuis, H. (2014). Chronic kidney disease in older people with intellectual disability: Results of the HA-ID study. Research in Developmental Disabilities, 35(3), 726732. https://doi.org/10.1016/j.ridd.2013.11.005

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Evenhuis, H., Hermans, H., Hilgenkamp, T., Bastiaanse, L., & Echteld, M. (2012). Frailty and disability in older adults with intellectual disabilities: Results from the healthy ageing and intellectual disability study. Journal of the American Geriatrics Society, 60(5), 934938. https://doi.org/10.1111/j.1532-5415.2012.03925.x

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Foley, J., Lloyd, M., & Temple, V. (2013). Body mass index trends among adult U.S. Special Olympians, 2005-2010. Adapted Physical Activity Quarterly, 30(4), 373386. https://doi.org/10.1123/apaq.30.4.373

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Foley, J.T., Lloyd, M., Turner, L., & Temple, V.A. (2017). Body mass index and waist circumference of Latin American adult athletes with intellectual disability. Salud Pública de México, 59(4), 416422. https://doi.org/10.21149/8204

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Fried, L., Tangen, C., Walston, J., Newman, A., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W., Burke, G., & McBurnie, M. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology, 56(3), 146156. https://doi.org/10.1093/gerona/56.3.m146

    • Search Google Scholar
    • Export Citation
  • Gomez-Hixson, K., Batista, N., & Brown, M. (2021). Retrospective analysis of the Special Olympics Health Promotion database for nutrition-specific variables. Heliyon, 7(12), Article e08586. https://doi.org/10.1016/j.heliyon.2021.e08586

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hermans, H., & Evenhuis, H. (2014). Multimorbidity in older adults with intellectual disabilities. Research in Developmental Disabilities, 35(4), 776783. https://doi.org/10.1016/j.ridd.2014.01.022

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hilgenkamp, T.I.M., van Wijck, R., & Evenhuis, H.M. (2012a). Feasibility and reliability of physical fitness tests in older adults with intellectual disability: A pilot study. Journal of Intellectual and Developmental Disability, 37(2), 158162. https://doi.org/10.3109/13668250.2012.681773

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hilgenkamp, T.I.M., van Wijck, R., & Evenhuis, H.M. (2012b). Low physical fitness levels in older adults with ID: Results of the HA-ID study. Research in Developmental Disabilities, 33(4), 10481058. https://doi.org/10.1016/j.ridd.2012.01.013

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hologic. (1998). Sahara clinical bone sonometer: User’s guide. https://media.specialolympics.org/resources/health/disciplines/health-promotion/manual/Health-Promotion-Sahara-Manual.pdf?_ga=2.256853839.570630415.1613241944-1534604342.1526045275

    • Search Google Scholar
    • Export Citation
  • Kanis, J. (1994). Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report. Osteoporosis International, 4(6), 368381. https://doi.org/10.1007/BF01622200

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Lauretani, F., Russo, C., Bandinelli, S., Bartali, B., Cavazzini, C., Di Iorio, A., Corsi, A., Rantanen, T., Guralnik, J., & Ferrucci, L. (2003). Age-associated changes in skeletal muscles and their effect on mobility: An operational diagnosis of sarcopenia. Journal of Applied Physiology, 95(5), 18511860. https://doi.org/10.1152/japplphysiol.00246.2003

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Li, H., Frey, G.C., McCormick, B.P., & Johnston, J.D. (2015). Comparison of obesity among Chinese and U.S. Special Olympic athletes with intellectual disabilities. Research in Developmental Disabilities, 41–42, 94100. https://doi.org/10.1016/j.ridd.2015.05.005

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Lloyd, M., Foley, J., & Temple, V. (2018). Maximizing the use of Special Olympics International’s Healthy Athletes database: A call to action. Research in Developmental Disabilities, 73, 5866. https://doi.org/10.1016/j.ridd.2017.12.009

    • Search Google Scholar
    • Export Citation
  • Martone, A., Marzetti, E., Salini, S., Zazzara, M., Santoro, L., Tosato, M., Picca, A., Calvani, R., & Landi, F. (2020). Sarcopenia identified according to the EWGSOP2 definition in community-living people: Prevalence and clinical features. Journal of the American Medical Directors Association, 21(10), 14701474. https://doi.org/10.1016/j.jamda.2020.03.007

    • Search Google Scholar
    • Export Citation
  • Mathiowetz, V. (2002). Comparison of Rolyan and Jamar dynamometers for measuring grip strength. Occupational Therapy International, 9(3), 201209. https://doi.org/10.1002/oti.165

    • PubMed
    • Search Google Scholar
    • Export Citation
  • National Center for Health Statistics. (2014). NHANES 2011-2012: Muscle strength—Grip test data documentation, codebook, and frequencies. https://wwwn.cdc.gov/nchs/nhanes/2011-2012/MGX_G.htm

    • Search Google Scholar
    • Export Citation
  • Ng, N., Flygare Wallén, E., & Ahlström, G. (2017). Mortality patterns and risk among older men and women with intellectual disability: A Swedish national retrospective cohort study. BMC Geriatrics, 17(1), 269. https://doi.org/10.1186/s12877-017-0665-3

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O’Leary, L., Cooper, S.-A., & Hughes-McCormack, L. (2018). Early death and causes of death of people with intellectual disabilities: A systematic review. Journal of Applied Research in Intellectual Disabilities, 31(3), 325342. https://doi.org/10.1111/jar.12417

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Perna, F., Coa, K., Troiano, R., Lawman, H., Wang, C., Li, Y., Moser, R., Ciccolo, J., Comstock, B., & Kraemer, W. (2016). Muscular grip strength estimates of the U.S. population from the National Health and Nutrition Examination Survey 2011–2012. Journal of Strength and Conditioning Research, 30(3), 867874. https://doi.org/10.1519/JSC.0000000000001104

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Petrone, L. (2012). Osteoporosis in adults with intellectual disabilities. Southern Medical Journal, 105(2), 8792. https://doi.org/10.1097/SMJ.0b013e3182427042

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Ptomey, L., & Wittenbrook, W. (2015). Position of the Academy of Nutrition and Dietetics: Nutrition services for individuals with intellectual and developmental disabilities and special health care needs. Journal of the Academy of Nutrition and Dietetics, 115(4), 593608. https://doi.org/10.1016/j.jand.2015.02.002

    • Search Google Scholar
    • Export Citation
  • Ranjan, S., Nasser, J., & Fisher, K. (2018). Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders. Journal of Applied Research in Intellectual Disabilities, 31, 2938. https://doi.org/10.1111/jar.12370

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Rintala, P., Temple, V., Lloyd, M., Faro, C., & Foley, J. (2017). Association of poverty and social exclusion with body mass index among Special Olympics athletes in Europe. International Journal of Public Health, 62(8), 921928. https://doi.org/10.1007/s00038-017-0982-5

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Santarossa, S., Temple, V.A., Rintala, P., Lloyd, M., DeMarco, B., & Foley, J.T. (2017). Muscular strength of adult Special Olympians by country economic status. European Journal of Adapted Physical Activity, 10, 1016. https://doi.org/10.5507/euj.2017.002

    • Search Google Scholar
    • Export Citation
  • Scott, D. (2019). Osteosarcopenic obesity. In G. Duque (Ed.), Osteosarcopenia: Bone, muscle and fat interactions (pp. 323343). Springer International Publishing. https://doi.org/10.1007/978-3-030-25890-0_14

    • Search Google Scholar
    • Export Citation
  • Special Olympics International. (2018). Healthy Athletes 2018 prevalence report. https://media.specialolympics.org/resources/research/health/2018-Healthy-Athletes-Prevalence-Report.pdf?_ga=2.89841563.181791511.1594759949-587696064.1590501871

    • Search Google Scholar
    • Export Citation
  • Special Olympics International. (2020a). FUNFitness: Learn how to organize, promote, and present. https://media.specialolympics.org/resources/health/disciplines/funfitness/FUNfitness-Training-Manual-September-2020.pdf

    • Search Google Scholar
    • Export Citation
  • Special Olympics International. (2020b). Health Promotion clinical director manual. https://media.specialolympics.org/resources/health/disciplines/health-promotion/manual/Health-Promotion-Clinical-Director-Manual-Sept-2020-2.pdf?_ga=2.180184672.570630415.1613241944-1534604342.1526045275

    • Search Google Scholar
    • Export Citation
  • Tang, J., Luo, H., Wong, G., Lau, M., Joe, G., Tse, M., Ip, P., Wong, I., & Lum, T. (2019). Bone mineral density from early to middle adulthood in persons with Down syndrome. Journal of Intellectual Disability Research, 63(8), 936946. https://doi.org/10.1111/jir.12608

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Temple, V., Foley, J., & Lloyd, M. (2014). Body mass index of adults with intellectual disability participating in Special Olympics by world region. Journal of Intellectual Disability Research, 58(3), 277284. https://doi.org/10.1111/jir.12011

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Temple, V.A., Rintala, P., Zeitz, S., Lloyd, M., & Foley, J.T. (2022). Age and sex-based differences in functional strength of adults participating in Special Olympics. European Journal of Adapted Physical Activity, 15(5), 1. https://doi.org/10.5507/euj.2021.009

    • Search Google Scholar
    • Export Citation
  • Teng, Z., Zhu, Y., Teng, Y., Long, Q., Hao, Q., Yu, X., Yang, L., Lv, Y., Liu, J., Zeng, Y., & Lu, S. (2021). The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls. Osteoporosis International, 32(11), 21732183. https://doi.org/10.1007/s00198-021-05963-x

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tyrer, F., Dunkley, A.J., Singh, J., Kristunas, C., Khunti, K., Bhaumik, S., Davies, M.J., Yates, T.E., & Gray, L.J. (2019). Multimorbidity and lifestyle factors among adults with intellectual disabilities: A cross-sectional analysis of a UK cohort. Journal of Intellectual Disability Research, 63(3), 255265. https://doi.org/10.1111/jir.12571

    • PubMed
    • Search Google Scholar
    • Export Citation
  • van Biesen, D., & Pineda, R. (2019). Balance and strength assessment of Special Olympics athletes: How feasible and reliable is the Fun Fitness test battery? European Journal of Adapted Physical Activity, 12(1), 6. https://doi.org/10.5507/euj.2019.004

    • Search Google Scholar
    • Export Citation
  • Weaver, C., Gordon, C., Janz, K., Kalkwarf, H., Lappe, J., Lewis, R., O’Karma, M., Wallace, T., & Zemel, B. (2016). The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: A systematic review and implementation recommendations. Osteoporosis International, 27(4), 12811386. https://doi.org/10.1007/s00198-015-3440-3

    • PubMed
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (1995). Physical status: The use and interpretation of anthropometry. http://apps.who.int/iris/bitstream/10665/37003/1/WHO_TRS_854.pdf

    • Search Google Scholar
    • Export Citation
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