Muscle Ageing in Older Adults with and without Heart Failure

Jalali Farahani, Sima (2026) Muscle Ageing in Older Adults with and without Heart Failure. Doctoral thesis, Liverpool Hope University.

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Abstract

Background: Ageing changes the whole-body mechanism, particularly skeletal muscle, which undergoes the most problematic alteration. The prevalence of multiple chronic conditions, particularly heart failure (HF), rises significantly with age, and a more rapid progression of muscle ageing is prevalent among older adults with HF (OAHF) compared to healthy older adults (HOA). As such, the aim of this study was to characterise skeletal muscle ageing biomarkers, including muscle mass, neuromuscular function (neuromuscular fatigue (NMF) and muscle activation), oxidative function (vascular endothelial function and mitochondrial oxidative capacity (MOC), muscle strength and physical performance (PP) in HOA and OAHF.

Methodology: A cross-sectional study with no patient follow-up was conducted. A total of 29 HOA (age: 68.1 ± 10.6 years [mean ± SD], BMI: 25 ± 3.01) and 25 OAHF (age: 68.8 ± 10.6 years, BMI: 30 ± 6.72) were recruited for the study. Muscle ageing biomarkers were assessed using distinct, validated experimental techniques including dual energy X-ray absorptiometry (DXA) scan, surface electromyography (sEMG)and near-infrared spectroscopy (NIRS), as well as Jamar handgrip dynamometer and Hand-held dynamometry. Moreover, correlation analysis was conducted to determine the relationship between the variables. In addition, overall musculoskeletal function was analysed through cluster analysis of three factors: adiposity component, strength, and PP using two distinct cluster configurations.

Result: The findings indicated a significant difference in muscle mass (p=0.003), muscle activation level in the extensor carpi radialis (ECR) muscle (p=0.012), and vascular endothelial function (p=0.004) in OAHF compared to the HOA. However, there was no significant difference between the groups in dominant (D) and non-dominant (ND) handgrip strength (HGS) (p= 0.347, p= 0.877), D and ND knee extension strength (KES) (p= 0.252, p= 0.524), NMF in ECR (p= 0.757) and flexor carpi radialis (FCR) (p= 0.294), as well as MOC (p= 0.554). Total lean mass was positively correlated with fat mass in OAHF, but it was not significant in HOA. A strong positive correlation was found between muscle mass and muscle strength in both groups. The PP tests showed weak or no association with muscle mass but were correlated with muscle strength and MQ, with stronger relationships observed in the OAHF. Moreover, no significant difference in musculoskeletal function between OAHF and HOA was found in Cluster 1 (C1) (P = 0.055). However, in Cluster 2 (C2), OAHF exhibited significantly greater musculoskeletal function than HOA (p = 0.008) when cluster scores were compared by ANCOVA, using age as a covariate.

Conclusion: This study evaluated key muscle ageing biomarkers in older adults with and without HF. The findings revealed that OAHF exhibited a distinct progression of muscle ageing, characterised by diminished muscle activation and reduced vascular and endothelial function compared to HOA. These results may inform a more precise and effective research approach for understanding the underlying mechanisms involved in muscle ageing. Future studies should investigate these pathways further to deepen insights into the progression of muscle ageing, particularly in OAHF.

Item Type:	Thesis (Doctoral)
Additional Information and Comments:	Copyright © The Author 2026. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
Faculty / Department:	Faculty of Human and Digital Sciences > School of Health and Sport Sciences
SWORD Depositor:	RISE Symplectic
Depositing User:	RISE Symplectic
Date Deposited:	18 Sep 2026 10:39
Last Modified:	18 Sep 2026 10:39
URI:	https://hira.hope.ac.uk/id/eprint/4985

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