Hi,

I have strength data in young and older individuals before and after 12 weeks of training. In the young group there are only 5 subjects, in the older group there are 30 subjects.

I wanted to know if older people can increase their strength to the same extend as their young counterparts. You have to bear in mind that young individuals start with higher baseline values (which is normal, because strength is diminished in elderly). That is why I wanted to compare increase rates by looking at the group x time interaction. This can be done with a repeated measures ANOVA, but also with Generalized Estimating Equations or Linear Mixed Models. (I am working in SPSS by the way.)

I am trying to understand why the results are different in terms of significance.

Linear mixed model (group = fixed factor, time = covariate, model: group, time, group x time, random intercept)

>>> GROUP: p < 0.001

>>> Time: p < 0.001

>>> GROUP x TIME: p = 0.096 (difference in slope between young and old 46.4 +/- 27.0 (SE))

GEE (Repeated measures effect = time (unstructured covariance matrix, but it doesn't really matter because we only have pre-post), group = fixed factor, time = covariate, model: group, time, group x time)

>>> GROUP: p < 0.001

>>> TIME: p < 0.001

>>> GROUP X TIME: p = 0.005 (difference in slope between young and old 46.4 +/- 16.6 (SE))

Repeated measures ANOVA (within subject factor = kracht pre-post, between subject factor = group, model = full factorial)

>>> GROUP: p < 0.001

>>> TIME: p < 0.001

>>> GROUP x TIME: p = 0.096 (does not present difference in slopes)

Ultimately I understand that GEE displays a significant GROUP x TIME interaction because of the lower SE. But why is the SE lower? And which result should I follow? I really would like to understand what I am doing.

I was also thinking about doing ANCOVA with baseline value as covariate, but I am more interested in the gain than in the post-value (see this article https://www.theanalysisfactor.com/pre-post-data-repeated-measures/), so I decided not to do the ANCOVA.

And finally: a last question. Some papers report relative strength gains to compare young and old (expressed in percentage change). They report in their statistical analyses part that they are doing a repeated measures ANOVA, but ultimately they report the percentage change in young and old. This does not seem right? When you do the repeated measures ANOVA you are comparing absolute changes and you should not report percentage change. If you want to compare percentage change, you can just do a independent t-test? Or am I wrong? The reason I find this important is because I noticed that old and your gain relatively the same, but in absolute terms young people seem to increase more.

Thanks in advance!

Sara

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