151
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Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas 2016; 93:89-99. [DOI: 10.1016/j.maturitas.2016.04.009] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/05/2016] [Accepted: 04/11/2016] [Indexed: 12/14/2022]
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152
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Morley JE. JAMDA: The State of the Journal. J Am Med Dir Assoc 2016; 17:867-71. [DOI: 10.1016/j.jamda.2016.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 11/25/2022]
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153
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Morley JE. Frailty and sarcopenia in elderly. Wien Klin Wochenschr 2016; 128:439-445. [PMID: 27670855 DOI: 10.1007/s00508-016-1087-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/23/2016] [Indexed: 12/18/2022]
Abstract
Frailty is a pre-disability syndrome where an older person can be identified as being at risk when exposed to stressors associated with high risk for disability or needing to be hospitalized. Two major frailty definitions exist. The physical phenotype of frailty and the multiple deficit model. A simple frailty screening tool-FRAIL-has been validated. Treatment of frailty involves resistance exercise, optimization of nutrition, and treatment of fatigue (sleep apnea, depression), treatable causes of weight loss and adjustment of polypharmacy. Sarcopenia (decline in function with low muscle mass) is a major cause of frailty. A simple sarcopenia screening tool-SARC-F-has been validated. The multiple causes of sarcopenia are reviewed. Optimal treatment is resistance exercise, leucine-enriched essential amino acids and vitamin D replacement.
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Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, 63104, St. Louis, MO, USA.
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154
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155
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De Buyser SL, Petrovic M, Taes YE, Toye KRC, Kaufman JM, Lapauw B, Goemaere S. Validation of the FNIH sarcopenia criteria and SOF frailty index as predictors of long-term mortality in ambulatory older men. Age Ageing 2016; 45:602-8. [PMID: 27126327 DOI: 10.1093/ageing/afw071] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 03/09/2016] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE we aimed to evaluate the Foundation for the National Institutes of Health (FNIH) criteria for weakness and low muscle mass and the Study of Osteoporotic Fractures (SOF) frailty index for prediction of long-term, all-cause mortality. DESIGN community-based cohort study. SETTING semi-rural community of Merelbeke (Belgium). SUBJECTS ambulatory men aged 74 and more (n = 191). METHODS weakness was defined on previously established criteria as low grip strength (<26 kg) or low grip strength-to-body mass index (BMI) ratio (<1.00). Low muscle mass (dual-energy x-ray absorptiometry) was categorised as low appendicular lean mass (ALM; predefined <19.75 kg) or low ALM-to-BMI ratio (predefined <0.789). Frailty status was assessed using the components of weight loss, inability to rise from a chair and poor energy (SOF index). Survival time was calculated as the number of months from assessment in 2000 until death or up to 15 years of follow-up. RESULTS mean age of the participants was 78.4 ± 3.5 years. Combined weakness and low muscle mass was present in 3-8% of men, depending on the criteria applied. Pre-frailty and frailty were present in 30 and 7% of men, respectively. After 15 years of follow-up, 165 men (86%) died. Both the presence of combined weakness and low ALM-to-BMI ratio (age-adjusted HR = 2.50, 95% CI = 1.30-4.79) and the presence of SOF frailty (age-adjusted HR = 2.64, 95% CI = 1.44-4.86) were associated with mortality. CONCLUSIONS our findings confirm the predictive value for mortality of the non-distribution-based FNIH criteria and SOF index in older community-dwelling Belgian men.
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Affiliation(s)
| | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - Youri E Taes
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Kaatje R C Toye
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Jean-Marc Kaufman
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Bruno Lapauw
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
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156
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Morley JE. The Complexities of Diabetes in Older Persons. J Am Med Dir Assoc 2016; 17:872-4. [PMID: 27590405 DOI: 10.1016/j.jamda.2016.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 12/25/2022]
Affiliation(s)
- John E Morley
- Division of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, MO.
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157
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Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2016; 17:767.e1-7. [DOI: 10.1016/j.jamda.2016.05.016] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 12/13/2022]
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158
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Cawthon PM, Lui LY, McCulloch CE, Cauley JA, Paudel ML, Taylor B, Schousboe JT, Ensrud KE. Sarcopenia and Health Care Utilization in Older Women. J Gerontol A Biol Sci Med Sci 2016; 72:95-101. [PMID: 27402050 DOI: 10.1093/gerona/glw118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 06/05/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. METHODS We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997-1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. RESULTS None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. CONCLUSION Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization.
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Affiliation(s)
- Peggy M Cawthon
- California Pacific Medical Center, Research Institute, San Francisco. .,Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Li-Yung Lui
- California Pacific Medical Center, Research Institute, San Francisco
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Misti L Paudel
- Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota
| | - Brent Taylor
- Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.,Department of Medicine.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - John T Schousboe
- Park Nicollet Clinic, St. Louis Park, Minnesota.,Division of Health Policy and Management, University of Minnesota, Minneapolis
| | - Kristine E Ensrud
- Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.,Department of Medicine.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
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159
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160
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Kim KM, Jang HC, Lim S. Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. Korean J Intern Med 2016; 31:643-50. [PMID: 27334763 PMCID: PMC4939509 DOI: 10.3904/kjim.2016.015] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/15/2016] [Indexed: 02/06/2023] Open
Abstract
Aging processes are inevitably accompanied by structural and functional changes in vital organs. Skeletal muscle, which accounts for 40% of total body weight, deteriorates quantitatively and qualitatively with aging. Skeletal muscle is known to play diverse crucial physical and metabolic roles in humans. Sarcopenia is a condition characterized by significant loss of muscle mass and strength. It is related to subsequent frailty and instability in the elderly population. Because muscle tissue is involved in multiple functions, sarcopenia is closely related to various adverse health outcomes. Along with increasing recognition of the clinical importance of sarcopenia, several international study groups have recently released their consensus on the definition and diagnosis of sarcopenia. In practical terms, various skeletal muscle mass indices have been suggested for assessing sarcopenia: appendicular skeletal muscle mass adjusted for height squared, weight, or body mass index. A different prevalence and different clinical implications of sarcopenia are highlighted by each definition. The discordances among these indices have emerged as an issue in defining sarcopenia, and a unifying definition for sarcopenia has not yet been attained. This review aims to compare these three operational definitions and to introduce an optimal skeletal muscle mass index that reflects the clinical implications of sarcopenia from a metabolic perspective.
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Affiliation(s)
| | | | - Soo Lim
- Correspondence to Soo Lim, M.D. Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7035 Fax: +82-31-787-4051 E-mail:
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161
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Morley JE, Abele P. The Medicare Annual Wellness Visit in Nursing Homes. J Am Med Dir Assoc 2016; 17:567-9. [DOI: 10.1016/j.jamda.2016.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/06/2016] [Indexed: 12/11/2022]
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162
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Bruyère O, Beaudart C, Locquet M, Buckinx F, Petermans J, Reginster JY. Sarcopenia as a public health problem. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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163
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Burden-of-illness of Dutch community-dwelling older adults with sarcopenia: Health related outcomes and costs. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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164
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Morley JE. High-Quality Exercise Programs Are an Essential Component of Nursing Home Care. J Am Med Dir Assoc 2016; 17:373-5. [PMID: 26972346 DOI: 10.1016/j.jamda.2016.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 12/22/2022]
Affiliation(s)
- John E Morley
- Division of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, Missouri.
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165
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Morley JE. Telemedicine: Coming to Nursing Homes in the Near Future. J Am Med Dir Assoc 2016; 17:1-3. [DOI: 10.1016/j.jamda.2015.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 01/02/2023]
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166
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Molino S, Dossena M, Buonocore D, Verri M. Sarcopenic Obesity: An Appraisal of the Current Status of Knowledge and Management in Elderly People. J Nutr Health Aging 2016; 20:780-8. [PMID: 27499312 DOI: 10.1007/s12603-015-0631-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Today's increased life expectancy highlights both age-related changes in body composition and a higher prevalence of obesity. Sarcopenic obesity (SO) is assuming a prominent role in cardio-metabolic risk because of the double metabolic burden derived from low muscle mass (sarcopenia) and excess adiposity (obesity). This review evaluates the related studies that have been published over the past 10 years in order to give an updated overview of this new syndrome. There is no consensus on the definition of SO due to the wide heterogeneity of diagnostic criteria and choice of body composition components needed to assess this phenotype. There is a growing body of evidence that the ethio-pathogenesis of SO is complex and multi-factorial, as the consequences are a combination of the outcomes of both sarcopenia and obesity, where the effects are maximised. In order to manage SO, it is important to make lifestyle changes that incorporate weight loss, physical exercise and protein supplementation.
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Affiliation(s)
- S Molino
- Dr. Manuela Verri, Dipartimento di Biologia e Biotecnologie "Lazzaro Spallanzani", Università degli Studi di Pavia, Via Ferrata 9, 27100 Pavia, Italy, Tel.: +39-0382-986423, fax: +39-0382-986385, e-mail:
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167
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Reinders I, Murphy RA, Brouwer IA, Visser M, Launer L, Siggeirsdottir K, Eiriksdottir G, Gudnason V, Jonsson PV, Lang TF, Harris TB. Muscle Quality and Myosteatosis: Novel Associations With Mortality Risk: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study. Am J Epidemiol 2016; 183:53-60. [PMID: 26643983 DOI: 10.1093/aje/kwv153] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/04/2015] [Indexed: 12/30/2022] Open
Abstract
Muscle composition may affect mortality risk, but prior studies have been limited to specific samples or less precise determination of muscle composition. We evaluated associations of thigh muscle composition, determined using computed tomography imaging, and knee extension strength with mortality risk among 4,824 participants aged 76.4 (standard deviation (SD), 5.5) years from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (2002-2006). Cox proportional hazards models were used to estimate hazard ratios. After 8.8 years of follow-up, there were 1,942 deaths. For men, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 11% and 22%. Each SD-increment increase in intermuscular adipose tissue and intramuscular adipose tissue was associated with higher mortality risk (hazard ratio (HR) = 1.13 (95% confidence interval (CI): 1.06, 1.22) and HR = 1.23 (95% CI: 1.15, 1.30), respectively). For women, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 12% and 19%. Greater intramuscular adipose tissue was associated with an 8% higher mortality risk (HR = 1.08, 95% CI: 1.01, 1.16). This study shows that muscle composition is associated with mortality risk. These results also show the importance of improving muscle strength and area and lowering muscle adipose tissue infiltration.
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168
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Morley JE. Aging Successfully: The Key to Aging in Place. J Am Med Dir Assoc 2015; 16:1005-7. [DOI: 10.1016/j.jamda.2015.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 12/16/2022]
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169
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Morley JE, Cao L. Rapid screening for sarcopenia. J Cachexia Sarcopenia Muscle 2015; 6:312-4. [PMID: 26676168 PMCID: PMC4670738 DOI: 10.1002/jcsm.12079] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 02/05/2023] Open
Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine St. Louis, MO, USA
| | - Li Cao
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University Sichuan, China
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170
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Woo J, Leung J. Anthropometric Cut Points for Definition of Sarcopenia Based on Incident Mobility and Physical Limitation in Older Chinese People. J Gerontol A Biol Sci Med Sci 2015; 71:935-40. [DOI: 10.1093/gerona/glv197] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/07/2015] [Indexed: 12/21/2022] Open
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171
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Cawthon PM, Blackwell TL, Cauley J, Kado DM, Barrett-Connor E, Lee CG, Hoffman AR, Nevitt M, Stefanick ML, Lane NE, Ensrud KE, Cummings SR, Orwoll ES. Evaluation of the Usefulness of Consensus Definitions of Sarcopenia in Older Men: Results from the Observational Osteoporotic Fractures in Men Cohort Study. J Am Geriatr Soc 2015; 63:2247-59. [PMID: 26502831 DOI: 10.1111/jgs.13788] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. DESIGN Osteoporotic Fractures in Men Study. SETTING Six clinical centers. PARTICIPANTS Community-dwelling men aged 65 and older (N = 5,934). MEASUREMENTS Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. RESULTS The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change ≤1% in all models). CONCLUSION Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men.
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Affiliation(s)
- Peggy M Cawthon
- Research Institute, San Francisco Coordinating Center, California Pacific Medical Center, San Francisco, California
| | - Terri L Blackwell
- Research Institute, San Francisco Coordinating Center, California Pacific Medical Center, San Francisco, California
| | - Jane Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Deborah M Kado
- Department of Family and Preventive Medicine, University of California at San Diego, San Diego, California
| | - Elizabeth Barrett-Connor
- Department of Family and Preventive Medicine, University of California at San Diego, San Diego, California
| | | | - Andrew R Hoffman
- Department of Medicine, Stanford University, Stanford, California
| | - Michael Nevitt
- Department of Epidemiology, University of California at San Francisco, San Francisco, California
| | | | - Nancy E Lane
- Medical Center, University of California at Davis, Sacramento, California
| | - Kristine E Ensrud
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Minneapolis Veterans Affairs Health System, Minneapolis, Minnesota
| | - Steven R Cummings
- Research Institute, San Francisco Coordinating Center, California Pacific Medical Center, San Francisco, California
| | - Eric S Orwoll
- School of Medicine, Oregon Health & Science University, Portland, Oregon
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172
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173
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174
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Morley JE. Nutritional Supplementation and Sarcopenia: The Evidence Grows. J Am Med Dir Assoc 2015; 16:717-9. [DOI: 10.1016/j.jamda.2015.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 12/25/2022]
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175
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Sarcopenia Is Associated With Incident Disability, Institutionalization, and Mortality in Community-Dwelling Older Men: The Concord Health and Ageing in Men Project. J Am Med Dir Assoc 2015; 16:607-13. [DOI: 10.1016/j.jamda.2015.02.006] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/11/2015] [Accepted: 02/11/2015] [Indexed: 01/17/2023]
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176
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Abstract
Disturbances of serum sodium are one of the most common findings in older persons. They are also a major cause of hospital admissions and delirium and are associated with frailty, falls, and hip fractures. Both hypernatremia and hyponatremia are potentially preventable. Treatment involves treating the underlying cause and restoring sodium and volume status to normal. The arginine vasopressin antagonists, vaptans, have increased the therapeutic armamentarium available to physicians.
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Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA.
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177
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Morley JE. Exercise: The Ultimate Medicine. J Am Med Dir Assoc 2015; 16:351-3. [DOI: 10.1016/j.jamda.2015.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 12/25/2022]
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178
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179
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Hubbard RE, Lang I. Avoiding Depression, Dementia, and Frailty: Do You Feel Lucky? J Am Med Dir Assoc 2015; 16:270-1. [DOI: 10.1016/j.jamda.2015.01.085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 01/15/2015] [Indexed: 11/27/2022]
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