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Li X, Wang R, Hou Z, Sun Q. Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 122:105390. [PMID: 38460267 DOI: 10.1016/j.archger.2024.105390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors. METHODS Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis. RESULTS Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia. CONCLUSIONS Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.
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Affiliation(s)
- Xiaoyan Li
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhuoer Hou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiuhua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
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Moreno-González R, Cruzado JM, Corsonello A, Fabbietti P, Tap L, Mattace-Raso F, Ärnlöv J, Carlsson AC, Guligowska A, Kostka T, Artzi-Medvedik R, Melzer I, Roller-Wirnsberger R, Wirnsberger G, Kob R, Sieber C, Lattanzio F, Formiga F. Kidney function and other associated factors of sarcopenia in community-dwelling older adults: The SCOPE study. Eur J Intern Med 2024; 123:81-93. [PMID: 38103954 DOI: 10.1016/j.ejim.2023.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/08/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Abstract
AIM Sarcopenia is associated with several factors and medical conditions among older adults, though previous research has shown limitations and inconsistencies, especially regarding chronic kidney disease (CKD). We investigated the clinical and laboratory variables associated with sarcopenia and severe sarcopenia in older adults, focusing on kidney function measures. METHODS Data from community-dwelling adults aged ≥75 years participating in the SCOPE multicenter prospective cohort study were assessed cross-sectionally. Comprehensive geriatric assessment was conducted; sociodemographic and lifestyle factors, clinical variables and comorbidities, anthropometric and bioelectrical impedance analysis, blood and urine laboratory variables were collected. EWGSOP2 revised criteria were used to define sarcopenia and its severity. Estimated glomerular filtration rate (eGFR) was calculated using creatinine and non-creatinine-based equations, and CKD stages were defined accordingly. RESULTS 1420 participants were included, prevalence of sarcopenia was 10.6 %, and 6 % had severe sarcopenia. Multivariate logistic regression analysis showed that age [OR =1.14; 95 %CI (1.09-1.19)], body mass index (BMI) [0.83 (0.79-0.88)], disability performing instrumental activities of daily living (IADL) [2.61 (1.69-4.06)], Mini Mental State Examination (MMSE) score <24 [2.75 (1.62-4.67)], osteoporosis [2.39 (1.55-3.67)], and stage 4 CKD defined by CKD-EPIBTP-B2M, a non-creatinine-based eGFR equation [2.88 (1.11-7.49)], were independently associated with sarcopenia; as were specifically with severe sarcopenia, with more pronounced associations. CONCLUSIONS In community-dwelling older adults, sarcopenia is a relevant condition and is associated with severe CKD, older age, IADL, cognitive impairments, osteoporosis and low BMI. These factors should be assessed for proper identification and management of older patients with sarcopenia, and even more so with severe sarcopenia.
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Affiliation(s)
- Rafael Moreno-González
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Maria Cruzado
- Nephrology Department, Hospital Universitari de Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Andrea Corsonello
- Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Italy; Unit of Geriatric Medicine, Italian National Research Center on Ageing (IRCCS INRCA), Cosenza, Italy and Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Paolo Fabbietti
- Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Italy
| | - Lisanne Tap
- Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Francesco Mattace-Raso
- Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Johan Ärnlöv
- School of Health and Social Studies, Dalarna University, Falun, Sweden; Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Axel C Carlsson
- Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Poland
| | - Rada Artzi-Medvedik
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel
| | | | | | - Robert Kob
- Department of General Internal Medicine and Geriatrics, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Regensburg, Germany
| | - Cornel Sieber
- Department of General Internal Medicine and Geriatrics, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Regensburg, Germany
| | - Fabrizia Lattanzio
- Scientific Direction, Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona, Spain
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Jelaska J, Vučković M, Gugić Ordulj I, Kolak E, Šolić Šegvić L, Đapić Kolak Z, Keser I, Radić J. Unlocking Cognitive Potential: Association of Sarcopenia and Mediterranean Diet on Cognitive Function in Community-Dwelling Elderly of the Dalmatian Region. Nutrients 2024; 16:991. [PMID: 38613024 PMCID: PMC11013823 DOI: 10.3390/nu16070991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
The aim of this study was to determine the association between muscle strength, adherence to the Mediterranean diet (MeDi) and cognitive function in community-dwelling elderly. General data, data of body composition and anthropometric parameters, clinical and laboratory findings, cognitive test questionnaires (Mini-Mental State Examination-MMSE, Trail Making Test-TMT, Symbol Digit Modalities Test-SDMT), and nutritional assessments (Mini Nutritional Assessment-MNA, Mediterranean Diet Serving Score-MDSS) were obtained for each study participant. Handgrip strength (HS) was used as one of the key parameters for defining probable sarcopenia, among the Short Physical Performance Battery test (SPPB) (for defining physical activity) and the strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire (SARC-F). Our cross-sectional study involved 114 participants aged ≥ 60 years, and two-thirds of the participants were female (76.3% vs. 23.7%). Probable sarcopenia was found in 34.7% of them. Using bivariate regression analysis, cognitive deficit among the sarcopenic population was associated with the following groups of collected data: (a) sociodemographic-associated factors-advanced age (OR: 1.07; p = 0.004), single marital status (OR: 3.25; p = 0.03), and low level of education (OR: 0.22; p < 0.003); (b) behavioral-associated factors-duration of institutionalization (OR: 1.05; p = 0.007), performance of heavy physical work (OR: 6.26; p = 0.001), low physical activity (OR: 0.08; p = 0.002), and risk of malnutrition (OR: 3.87; p = 0.005); (c) disease-related factors-loss of appetite (OR: 2.24; p = 0.04), information processing speed (OR: 0.88; p < 0.001), blood pressure systolic/diastolic variables (OR: 0.96/0.96; p = 0.002/0.02), medications (OR: 1.19; p = 0.005), predictive sarcopenia score ≥ 4 (OR: 3.1; p = 0.003), and low muscle strength (OR: 0.92; p = 0.002). Cognitive preservation among the sarcopenic population was associated with married status (OR: 0.23; p = 0.20), a high level of education (OR: 0.18; p = 0.002), smoking (OR: 0.33; p = 0.02), high physical activity (OR: 0.07; p < 0.001), and dietary habits using poultry (OR: 0.12; p = 0.004). The results suggest a significant association between sarcopenia and cognitive function in community-dwelling elderly, highlighting the need for regular nutritional interventions in this special population.
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Affiliation(s)
- Julija Jelaska
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia; (J.J.); (I.G.O.)
| | - Marijana Vučković
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
| | - Ivana Gugić Ordulj
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia; (J.J.); (I.G.O.)
| | - Ela Kolak
- Nutrition and Dietetics Department, University Hospital of Split, 21000 Split, Croatia;
| | - Lucija Šolić Šegvić
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
| | | | - Irena Keser
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Josipa Radić
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
- Department of Internal Medicine, School of Medicine, University of Split, 21000 Split, Croatia
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Ji S, Jung HW, Baek JY, Jang IY, Lee E. Sarcopenia as the Mobility Phenotype of Aging: Clinical Implications. J Bone Metab 2024; 31:1-12. [PMID: 38485236 PMCID: PMC10940105 DOI: 10.11005/jbm.2024.31.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/02/2023] [Accepted: 12/19/2023] [Indexed: 03/17/2024] Open
Abstract
Sarcopenia, which is characterized by an age-related decline in muscle mass and function, poses significant challenges to geriatric care. Its definition has evolved from muscle-specific criteria to include muscle mass, muscle function, and physical performance, recognizing sarcopenia as a physical frailty. Sarcopenia is associated with adverse outcomes, including mortality, falls, fractures, cognitive decline, and admission to long-term care facilities. Neuromechanical factors, protein-energy balance, and muscle protein synthesis-breakdown mechanisms contribute to its pathophysiology. The identification of sarcopenia involves screening tests and a comprehensive assessment of muscle mass, strength, and physical function. Clinical approaches aligned with the principles of comprehensive geriatric assessment prioritize patient-centered care. This assessment aids in identifying issues related to activities of daily living, cognition, mood, nutrition, and social support, alongside other aspects. The general approach to factors underlying muscle loss and functional decline in patients with sarcopenia includes managing chronic diseases and evaluating administered medications, with interventions including exercise and nutrition, as well as evolving pharmacological options. Ongoing research targeting pathways, such as myostatin-activin and exercise mimetics, holds promise for pharmacological interventions. In summary, sarcopenia requires a multifaceted approach, acknowledging its complex etiology and tailoring interventions to individual patient needs.
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Ji S, Baek JY, Lee E, Jang IY, Jung HW. Phenotype validation of the Korean working group on sarcopenia guideline. Arch Gerontol Geriatr 2024; 117:105251. [PMID: 37956586 DOI: 10.1016/j.archger.2023.105251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/28/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND This study aimed to validate the proposed Korean Working Group on Sarcopenia (KWGS) guideline, which introduces the concept of functional sarcopenia, in older Korean adults. METHODS Data from the Aging Study of Pyeongchang Rural Area, a longitudinal cohort of community-dwelling older adults, were utilized to compare frailty status and institutionalization-free survival among participants according to sarcopenia status. Based on the KWGS guideline, severe sarcopenia was defined as low muscle mass and strength with slow gait speed; sarcopenia (not severe) was defined as low muscle mass with low muscle strength or slow gait speed; and functional sarcopenia was defined as low muscle strength and slow gait speed without low muscle mass. RESULTS Among the 1302 participants, 329 (25.3 %) had severe sarcopenia, 147 (11.3 %) had sarcopenia (not severe), and 277 (21.3 %) had functional sarcopenia. Frailty was significantly greater in participants with any phenotype of sarcopenia than in those without sarcopenia. Additionally, participants with functional sarcopenia were frailer than those with sarcopenia (not severe). Furthermore, the rates of institutionalization and mortality were higher in participants with any phenotype of sarcopenia than in those without sarcopenia. There was no statistical difference between the rates of sarcopenia (not severe) and those with functional sarcopenia. These findings remained consistent after adjusting for age and sex. CONCLUSIONS Each phenotype according to the KWGS guideline was associated with significantly greater frailty and increased risk of institutionalization and mortality. Functional sarcopenia was associated with greater frailty and had comparable prognosis with sarcopenia (not severe).
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Murphy CH, McCarthy SN, McMorrow AM, Egan B, McGowan MJ, Rafferty S, Corish CA, Roche HM. Prevalence and determinants of sarcopenia in community-dwelling older adults in Ireland. Aging Clin Exp Res 2023; 35:1651-1660. [PMID: 37326940 DOI: 10.1007/s40520-023-02453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/24/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Data on the prevalence of sarcopenia among older adults in Ireland are lacking. AIMS To assess the prevalence and determinants of sarcopenia among community-dwelling older adults in Ireland. METHODS This cross-sectional analysis involved n = 308 community-dwelling adults aged ≥ 65 y living in Ireland. Participants were recruited via recreational clubs and primary healthcare services. Sarcopenia was defined according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Skeletal muscle mass was estimated using bioelectrical impedance analysis, strength was measured via handgrip dynamometry, and physical performance was assessed using the Short Physical Performance Battery. Detailed information was collected on demographics, health, and lifestyle. Dietary macronutrient intake was measured via a single 24 h recall. Binary logistic regression was used to examine potential demographic, health, lifestyle, and dietary determinants of sarcopenia (where both probable and confirmed sarcopenia were combined). RESULTS The prevalence of EWGSOP2-defined probable sarcopenia was 20.8% and confirmed sarcopenia was 8.1% (5.8% had severe sarcopenia). Polypharmacy (OR 2.60, 95% confidence interval [CI] 1.3, 5.23), height (OR 0.95, 95% CI 0.91, 0.98), and Instrumental Activities Of Daily Living (IADL) score (OR 0.71, 95% CI 0.59, 0.86) were independently associated with sarcopenia (probable and confirmed combined). There were no independent associations between energy-adjusted macronutrient intakes, as determined by 24 h recall, and sarcopenia. CONCLUSION Sarcopenia prevalence within this sample of community-dwelling older adults in Ireland is broadly similar to other European cohorts. Polypharmacy, lower height, and lower IADL score were independently associated with EWGSOP2-defined sarcopenia.
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Affiliation(s)
- Caoileann H Murphy
- Rural Economy and Development Programme, Teagasc Food Research Centre, Ashtown, Dublin, D15 KN3K, Ireland
- School of Public Health, Physiotherapy and Sport Science, UCD Conway Institute, UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Ireland
| | - Sinead N McCarthy
- Rural Economy and Development Programme, Teagasc Food Research Centre, Ashtown, Dublin, D15 KN3K, Ireland.
| | - Aoibheann M McMorrow
- School of Public Health, Physiotherapy and Sport Science, UCD Conway Institute, UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Ireland
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Maureen J McGowan
- Health Service Executive Community Health Organisation 6, Wicklow, Ireland
| | - Sheena Rafferty
- Health Service Executive Community Health Organisation 9, Dublin, Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sport Science, UCD Conway Institute, UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Ireland
| | - Helen M Roche
- School of Public Health, Physiotherapy and Sport Science, UCD Conway Institute, UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Ireland
- Institute for Global Food Security, Queen's University, Belfast, UK
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Torres-Costoso A, Zymbal V, Janz KF, Martínez Vizcaíno V, Baptista F. Body composition and musculoskeletal fitness: A cluster analysis for the identification of risk phenotypes for pediatric sarcopenia. Clin Nutr 2023; 42:1151-1158. [PMID: 37244754 DOI: 10.1016/j.clnu.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/27/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND AIM Sarcopenia is primarily a disease in older people characterized by reduced muscle mass and strength. Nevertheless, sarcopenia may, at least partially, have pediatric origins. The study aimed to identify risk phenotypes for sarcopenia in healthy young people using clustering analysis procedures based on body composition and musculoskeletal fitness. METHODS We conducted a cluster cross-sectional analysis of data from 529 youth aged 10-18 yr. Body composition was assessed using whole-body dual-energy x-ray absorptiometry (DXA), determining: lean body mass index (LBMI, kg/m2), fat body mass index (FBMI, kg/m2), abdominal FBMI (kg/m2), and lean body mass/fat body mass ratio (LBM/FBM); body mass index was also calculated (BMI, kg/m2). Musculoskeletal fitness was assessed using handgrip strength (kg) and vertical jump power (W) tests. Results were presented as absolute values and adjusted by body mass. Plank endurance (s) was also assessed. All variables were sex and age in years standardized (Z-score). LBMI or LBM/FBM ratio ≤ -1 SD were used to identify participants at risk for sarcopenia. Maturity was estimated as the years of distance from the peak height velocity (PHV) age. RESULTS Using the Z-score means for body composition and musculoskeletal fitness and having LBMI or LBM/FBM ratio as the categorical variables (at risk vs. not at risk), the cluster analyses indicated three homogeneous groups (phenotypes, P): P1, risk body composition and unfit; P2, non-risk body composition and non-fit, and P3, non-risk body composition and fit. With the LBMI as a categorical variable, the ANOVA models showed that the body composition and absolute values of musculoskeletal fitness were in P1 < P2 < P3 and the estimated PHV age of P1 > P3 in both sexes (p < 0.001). Having the LBM/FBM as a categorical variable, higher values of BMI, FBMI, and abdominal FBMI, and lower values of handgrip strength and vertical jump power both adjusted for body mass and plank endurance were observed in P1 than in P2 and/or P3 and the P2 than in the P3 in boys and girls (p < 0.001). CONCLUSIONS Two risk phenotypes for sarcopenia were identified in apparently healthy young people: I. a low LBMI phenotype with low BMI and II. a low LBM to FBM phenotype with high BMI and FBMI. In both risk phenotypes I and II, musculoskeletal fitness was low. For screening, we suggest using absolute measures of handgrip strength and vertical jump power in phenotype I and body mass adjusted measures of these markers, as well as the plank endurance time in phenotype II.
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Affiliation(s)
- Ana Torres-Costoso
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain; Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain.
| | - Vera Zymbal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal; ESS, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Kathleen F Janz
- Department of Health and Human Physiology, Department of Epidemiology, The University of Iowa, Iowa City, USA
| | - Vicente Martínez Vizcaíno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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Ji S, Park SJ, Lee JY, Baek JY, Jung HW, Kim K, Yoo HJ, Jang IY, Kim BJ. Lack of association between serum myonectin levels and sarcopenia in older Asian adults. Exp Gerontol 2023; 178:112229. [PMID: 37270069 DOI: 10.1016/j.exger.2023.112229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Myonectin is a muscle-secreted factor that helps maintain homeostasis in the body by regulating several functions, including lipid metabolism. Previous studies suggested that myonectin may play a role in muscle health in an autocrine manner, but its impact on human skeletal muscle is still unclear. We aimed to investigate the relationship of serum myonectin levels with sarcopenia and related muscle parameters. We conducted a cross-sectional study of 142 older adults whose muscle mass, grip strength, gait speed, chair stands, and short physical performance battery (SPPB) were evaluated in the geriatric clinic of a tertiary medical center. Sarcopenia was defined based on Asian-specific cutoff values, and circulating myonectin levels were measured using an enzyme immunoassay. Before and after adjusting for age, sex, and body mass index, the serum myonectin level was not significantly different when the patients were stratified by status of sarcopenia, muscle mass, muscle strength, and physical performance. Furthermore, whether given as a continuous variable or divided into quartile groups, the serum myonectin level had no association with the skeletal muscle mass, grip strength, gait speed, chair stand test, or SPPB score. Our findings did not confirm the potential role of myonectin in muscle metabolism observed in experimental research. Thus, serum myonectin levels cannot predict the risk of sarcopenia in older Asian adults.
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea; Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
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9
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Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, Triantafyllidis KK, Kechagias KS, Dionyssiotis Y, Cesari M, Ibrahim K, Scott D, Barbagallo M, Veronese N. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:671-683. [PMID: 36781175 PMCID: PMC10067503 DOI: 10.1002/jcsm.13190] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Society of Meta‐research and Biomedical InnovationLondonUK
| | - Panagiotis Giannos
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Jean Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and AgingLiègeBelgium
- Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and AgeingUniversity of LiègeLiègeBelgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and PaediatricsGhent UniversityGhentBelgium
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCAAnconaItaly
| | - Konstantinos K. Triantafyllidis
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Nutrition and DieteticsHomerton University Hospital Foundation TrustLondonUK
| | - Konstantinos S. Kechagias
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Metabolism, Digestion and Reproduction, Faculty of MedicineImperial College LondonLondonUK
| | - Yannis Dionyssiotis
- Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital PatrasUniversity of PatrasPatrasGreece
| | - Matteo Cesari
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Geriatric UnitIRCCS Istituti Clinici Scientifici MaugeriMilanItaly
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University Hospital SouthamptonUniversity of SouthamptonSouthamptonUK
- Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR)University of SouthamptonSouthamptonUK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Mario Barbagallo
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Nicola Veronese
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
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10
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Stuck AK, Basile G, Freystaetter G, de Godoi Rezende Costa Molino C, Lang W, Bischoff-Ferrari HA. Predictive validity of current sarcopenia definitions (EWGSOP2, SDOC, and AWGS2) for clinical outcomes: A scoping review. J Cachexia Sarcopenia Muscle 2023; 14:71-83. [PMID: 36564353 PMCID: PMC9891988 DOI: 10.1002/jcsm.13161] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/25/2022] [Indexed: 12/25/2022] Open
Abstract
Over the last 3 years new definitions of sarcopenia by the Sarcopenia Definition and Outcome Consortium (2020, SDOC), European Working Group on Sarcopenia in Older People (2019, EWGSOP2) and Asian Working Group on Sarcopenia (2019, AWGS2) have been proposed. The objective of this scoping review was to explore predictive validity of these current sarcopenia definitions for clinical outcomes. We followed the PRISMA checklist for scoping reviews. Based on a systematic search performed by two independent reviewers of databases (Pubmed and Embase) articles comparing predictive validity of two or more sarcopenia definitions on prospective clinical outcomes published since January 2019 (the year these definitions were introduced) were included. Data were extracted and results collated by clinical outcomes and by sarcopenia definitions, respectively. Of 4493 articles screened, 11 studies (mean age of participants 77.6 (SD 5.7) years and 50.0% female) comprising 82 validity tests were included. Overall, validity tests on the following categories of clinical outcomes were performed: fracture (n = 40, assessed in one study), mortality (n = 18), function (n = 11), institutionalization (n = 7), falls (n = 4), and hospitalization (n = 2). Thereby, EWGSOP2 was investigated in 15 validity tests (18.3%) on all categories of clinical outcomes, whereas SDOC was investigated in four validity tests (4.9%) in one study on fractures in men only, and none of the validity tests investigated predictive validity by the AWGS2. However, we were not able to pool the data using a meta-analytic approach due to important methodological heterogeneity between the studies. We identified various definitions of clinical outcomes that were used to test predictive validity of sarcopenia definitions suggesting that an agreement on an operational definition of a clinical outcome is key to advance in the field of sarcopenia. Moreover, data on predictive validity using the sarcopenia definitions by the SDOC and AWGS2 are still scarce and lacking, respectively. In a next step, prospective studies including both women and men are needed to compare predictive validity of current sarcopenia definitions on defined key clinical outcomes.
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Affiliation(s)
- Anna K Stuck
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Giacomo Basile
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gregor Freystaetter
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Aging Medicine, University Hospital Zurich, Zurich, Switzerland
| | | | - Wei Lang
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Aging Medicine, University Hospital Zurich, Zurich, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
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11
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Height loss as an indicator of ageing through its association with frailty and sarcopenia: An observational cohort study. Arch Gerontol Geriatr 2022; 110:104916. [PMID: 36905804 DOI: 10.1016/j.archger.2022.104916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/06/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Height loss is associated with various health-related variables such as cardiovascular disease, osteoporosis, cognitive function, and mortality. We hypothesized that height loss can be used as an indicator of aging, and we assessed whether the degree of height loss for 2 years was associated with frailty and sarcopenia. METHODS This study was based on a longitudinal cohort, the Pyeongchang Rural Area cohort. The cohort included people aged 65 years or older, ambulatory, and living at home. We divided individuals according to the ratio of height change (height change for 2 years divided by height at 2 years from baseline): HL2 (<-2%), HL1 (-2%--1%), and REF (-1%≤). We compared the frailty index, diagnosis of sarcopenia after 2 years from baseline, and the incidence of a composite outcome (mortality and institutionalization). RESULTS In total, 59 (6.9%), 116 (13.5%), and 686 (79.7%) were included in the HL2, HL1, and REF groups, respectively. Compared with the REF group, groups HL2 and HL1 had a higher frailty index, and higher risks of sarcopenia and composite outcome. When groups HL2 and HL1 were merged, the merged group had higher frailty index (standardized B, 0.06; p = 0.049), a higher risk of sarcopenia (OR, 2.30; p = 0.006), and a higher risk of composite outcome (HR, 1.78; p = 0.017) after adjusting for age and sex. CONCLUSIONS Individuals with greater height loss were frailer, more likely to be diagnosed with sarcopenia and had worse outcomes regardless of age and sex.
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12
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Ahn SH, Jung HW, Lee E, Baek JY, Jang IY, Park SJ, Lee JY, Choi E, Lee YS, Hong S, Kim BJ. Decreased Serum Level of Sclerostin in Older Adults with Sarcopenia. Endocrinol Metab (Seoul) 2022; 37:487-496. [PMID: 35619214 PMCID: PMC9262689 DOI: 10.3803/enm.2022.1428] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGRUOUND Although muscles and bones interact with each other through various secretory factors, the role of sclerostin, an osteocyte-secreted factor, on muscle metabolism has not been well studied. We investigated the levels of serum sclerostin in Korean older adults with sarcopenia. METHODS Blood samples were collected from 129 participants who underwent evaluation of muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related parameters were determined using cutoff values for the Asian population. Serum sclerostin levels were measured using an enzyme-linked immunosorbent assay. RESULTS The mean age of the participants was 69.6 years, and 20 participants (15.5%) were classified as having sarcopenia. After adjusting for age, sex, and body mass index, serum sclerostin levels were significantly lower in participants with sarcopenia, low muscle mass, or weak muscle strength (P=0.003 to 0.045). Serum sclerostin levels were positively associated with skeletal muscle index and grip strength after adjusting for confounders (P=0.001 and P=0.003), whereas sarcopenic phenotype score showed a negative association (P=0.006). These increases in muscle mass and strength were also dose dependent as serum sclerostin levels increased (P for trends=0.003 and P for trends=0.015). Higher serum sclerostin levels were associated with lower odds ratio (ORs) for sarcopenia, low muscle mass, and weak muscle strength after adjusting for confounders (OR, 0.27 to 0.50; P<0.001 to 0.025). CONCLUSION Higher serum sclerostin levels were associated with a lower risk of sarcopenia, low muscle mass, and weak muscle strength in Korean older adults.
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Affiliation(s)
- Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunah Choi
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Sun Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
- Corresponding authors: Seongbin Hong Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: +82-32-890-3360, Fax: +82-32-883-6578, E-mail:
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Beom-Jun Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5876, Fax: +82-2-3010-6962, E-mail:
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13
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Fernandes LV, Paiva AEG, Silva ACB, de Castro IC, Santiago AF, de Oliveira EP, Porto LCJ. Prevalence of sarcopenia according to EWGSOP1 and EWGSOP2 in older adults and their associations with unfavorable health outcomes: a systematic review. Aging Clin Exp Res 2022; 34:505-514. [PMID: 34398438 DOI: 10.1007/s40520-021-01951-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/01/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People (EWGSOP) recently updated the definition and diagnostic criteria to assess sarcopenia, which can result in important changes in sarcopenia prevalence in older adults. AIM To compare the prevalence of sarcopenia through the diagnostic criteria and definition proposed by the first (EWGSOP1) and recent (EWGSOP2) European consensus in older adults. We also aimed to evaluate which sarcopenia consensus is better associated with unfavorable health outcomes. METHODS The review followed PRISMA guidelines. Embase, Medline (PubMed), Scopus and Web of Science were searched from 2018 to February 2021. The systematic review protocol was registered at PROSPERO (CRD42020213303). The search, selection, and evaluation processes were done in a duplicate and independent manner. RESULTS Of the 298 potentially eligible articles, 9 were included in this review. The prevalence of sarcopenia was 17.7% by EWGSOP1 and 11% by EWGSOP2. Evaluating all the studies, the sarcopenia prevalence ranged from 6.2 to 35.3% for the EWGSOP1, and from 3.2 to 26.3% for the EWGSOP2. Five studies have evaluated the association between the prevalence of sarcopenia (EWGSOP1 versus EWGSOP2) and unfavorable health outcomes, in which three studies showed that EWGSOP1 was better associated with increased risk of hospitalization and/or mortality. CONCLUSION In comparison with EWGSOP1, the prevalence of sarcopenia in older adults decreased when diagnosed according to EWGSOP2. Based on limited evidence, EWGSOP2 seems to be worse for predicting unfavorable outcomes compared with EWGSOP1.
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Affiliation(s)
- Lara Vilar Fernandes
- Graduate Program in Nutrition and Health-PPGNS, Federal University of Lavras-UFLA, Lavras, Minas Gerais, Brazil
| | | | - Ana Clara Borges Silva
- Department of Nutrition, Federal University of Lavras-UFLA, University Campus, Lavras, 37200-000, Brazil
| | - Isabela Coelho de Castro
- Graduate Program in Nutrition and Health-PPGNS, Federal University of Lavras-UFLA, Lavras, Minas Gerais, Brazil
- Department of Nutrition, Federal University of Lavras-UFLA, University Campus, Lavras, 37200-000, Brazil
| | - Andrezza Fernanda Santiago
- Graduate Program in Nutrition and Health-PPGNS, Federal University of Lavras-UFLA, Lavras, Minas Gerais, Brazil
- Department of Nutrition, Federal University of Lavras-UFLA, University Campus, Lavras, 37200-000, Brazil
| | - Erick P de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Laura Cristina Jardim Porto
- Graduate Program in Nutrition and Health-PPGNS, Federal University of Lavras-UFLA, Lavras, Minas Gerais, Brazil.
- Department of Nutrition, Federal University of Lavras-UFLA, University Campus, Lavras, 37200-000, Brazil.
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14
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Baek JY, Jang IY, Jung HW, Park SJ, Lee JY, Choi E, Lee YS, Lee E, Kim BJ. Serum irisin level is independent of sarcopenia and related muscle parameters in older adults. Exp Gerontol 2022; 162:111744. [PMID: 35182609 DOI: 10.1016/j.exger.2022.111744] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Accumulating evidence indicates that irisin, a myokine consisting of 112 amino acids, protects against muscle wasting in an autocrine manner; however, its impact on human muscle metabolism is still inconclusive. In this cross-sectional study, we aimed to investigate whether circulating irisin could be a potential biomarker reflecting muscle health in older adults. METHODS Comprehensive assessment of muscle mass; muscle function, including grip strength, gait speed, chair stand test, and short physical performance battery (SPPB); and muscle quality was performed in 143 older adults who visited outpatient geriatrics and endocrinology clinics. Sarcopenia was defined using the Asian-specific cutoff value. Blood samples were also collected to determine serum irisin concentration which was measured using enzyme immunoassay. RESULTS The serum irisin level was not significantly different according to the status of sarcopenia, low muscle mass, weak muscle strength, poor physical performance, and poor muscle quality, before or after adjustment for age, sex, appendicular skeletal muscle (ASM), and body mass index. Consistently, the association of circulating irisin level with sarcopenia-related parameters (skeletal muscle index, grip strength, gait speed, chair stand test, SPPB, and grip strength/body weight or ASM) was not evident in any adjustment models. CONCLUSIONS Despite the clear implication of irisin's involvement in muscle metabolism based on experimental research, we did not observe a definite association between its serum level and clinical muscle parameters in humans. These results suggest that the blood irisin level may not accurately predict the risk of sarcopenia in older adults.
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Affiliation(s)
- Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Eunah Choi
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yun Sun Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
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15
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Noguchi T, Nakagawa T, Komatsu A, Ishihara M, Shindo Y, Otani T, Saito T. Social functions and adverse outcome onset in older adults with mild long-term care needs: A two-year longitudinal study. Arch Gerontol Geriatr 2022; 100:104631. [DOI: 10.1016/j.archger.2022.104631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/24/2022]
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Park H, Lim J, Baek JY, Lee E, Jung HW, Jang IY. Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111083. [PMID: 34769606 PMCID: PMC8583223 DOI: 10.3390/ijerph182111083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 12/16/2022]
Abstract
(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.
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Affiliation(s)
- Hyungchul Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.P.); (J.L.)
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea
| | - Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.P.); (J.L.)
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
- Correspondence: (H.-W.J.); (I.-Y.J.); Tel.: +82-2-3010-1852 (H.-W.J.); +82-2-3010-1658 (I.-Y.J.)
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
- Correspondence: (H.-W.J.); (I.-Y.J.); Tel.: +82-2-3010-1852 (H.-W.J.); +82-2-3010-1658 (I.-Y.J.)
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Pana A, Sourtzi P, Kalokairinou A, Velonaki VS. Sarcopenia and polypharmacy among older adults: A scoping review of the literature. Arch Gerontol Geriatr 2021; 98:104520. [PMID: 34619629 DOI: 10.1016/j.archger.2021.104520] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sarcopenia and polypharmacy are both prevalent conditions in the geriatric population, leading to poor quality of life and adverse outcomes. OBJECTIVE To explore the evidence on the relationship between sarcopenia and polypharmacy and to summarize the findings and the gaps from the existing literature. METHOD A systematic scoping review was conducted between March and May 2021, with no restriction on publication date, using the Arksey and O'Malley framework and reported according to PRISMA-ScR. Four bibliographic databases, PubMed, Web of Science, Scopus, Proquest One Academic, and four sources of gray literature were searched for studies written in English or Greek. Data were extracted quantitatively and using thematic analysis. RESULTS Of the 397 initially retrieved records, 22 studies were finally included in this review, 20 published articles and 2 posters-presentations. Most of the studies used cross-sectional data. The relationship between sarcopenia and polypharmacy should be interpreted on the basis of the definition of polypharmacy, the diagnostic criteria of sarcopenia used, and the population setting. Sarcopenia or risk for sarcopenia are associated with polypharmacy or the number of medications in community-dwelling older adults, regardless of diagnostic criteria used for sarcopenia. CONCLUSION There is an association between sarcopenia or risk for sarcopenia and polypharmacy or the number of medications in community-dwelling older adults but not among residents of nursing homes or inpatients. Specific widely accepted definitions of polypharmacy and sarcopenia, a consensus on the method of sarcopenia assessment, and prospective studies are needed to identify polypharmacy as a potential risk factor for sarcopenia.
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Affiliation(s)
- Anastasia Pana
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece; General Hospital Asklepieio, Voula, Greece.
| | - Panayota Sourtzi
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece
| | - Athina Kalokairinou
- National and Kapodistrian University of Athens, Department of Nursing, Greece
| | - Venetia Sofia Velonaki
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece
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Lim J, Park H, Lee H, Lee E, Lee D, Jung HW, Jang IY. Longitudinal impact of oral health on geriatric syndromes and clinical outcomes in community-dwelling older adults. BMC Geriatr 2021; 21:482. [PMID: 34481482 PMCID: PMC8418721 DOI: 10.1186/s12877-021-02416-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 08/04/2021] [Indexed: 02/03/2023] Open
Abstract
Background Oral health is essential for daily living and plays a pivotal role in overall health conditions and well-being. This study evaluated the impact of self-reported oral health on geriatric conditions, institutionalization, and mortality. Methods This study analyzed the population of the Aging Study of Pyeongchang Rural Area that had undergone geriatric assessments between 2016 and 2017. The oral health status of the participants was determined using three items from the General Oral Health Assessment Index, and the participants were classified into three groups according to the total sum of the scores as good (3), fair (4–7), or poor (8–15). The outcomes were the incidence of geriatric syndromes at 2 years and the composite outcome of mortality and institutionalization. Results Among the 1189 participants, 44.1 % were women, and the mean age of the study population was 75.0 years. Good, fair, and poor oral health were observed in 597 (50.2 %), 406 (34.1 %), and 186 (15.6 %) individuals, respectively. Worsening oral health status was associated with the incidences of various geriatric syndromes at follow-up, and these associations were attenuated after adjusting for baseline demographic and geriatric parameters. Similarly, the significant association between baseline oral health status and the incidence of the composite outcome was attenuated after adjusting for demographic and geriatric parameters. Conclusions Oral health affected the geriatric health conditions in this prospective, longitudinal cohort of community-dwelling older adults. The correlations and interactions of oral health status with other functional parameters may deserve consideration as a geriatric domain. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02416-2.
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Affiliation(s)
- Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hyungchul Park
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Heayon Lee
- Divison of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Jingwan-dong, Eunpyeong-gu, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Danbi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. .,PyeongChang Health Center and County Hospital, 11 Noseong-ro, Pyeongchang-eup, Pyeongchang-gun, Gangwon-do, Gangneung, Republic of Korea.
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Baek JY, Lee E, Oh G, Park YR, Lee H, Lim J, Park H, Park CM, Lee CK, Jung HW, Jang IY, Kim DH. The Aging Study of Pyeongchang Rural Area (ASPRA): Findings and Perspectives for Human Aging, Frailty, and Disability. Ann Geriatr Med Res 2021; 25:160-169. [PMID: 34610665 PMCID: PMC8497940 DOI: 10.4235/agmr.21.0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/05/2022] Open
Abstract
The Aging Study of Pyeongchang Rural Area (ASPRA) is a population-based, prospective cohort study of older adults in Pyeongchang, South Korea. Since the initial enrollment of 382 participants, the ASPRA has been maintained and has conducted comprehensive geriatric assessments annually, gradually expanding its population and coverage area. As a cohort study of aging-related conditions and their functional consequences, the ASPRA leveraged Pyeongchang's relatively low annual population movement rate and its healthcare delivery system, which was largely maintained by community health posts. Since its establishment, the ASPRA has reported numerous observational and multicomponent intervention studies on functional decline, geriatric syndrome, and frailty. Here, we discuss the findings and perspectives of ASPRA studies. We hope that the ASPRA enables the further implementation of a longitudinal study design on geriatric parameters and the development of public health strategies targeting aging-related conditions, especially in resource-limited community settings.
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Affiliation(s)
- Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gahee Oh
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Heayon Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyungchul Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Chan Mi Park
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Chang Ki Lee
- Goldman Urology Clinic, Seoul, Korea
- PyeongChang Health Center & County Hospital, PyeongChang, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- PyeongChang Health Center & County Hospital, PyeongChang, Korea
| | - Dae Hyun Kim
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
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20
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Han SJ, Jung HW, Lee JH, Lim J, do Moon S, Yoon SW, Moon H, Lee SY, Kim H, Lee SR, Jang IY. Clinical Frailty Scale, K-FRAIL questionnaire, and clinical outcomes in an acute hospitalist unit in Korea. Korean J Intern Med 2021; 36:1233-1241. [PMID: 34078037 PMCID: PMC8435508 DOI: 10.3904/kjim.2020.677] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Frailty increases the risks of in-hospital adverse events such as delirium, falls, and functional decline in older adults. We assessed the feasibility and clinical relevance of frailty status in Korean older inpatients using the Clinical Frailty Scale (CFS) and Korean version of the Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (K-FRAIL) questionnaires. METHODS Frailty status was measured using the Korean-translated version of the CFS and K-FRAIL questionnaire within 3 days from admission in 144 consecutive patients aged 60 years or older. The correlation between CFS and K-FRAIL score was assessed. The criterion validity of CFS was assessed using receiver operating characteristic analysis. As outcomes, delirium, bedsore, length of stay (LOS), in-hospital mortality, and unplanned 30-day readmission were measured by reviewing medical records. RESULTS The mean age of the study population was 70.1 years (range, 60 to 91), and 75 (52.1%) were men. By linear regression analysis, CFS and K-FRAIL were positively correlated (B = 0.72, p < 0.001). A CFS cutoff of ≥ 5 maximized sensitivity + specificity to classify frailty using K-FRAIL as a reference (C-index = 0.893). Higher frailty burden by both CFS and K-FRAIL was associated with higher LOS and bedsores. Unplanned readmission and in-hospital mortality were associated with higher CFS score but not with K-FRAIL score, after adjusting for age, gender, polypharmacy, and multimorbidity. CONCLUSION Frailty status by CFS was associated with LOS, bedsores, unplanned readmission, and in-hospital mortality. CFS can be used to screen high-risk patients who may benefit from geriatric interventions and discharge planning in acutely hospitalized older adults.
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Affiliation(s)
- Seung Jun Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Hee-Won Jung
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jae Hyun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Jin Lim
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Sung do Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Sock-Won Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Hongran Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Seo-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Hyeanji Kim
- Regional Emergency Medical Center, Seoul National University Hospital, Seoul,
Korea
| | - Sae-Rim Lee
- Hospital Medicine Center, Seoul National University Hospital, Seoul,
Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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21
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Jung HW, Jang IY, Back JY, Park S, Park CMI, Han SJ, Lee E. Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic. Korean J Intern Med 2021; 36:1242-1250. [PMID: 34503320 PMCID: PMC8435494 DOI: 10.3904/kjim.2020.652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. METHODS The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. RESULTS The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden's J to classify frailty by both the CHS scale and CGAFI. CONCLUSION The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Back
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seunghyun Park
- Department of Health Promotion and Management, National Health Insurance Service, Wonju, Korea
| | - Chan MI Park
- Department of Family Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Seung Jun Han
- Department of Internal Medicine, Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Eunju Lee, M.D. Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3308 Fax: +82-2-2045-4268 E-mail:
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22
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Endo T, Akai K, Kijima T, Kitahara S, Abe T, Takeda M, Nabika T, Yano S, Isomura M. An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: A cross-sectional analysis. PLoS One 2021; 16:e0252784. [PMID: 34292967 PMCID: PMC8297796 DOI: 10.1371/journal.pone.0252784] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/23/2021] [Indexed: 12/12/2022] Open
Abstract
Sarcopenia is intricately related to aging associated diseases, such as neuropsychiatric disorders, oral status, and chronic diseases. Dementia and depression are interconnected and also related to sarcopenia. The preliminary shift from robust to sarcopenia (i.e., pre-sarcopenia) is an important albeit underdiscussed stage and is the focus of this study. Identifying factors associated with pre-sarcopenia may lead to sarcopenia prevention. To separately examine the effects of dementia and depression on pre-sarcopenia/sarcopenia, we conducted multiple analyses. This cross-sectional study used health checkup data from a rural Japanese island. The participants were aged 60 years and above, and the data included muscle mass, gait speed, handgrip strength, oral status (teeth and denture), chronic diseases (e.g., hypertension), dementia (cognitive assessment for dementia, iPad Version), and depression (self-rating depression scale). A total of 753 older adult participants were divided into the sarcopenia (n = 30), pre-sarcopenia (n = 125), and robust (n = 598) groups. An ordered logit regression analysis indicated that age and depression were positively correlated with sarcopenia, while hypertension was negatively associated with it. A multiple logistic regression analysis between the robust and pre-sarcopenia groups showed significant associations between the same three variables. Depression was associated with pre-sarcopenia, but not dementia. There was also a significant association between hypertension and pre-sarcopenia. Further research is needed to reveal whether the management of these factors can prevent sarcopenia.
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Affiliation(s)
- Takeshi Endo
- Division of Internal Medicine, Unnan City Hospital, Shimane, Japan
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- * E-mail:
| | - Kenju Akai
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Tsunetaka Kijima
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of General Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | | | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of Functional Pathology Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of Laboratory Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Shimane University Faculty of Human Sciences, Shimane, Japan
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Baek JY, Lee E, Kim WJ, Jang IY, Jung HW. A Cumulative Muscle Index and Its Parameters for Predicting Future Cognitive Decline: Longitudinal Outcomes of the ASPRA Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147350. [PMID: 34299801 PMCID: PMC8303449 DOI: 10.3390/ijerph18147350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022]
Abstract
Sarcopenia and cognitive decline share the major risk factors of physical inactivity; previous studies have shown inconsistent associations. We aimed to identify the association of sarcopenia and its parameters with cognitive decline. The 3-year longitudinal outcomes of 1327 participants from the Aging Study of the Pyeongchang Rural Area (ASPRA) cohort were analyzed. Cognitive performance was evaluated using the Mini-Mental State Examination (MMSE), and sarcopenia was defined by the following: the original and revised Asian Working Group for Sarcopenia (AWGS), the original and revised European Working Group on Sarcopenia in Older People (EWGSOP), and the Cumulative Muscle Index (CMI), a novel index based on the number of impaired domains of sarcopenia. Approximately half of the participants showed meaningful cognitive decline. Sarcopenia by the original EWGSOP and the CMI were associated with cognitive decline. Only the CMI showed consistent predictability for cognitive impairment even with different criteria of the MMSE score (OR 1.23 [1.04-1.46]; OR 1.34 [1.12-1.59]; OR 1.22 [1.01-1.49], using the 1, 2, and 3 cut-off value, respectively). Of the CMI parameters, gait speed was satisfactorily predictive of 3-year cognitive impairment (OR 0.54 [0.30-0.97]). In conclusion, sarcopenia based on the CMI may be predictive of future cognitive impairment. Gait speed was the single most important indicator of cognitive decline.
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Affiliation(s)
- Ji-Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.B.); (E.L.)
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.B.); (E.L.)
| | - Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea;
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.B.); (E.L.)
- Correspondence: (I.-Y.J.); (H.-W.J.); Tel.: +82-2-3010-1658 (I.-Y.J.); +82-2-3010-1852 (H.-W.J.)
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.B.); (E.L.)
- Correspondence: (I.-Y.J.); (H.-W.J.); Tel.: +82-2-3010-1658 (I.-Y.J.); +82-2-3010-1852 (H.-W.J.)
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Baek JY, Lee E, Jung HW, Jang IY. Geriatrics Fact Sheet in Korea 2021. Ann Geriatr Med Res 2021; 25:65-71. [PMID: 34187140 PMCID: PMC8272996 DOI: 10.4235/agmr.21.0063] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/25/2021] [Indexed: 11/01/2022] Open
Abstract
South Korea became an aged society in 2017 and is predicted to become a super-aged society by 2025. Therefore, knowing the trends among older adults and identifying the geriatric burden are crucial for both healthcare professionals and policymakers. We previously summarized the general health and socioeconomic profiles of Korean older adults from the 2017 National Survey of Living Conditions and Welfare Needs of Older Koreans. In this update, we briefly summarized the results of the 2020 National Survey of Living Conditions and Welfare Needs of Older Koreans by categorizing them according to their general aging profile, socioeconomic status, lifestyle, and health status. In addition, we reviewed recent updates in the field of frailty and sarcopenia from population-based community cohorts in Korea. We hope this study will serve as a current reference for nationwide statistical data on common clinical and social parameters used in geriatrics and gerontology.
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Affiliation(s)
- Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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25
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Lee H, Chong J, Jung HW, Baek JY, Lee E, Jang IY. Association of the FRAIL Scale with Geriatric Syndromes and Health-Related Outcomes in Korean Older Adults. Ann Geriatr Med Res 2021; 25:79-85. [PMID: 33975422 PMCID: PMC8273001 DOI: 10.4235/agmr.20.0095] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/05/2021] [Indexed: 01/03/2023] Open
Abstract
Background Owing to the growing older population, appropriate tools are needed for frailty screening in community-dwelling older people. We investigated the association between geriatric conditions and health-related outcomes using the five-item Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight (FRAIL) scale in a Korean rural community setting. Methods We performed comprehensive geriatric assessments, including the FRAIL scale, in 1,292 community-dwelling people (mean age, 74.6 years) in the Aging Study of Pyeongchang Rural Area. These populations were prospectively followed up for 3 years to analyze the outcomes of death, institutionalization, disability, and quality of life. We investigated the association between frailty status and outcomes using the FRAIL scale. Results According to the FRAIL scale, 524 (36.5%) participants were prefrail and 297 (23.0%) were frail. According to the adjusted model, the degree of frailty status was significantly associated with concurrent geriatric syndromes and 3-year incidences of mortality, institutionalization, and disability; Kaplan–Meier analysis showed significant differences in 3-year survival based on frailty status (92.6% for robust, 85.7% for prefrail, and 74.2% for frail; log-rank p<0.001). Conclusion The five-item FRAIL scale can be used to screen for accompanying geriatric syndromes and is associated with the 3-year health-related outcomes in community-dwelling Korean older adults. From the public health perspective, this simple screening tool for frailty assessment might be applicable to older populations in Korea.
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Affiliation(s)
- Heayon Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Junyong Chong
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Pyeongchang Health Center & Country Hospital, Gangwon-do, Korea
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26
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Choi H, Hong N, Park N, Kim CO, Kim HC, Choi JY, Youm Y, Rhee Y. Computed Tomography-Derived Skeletal Muscle Radiodensity Predicts Peak Weight-Corrected Jump Power in Older Adults: The Korean Urban Rural Elderly (KURE) Study. Calcif Tissue Int 2021; 108:764-774. [PMID: 33566115 DOI: 10.1007/s00223-021-00812-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/16/2021] [Indexed: 01/06/2023]
Abstract
Computed tomography (CT)-derived skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) reflect distinctive quantitative and qualitative characteristics of skeletal muscles. However, data on whether CT-based muscle parameters, especially SMD, can predict muscle function is limited. In a prospective cohort, 1523 community-dwelling older adults who underwent abdominal CT scans and the countermovement two-legged jumping test on a ground reaction force platform were analyzed (mean age 74.7 years, 65.1% women). SMA and SMD were measured at third lumbar vertebra level (L3). Individuals with low jump power (peak weight-corrected jump power < 23.8 W/kg in men and < 19.0 W/kg in women using clinically validated threshold) were older; had lower SMA, SMD, and maximal grip strength values; and had lower chair rise test and timed up and go test performance than those without low jump power. SMD was positively associated with peak weight-corrected jump power (adjusted β = 0.33 and 0.23 per 1 HU increase in men and women, respectively, p < 0.001). One HU decrement in SMD was associated with 10% elevated odds of low jump power (adjusted OR [aOR] 1.10, p < 0.001) after adjusting for age, sex, height, inflammation, and insulin resistance markers, whereas the association of SMA with low jump power was attenuated (aOR 1.00, p = 0.721). SMD showed better discrimination for low jump power than SMA (AUC 0.699 vs. 0.617, p < 0.001), with additional improvement when added to SMA and conventional risk factors (AUC 0.745 to 0.773, p < 0.001). Therefore, CT-measured L3 SMD can be a sensitive surrogate marker for muscle function along with SMA in older adults, which merits further investigation.
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Affiliation(s)
- Heewon Choi
- Yonsei University College of Medicine, Seoul, South Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Narae Park
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Choi
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Jung HW, Park JH, Kim DA, Jang IY, Park SJ, Lee JY, Lee S, Kim JH, Yi HS, Lee E, Kim BJ. Association between serum FGF21 level and sarcopenia in older adults. Bone 2021; 145:115877. [PMID: 33571698 DOI: 10.1016/j.bone.2021.115877] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND With emerging basic research evidence suggesting that fibroblast growth factor (FGF) 21 is a catabolic molecule on muscle metabolism, we aimed to analyze the serum FGF21 level in relation to sarcopenia in older adults. METHODS Blood samples were collected from 125 participants who underwent evaluation for muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related components were determined using cutoff values for the Asian population. The serum FGF21 level was measured using enzyme linked immunosorbent assay. RESULTS After controlling for age, sex, and body mass index (BMI), participants with sarcopenia, low muscle mass, and weak muscle strength had 2.3-, 2.0-, and 1.5-fold higher serum FGF21 levels than controls, respectively (p = .033 to <0.001). The serum FGF21 level was positively correlated with sarcopenia phenotype score and inversely correlated with skeletal muscle mass index and grip strength by both crude and multivariate analysis adjusting potential confounders (p = .017 to <0.001). Consistently, higher serum FGF21 level was significantly associated with increased odds for sarcopenia, low muscle mass, and low muscle strength after adjusting for age, sex, and BMI (odds ratio, 1.53-2.61; p = .048 to <0.001). CONCLUSIONS Higher circulating FGF21 was associated with the likelihood of sarcopenia, lower muscle mass, and worse grip strength in older adults, supporting a potential catabolic role of FGF21 on human muscle health.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Hyon-Seung Yi
- Department of Medical Science, Chungnam National University School of Medicine, 99 Daehak-ro, Yuseong-gu, Daejeon, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
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Jung HW, Baek JY, Jang IY, Guralnik JM, Rockwood K, Lee E, Kim DH. Short Physical Performance Battery as a crosswalk between frailty phenotype and deficit-accumulation frailty index. J Gerontol A Biol Sci Med Sci 2021; 76:2249-2255. [PMID: 33780526 DOI: 10.1093/gerona/glab087] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Growing evidence supports clinical importance of evaluating frailty in older adults, with its strong outcome relevance. We aimed to assess whether the Short Physical Performance Battery (SPPB) correlates with frailty status according to phenotype and deficit accumulation models and can be used as a link between these models. METHODS We analyzed records of 1064 individuals from the Aging Study of Pyeongchang Rural Area, a population-based, prospective cohort from South Korea. Frailty was determined using the Cardiovascular Health Study (CHS) phenotype (phenotype model), 26- and 34-item frailty indice (deficit accumulation model). Associations of SPPB score and frailty with a composite outcome of mortality or long-term institutionalization were assessed. Crosswalks for SPPB, the CHS frailty phenotype and the frailty index were created. RESULTS The mean age of the study population was 76.0 years, and 583 (54.8%) were women. According to the CHS phenotype, 26- and 34-item frailty index, 242 (22.7%), 161 (15.1%) and 280 (26.3%) participants, respectively, had frailty. Sensitivities/specificities for classifying CHS phenotype, 26- and 34- item frailty indices were 0.93/0.55, 0.71/0.84 and 0.80/0.83 by SPPB cut points of ≤9, ≤6 and ≤7, respectively. C-index of SPPB score (0.78) showed a predictive ability for the composite outcome that was comparable to that of CHS frailty phenotype (0.79), 26- (0.78) and 34-item frailty index (0.79). CONCLUSION We could create a crosswalk linking frailty phenotype and frailty index from correlations between SPPB and frailty models. This result may facilitate clinical adoption of the frailty concept in broader spectrum of older adults.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jack M Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kenneth Rockwood
- Divisions of Geriatric Medicine & Neurology Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dae Hyun Kim
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Lim J, Park H, Lee H, Lee E, Lee D, Jung HW, Jang IY. Higher frailty burden in older adults with chronic constipation. BMC Gastroenterol 2021; 21:137. [PMID: 33765938 PMCID: PMC7995705 DOI: 10.1186/s12876-021-01684-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background Despite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults. Methods This is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype. Results In the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity. Conclusions Frailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01684-x.
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Affiliation(s)
- Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hyungchul Park
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Heayon Lee
- Divison of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Jingwan-dong, Eunpyeong-gu, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Danbi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,PyeongChang Health Center and County Hospital, 11 Noseong-ro, Pyeongchang-gun, Gangwon-do, Republic of Korea.
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Lower Serum n-3 Fatty Acid Level in Older Adults with Sarcopenia. Nutrients 2020; 12:nu12102959. [PMID: 32992568 PMCID: PMC7600475 DOI: 10.3390/nu12102959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 11/25/2022] Open
Abstract
The n-3 fatty acid (FA) has evoked considerable interest as a modifiable factor for maintenance of muscle health owing to its anti-inflammatory properties. To clarify this possibility, we investigated circulating n-3 FA level, a reliable biomarker of FA status in the body, in relation to sarcopenia in a cohort of Asian older adults. Blood samples were collected from 125 participants who underwent comprehensive assessment of muscle mass and function. Serum FA level was measured by gas chromatography/mass spectrometry. Sarcopenia was diagnosed using the cut-off points specified for the Asian population. After adjusting for sex, age, and body mass index, subjects with sarcopenia and those with low muscle strength had 36.5% and 32.4% lower serum n-3 levels (P = 0.040 and 0.030), respectively, than controls. The odds ratios per standard deviation increment in serum n-3 level for sarcopenia and low muscle strength were 0.29 and 0.40 (P = 0.015 and 0.028), respectively. A higher serum n-3 level was significantly associated with greater muscle strength (P = 0.038). These findings suggest a possible protective effect of n-3 FA on human muscle homeostasis. Further well-designed large-scale longitudinal studies are necessary to understand the definite role of circulating n-3 FA level in sarcopenia risk assessment.
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Nakamura T, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Ichikawa T, Yamashita M, Maekawa E, Reed JL, Noda C, Meguro K, Yamaoka-Tojo M, Matsunaga A, Ako J. Quadriceps Strength and Mortality in Older Patients With Heart Failure. Can J Cardiol 2020; 37:476-483. [PMID: 32622879 DOI: 10.1016/j.cjca.2020.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study was performed to test the hypothesis that low quadriceps isometric strength (QIS) is associated with greater risk of mortality and has the additive prognostic significance to the severity of heart failure (HF) and gait speed in older patients with HF. METHODS A retrospective cohort study was performed in 1273 patients ≥ 60 years of age with HF (mean age 75 ± 8 years, 59.1% men); all of whom were evaluated during hospitalization for usual gait speed and maximal QIS. The QIS was expressed relative to body mass (% BM). The endpoint was all-cause mortality. RESULTS Over a median follow-up period of 1.59 years (interquartile range, 0.58 to 3.42 years), 224 patients died. The cutoff value based on the Youden index for the QIS discriminating those at high risk of mortality was 36.2% BM for overall, and we defined less than this cutoff point of QIS as low QIS. After adjustment for the HF risk score, the hazard ratio in low QIS was 1.55 for overall (95% confidence interval [CI], 1.17-2.06). The addition of low QIS to the HF risk score and gait speed was associated with significant increases in both net reclassification improvement (NRI, 0.239 for overall; 95% CI, 0.096-0.381) and integrated discrimination improvement (IDI, 0.004 for overall; 95% CI, 0.001-0.009) for all-cause mortality. CONCLUSION Low QIS was strongly associated with poor prognosis and showed complementary prognostic predictive capability to the HF risk score and gait speed in older patients with HF.
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Affiliation(s)
- Takeshi Nakamura
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Juntendo University Hospital, Tokyo, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Chiharu Noda
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kentaro Meguro
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Jang I, Lee E, Lee H, Park H, Kim S, Kim K, Jung H, Kim DH. Characteristics of sarcopenia by European consensuses and a phenotype score. J Cachexia Sarcopenia Muscle 2020; 11:497-504. [PMID: 31863645 PMCID: PMC7113507 DOI: 10.1002/jcsm.12507] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to assess the clinical characteristics of sarcopenia by the original and revised European Working Group on Sarcopenia in Older People (EWGSOP 1 and 2), and to propose a new sarcopenia phenotype score (SPS) to improve relevance of clinical outcomes. METHODS Analyses were performed in 1408 older adults of the Aging Study of PyeongChang Rural Area, a community-based cohort in Korea. For sarcopenia definitions, we used EWGSOP 1, EWGSOP 2, and SPS, a new index counting number of abnormal domains among components of grip strength, gait speed, or muscle mass. Frailty status by the frailty index and the Cardiovascular Health Study frailty score was compared with sarcopenia measures. Prediction ability for composite outcome combining death and institutionalization due to functional decline was assessed among sarcopenia measures. RESULTS Generally, sarcopenia spectrum by both EWGSOP 1 and 2 was associated with worse functional status in parameters of geriatric assessments. However, population who were considered as sarcopenic by EWGSOP 1, but not by EWGSOP 2, showed increased risk of composite outcome and worse frailty status, compared with people who were classified as not sarcopenic by both EWGSOP 1 and 2. With SPS, dose-response relationship was observed with both frailty status and outcome prediction. Prediction for composite outcome was better in SPS than in EWGSOP 2 classification. CONCLUSIONS A new SPS might be used to classify sarcopenic burden in older adults to resolve possible inconsistencies in phenotype correlation and outcome prediction of EWGSOP 2 criteria.
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Affiliation(s)
- Il‐Young Jang
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
- PyeongChang Health Center and County HospitalPyeongChangGangwon‐DoRepublic of Korea
| | - Eunju Lee
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Heayon Lee
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Hyungchul Park
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sunyoung Kim
- Department of Family MedicineKyung Hee University Medical CenterSeoulRepublic of Korea
| | - Kwang‐il Kim
- Division of Geriatrics, Department of Internal MedicineSeoul National University Bundang HospitalRepublic of Korea
| | - Hee‐Won Jung
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
| | - Dae Hyun Kim
- Marcus Institute for Aging ResearchHebrew Senior LifeBostonMAUSA
- Division of Gerontology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMAUSA
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Jung HW. Visualizing Domains of Comprehensive Geriatric Assessments to Grasp Frailty Spectrum in Older Adults with a Radar Chart. Ann Geriatr Med Res 2020; 24:55-56. [PMID: 32743323 PMCID: PMC7370779 DOI: 10.4235/agmr.20.0013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Hee-Won Jung
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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