Leisure-time physical activity and sarcopenia among older adults from low- and middle-income countries

Meta analysis of the influencing factors of sarcopenia in patients with Crohn's disease

OBJECTIVE

To conduct a meta-analysis of the factors influencing sarcopenia in patients with Crohn's disease and provide evidence-based findings for early clinical detection and prevention.

METHODS

The study was registered on PROSPERO(CRD42023470300). A systematic review was performed on literature pertaining to sarcopenia in patients with Crohn's disease utilizing eight Chinese and English databases, which consist of CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, and The Cochrane Library. The search was carried out from the inception of each database until October 8, 2023. Data analysis was carried out using the Stata 14.0 software.

RESULTS

A total of 603 Chinese and English literature sources were reviewed, and following the application of the inclusion and exclusion criteria, 9 articles were selected. These 9 articles take into account a total of 22 factors that may influence the occurrence of sarcopenia in Crohn's disease patients. The results of the meta-analysis demonstrate that gender (OR=5.49, 95% CI [2.08,14.51]), BMI (OR=0.77, 95% CI [0.62,0.95]), age (OR=1.03, 95% CI [1.01,1.05]), and low albumin levels (OR=1.08, 95% CI [1.01,1.15]) have significant impacts on the emergence of sarcopenia in patients with Crohn's disease.

CONCLUSIONS

The occurrence of sarcopenia in Crohn's disease patients is mainly influenced by gender, BMI, age, and low albumin levels. Additional factors that may influence the condition require further research to verify.

Skeletal muscle mass and kidney function among Chinese older adults: a cross-sectional study

OBJECTIVES

To assess the association between kidney function and odds of having low skeletal muscle mass (LSMM) in Chinese adults on the basis of a community study.

DATA AND METHODS

In this cross-sectional study, we included 3726 Chinese older persons who participated in an ongoing prospective study, the China Health and Retirement Longitudinal Study(CHARLS). Fasting blood samples were collected in 2012 and analyzed for serum creatinine. Estimated glomerular filtration rate(eGFR) was computed using serum creatinine, gender, and age, according to the 2021 race-free Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). We classified the target population into three categories according to eGFR (normal eGFR;90mL/min/1.73m2, mildly-impaired eGFR;60 to < 90 mL/min/1.73 m2, moderate to severve impaired eGFR;<60 mL/min/1.73 m2). BMI-adjusted muscle mass was used to measure skeletal muscle mass.The association between eGFR(per interquartile range(IQR) increment) and the risk of low skeletal muscle mass was assessed using logistic regression model.

RESULTS

Worsening renal function was associated with being high risk for LSMM after adjusting for potential confounders:the odds ratios (ORs) 95% confidence intervals (CIs) were 0.76 (95% CI = 0.63 - 0.88) for male, and [0.71, (0.61-0.82)]in female, p < 0.001. Specifically, male participants with mildly renal impairment were more prone to develop LSMM (multiadjusted OR, 1.43, 95% CI(0.92 to 2.09), p = 0.1) than femal(multiadjusted OR, 1.32, 95% CI(0.85 to 2.00), p = 0.2), the gender difference was not significant in severe renal dysfunction.However, there was a non-linear relationship between eGFR(per IQR increment) and risk of LSMM(eGFR/IQR =5.42, knot = 4 OR =1, p for non-linear <0.001).

CONCLUSIONS

Lower levels of eGFR had a high likelihood of being high risk for LSMM. Older male patients with mildly renal insufficiency are more likely to experience a decrease in skeletal muscle mass compared to female.

Sarcopenia risk in U.S. younger adults: the impact of physical activity intensity and occupational engagement-insights from a cross-sectional NHANES study

OBJECTIVE

This study aimed to investigate the associations between physical activity (PA) intensity, occupational PA engagement, and sarcopenia in younger adults.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) (from 2011 to 2018) were used for the study. PA data were extracted for the Global Physical Activity Questionnaire, and the ratio of limb muscle mass (ALM) to body mass index (BMI) was used to determine sarcopenia. Multiple logistic regression was performed, and dose-response curves were drawn to evaluate the associations.

RESULTS

Of the 8802 adults aged 20 to 59 years, 770 (8.7%) were identified as having sarcopenia. Compared to those in the reference group, the participants in the "low", "moderate", and "high" total METs groups had lower risks of sarcopenia (low: OR = 0.730, 95% CI = 0.583; 0.915; moderate: OR = 0.643, 95% CI = 0.485; 0.853; high: OR = 0.560, 95% CI = 0.457; 0.687). The risk of sarcopenia decreased in the high-intensity recreational PA group; however, such a significant association was observed only in the high-intensity occupational PA group. The relationship between total METs and sarcopenia showed a nonlinear U-shaped trend.

CONCLUSIONS

A greater intensity of PA is associated with a lower risk of sarcopenia among younger adults, regardless of whether moderate or vigorous PA is performed. Moreover, recreational PA may particularly advantageously contrast with occupational PA in lowering the risk of sarcopenia.

Associations between meeting 24-h movement guidelines and sarcopenia risk among adults aged ≥ 55 years in five low- and middle-income countries

OBJECTIVE

To diminish the negative influence of sarcopenia on senior adults, the study aimed to investigate the association between adherence to 24-h movement behavior guidelines (physical activity, sedentary behavior, sleep duration) and the risk of sarcopenia among individuals aged ≥55 years in five low- and middle-income countries (LMICs).

METHODS

A total of 16,503 adults aged ≥55 years were included in this cross-sectional study. The study utilized data from Global Aging and Adult Health Survey (SAGE). Participants reported their information about physical activity, sedentary behavior, and sleep duration using the questionnaire. Sarcopenia was identified as low skeletal muscle mass with a diminished gait speed or weakened handgrip strength. Multiple logistic regression models were used to investigate the association between adherence to 24-h movement behavior guidelines and the risk of sarcopenia.

RESULTS

Merely 32.73 % of participants met all three 24-h movement behavior guidelines (physical activity, less sedentary behavior, sleep). Meeting all three guidelines (p < 0.01) was significantly associated with a lower risk of sarcopenia. Meeting physical activity only (p < 0.05), or meeting both physical activity and sedentary behaivor (p < 0.05), or meeting both physical activity and sleep duration (p < 0.01) guidelines were also associated with a reduced risk of sarcopenia. Moreover, adults aged 65+ years who adhered to 24-h movement behavior guidelines exhibited a significantly reduced risk of developing sarcopenia.

CONCLUSION

The findings suggest that the adherence to 24-h movement behavior guidelines for regular physical activity, limited sedentary behavior, and sufficient sleep duration was associated with a reduced risk of sarcopenia in adults aged ≥55 years in five LMICs.

More Movement, Less Bodily Pain? Findings From a Large, Representative Multi-District Aging Study in Ghana

OBJECTIVE

The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association.

DESIGN

We used a quantitative cross-sectional study design.

SETTING AND PARTICIPANTS

Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used.

METHODS

PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations.

RESULTS

The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%).

CONCLUSIONS AND IMPLICATIONS

Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.

Association between sedentary behavior and dynapenic abdominal obesity among older adults from low- and middle-income countries

BACKGROUND

Sedentary behavior, or time spent sitting, may increase risk for dynapenic abdominal obesity (DAO), but there are currently no studies on this topic.

AIMS

Therefore, we investigated the association between sedentary behaviour and DAO in a nationally representative sample of older adults from six low- and middle-income countries.

METHODS

Cross-sectional data from the Study on Global AGEing and Adult Health were analysed. Dynapenia was defined as handgrip strength < 26 kg for men and < 16 kg for women. Abdominal obesity was defined as waist circumference of > 88 cm (> 80 cm for Asian countries) for women and > 102 cm (> 90 cm) for men. DAO was defined as having both dynapenia and abdominal obesity. Self-reported sedentary behavior was categorized as ≥ 8 h/day (high sedentary behaviour) or < 8 h/day. Multivariable multinomial logistic regression was conducted.

RESULTS

Data on 20,198 adults aged ≥ 60 years were analyzed [mean (SD) age 69.3 (13.1) years; 54.1% females]. In the overall sample, ≥ 8 h of sedentary behavior per day (vs. <8 h) was significantly associated with 1.52 (95%CI = 1.11-2.07) times higher odds for DAO (vs. no dynapenia and no abdominal obesity), and this was particularly pronounced among males (OR = 2.27; 95%CI = 1.42-3.62). Highly sedentary behavior was not significantly associated with dynapenia alone or abdominal obesity alone.

DISCUSSION

High sedentary behaviour may increase risk for DAO among older adults.

CONCLUSIONS

Interventions to reduce sedentary behaviour may also lead to reduction of DAO and its adverse health outcomes, especially among males, pending future longitudinal research.

Associations of physical activity intensity, frequency, duration, and volume with the incidence of sarcopenia in middle-aged and older adults: a 4-year longitudinal study in China

BACKGROUND

Physical activity (PA) plays an important role in the process of several chronic diseases. It may be also associated with the incidence of sarcopenia. This study aimed to determine the association of PA from different components including frequency, duration, intensity, and volume with the incidence of sarcopenia in middle-aged and older adults.

METHODS

This study used data from the China Health and Retirement Longitudinal Study in 2011 and 2015. A total of 3,760 individuals aged ≥ 40 years were involved in this study. Sarcopenia was diagnosed using muscle mass, strength and physical performance according to the Asian Working Group for Sarcopenia. PA information including frequency, duration, intensity, and volume was obtained by a self-reported questionnaire. Logistic regression analysis was employed to examine the association between PA and the incidence of sarcopenia at 4-year follow-up.

RESULTS

The incidence of sarcopenia was 5.9% during the 4-year follow-up. Compared to sedentary individuals, those taking 1-2 days or more per week, or a minimum of 10 min each time on vigorous-intensity PA (VPA) had a lower incidence of sarcopenia. Adults spending 3 days or more each week, a minimum of 30 min each time, or 150 min or more per week on moderate-intensity PA (MPA) had a lower presence of sarcopenia than sedentary adults. Adults taking 3 days or more per week, at least 30 min each time, or 150 min or more each week on light-intensity PA (LPA) tended to have a lower incidence of sarcopenia than sedentary individuals. Sensitivity analyses confirmed the robustness of the findings after removing persons with hypertension, dyslipidemia, or diabetes.

CONCLUSIONS

These findings suggest that the frequency, duration, and volume of VPA or MPA are negatively associated with the presence of sarcopenia. Participation in LPA tends to have a lower incidence of sarcopenia in middle-aged and older adults.

Prevalence of sarcopenia in Africa: a systematic review and meta-analysis of observational studies

BACKGROUND

Existing literature suggests that sarcopenia is a highly prevalent condition in older people. However, most studies to date reporting data on its prevalence have been mainly carried out in Western countries, while data on sarcopenia in Africa is scarce. With this systematic review and meta-analysis, we aimed to determine the prevalence of sarcopenia in African countries and to explore potential factors that could explain higher or lower prevalence of this condition in Africa.

METHODS

Major databases for studies reporting data on sarcopenia in African countries were searched from inception to June 2023. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of sarcopenia in Africa, applying a random effect model. Several sensitivity and meta-regression analyses were run.

RESULTS

Among 147 articles initially screened, six articles (with seven cohorts) including a total of 10,656 participants were included. Mean age of participants was 66.9 years, and the majority were female (58.1%). The weighted prevalence of sarcopenia in the selected countries of Africa was 25.72% (95%CI: 18.90-32.55). This outcome was characterized by a high heterogeneity (I2 = 99%) and by publication bias. Among the factors investigated, sarcopenia was lower when assessed using only one anthropometric measure, or in South Africa.

CONCLUSION

Sarcopenia is a prevalent condition in Africa and thus research regarding this topic is a public health priority. Future studies that cover African countries for which data are not available and using standardized criteria are needed.

Unraveling the causes of sarcopenia: Roles of neuromuscular junction impairment and mitochondrial dysfunction

Sarcopenia is a systemic skeletal muscle disease characterized by a decline in skeletal muscle mass and function. Originally defined as an age-associated condition, sarcopenia presently also encompasses muscular atrophy due to various pathological factors, such as intensive care unit-acquired weakness, inactivity, and malnutrition. The exact pathogenesis of sarcopenia is still unknown; herein, we review the pathological roles of the neuromuscular junction and mitochondria in this condition. Sarcopenia is caused by complex and interdependent pathophysiological mechanisms, including aging, neuromuscular junction impairment, mitochondrial dysfunction, insulin resistance, lipotoxicity, endocrine factors, oxidative stress, and inflammation. Among these, neuromuscular junction instability and mitochondrial dysfunction are particularly significant. Dysfunction in neuromuscular junction can lead to muscle weakness or paralysis. Mitochondria, which are plentiful in neurons and muscle fibers, play an important role in neuromuscular junction transmission. Therefore, impairments in both mitochondria and neuromuscular junction may be one of the key pathophysiological mechanisms leading to sarcopenia. Moreover, this article explores the structural and functional alterations in the neuromuscular junction and mitochondria in sarcopenia, suggesting that a deeper understanding of these changes could provide valuable insights for the prevention or treatment of sarcopenia.

Mobility limitations and emotional dysfunction in old age: The moderating effects of physical activity and social ties

BACKGROUND

This study aims to examine the association between mobility limitations and emotional dysfunction among older Ghanaians and evaluate the buffering effect of physical activity (PA) and social ties in this association.

METHODS

The analysis included 1201 adults aged ≥50 from the 2016-17 Aging, Health, Psychological Well-being, and Health-seeking Behavior study. The Medical Outcomes Study Short Form-36 (MOS SF-36) assessed mobility limitations and emotional dysfunction. We measured PA using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Hierarchical OLS regressions were performed to evaluate the hypothesized direct and interactive relationships.

RESULTS

The mean age of the sample was 66.2 (SD = 11.9), and 63.3% were women. After full adjustment for potential confounders, OLS regressions found that mobility limitations increased the risk of emotional dysfunction (β = 0.113, p = 0.004). Moreover, social ties (β = -0.157, p < 0.001) and PA (β = -0.096, p < 0.001) were independently and negatively associated with emotional dysfunction. We finally found a significant effect modification of the association of mobility limitations with emotional dysfunction by PA (β = -0.040, p < 0.002) and social ties (β = -0.013, p = 0.013).

CONCLUSIONS

Mobility-enhancing strategies such as engagement in positive behavioral choices, focusing on regular PA, and maintaining resourceful interpersonal social networks can mitigate the impact of mobility limitations on emotional dysfunction in later life.

Psychometric performance of the Kannada version of sarcopenia quality of life questionnaire (SarQoL®)

BACKGROUND

The Sarcopenia Quality of Life (SarQoL®) is a patient reported quality-of-life questionnaire specific to sarcopenia. In the Indian context, its availability is limited to Hindi, Marathi and Bengali vernacular languages.

AIMS

This study aimed to translate, cross-culturally adapt the SarQoL® questionnaire into Kannada and investigate its psychometric properties.

METHODS

The SarQoL®-English version was translated into Kannada with the developer's permission and in accordance with their requirements. To validate the discriminative power, internal consistency and floor and ceiling effect of the SarQoL®-Kannada questionnaire were assessed in the first step. In the second step, the construct validity and the test-retest reliability of the SarQoL®-Kannada was determined.

RESULT

There was no difficulty in the translation process. A total of n = 114 participants (sarcopenic participants n = 45 and n = 69 non-sarcopenic participants) were included. The good discriminative power of the SarQoL®-Kannada questionnaire {quality of life for sarcopenic subjects [56.43 ± 11.32] vs. non-sarcopenic ones [79.38 ± 8.16], p < 0.001}. High internal consistency (Cronbach's alpha coefficient was 0.904) and no ceiling/ floor effect were reflected. Excellent test-retest reliability (intraclass correlation coefficient was 0.97, 95% CI 0.92-0.98) were found. A good convergent and divergent validity with similar and different domains of WHOQOL-BREF was observed, while EQ-5D-3L had good convergent and weak divergent validity.

CONCLUSION

The SarQoL®-Kannada questionnaire is valid, consistent and reliable for the measurement of quality of life of sarcopenic participants. SarQoL®-Kannada questionnaire is now available to be used in clinical practice and as a treatment outcome indicator in research.