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Şenoymak İ, Egici MT, Şenoymak MC. Sarcopenia and Associated Factors in Adults Aged 40 and Above: A Study Conducted in Primary Healthcare. Cureus 2024; 16:e67618. [PMID: 39310536 PMCID: PMC11416839 DOI: 10.7759/cureus.67618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 09/25/2024] Open
Abstract
INTRODUCTION Sarcopenia, characterized by progressive skeletal muscle loss, has emerged as a significant public health concern, with a global prevalence of 10-27%. While traditionally studied in geriatric populations, recent evidence indicates its impact on individuals aged 40 and above, with early manifestations of muscle decline. Primary care settings play a pivotal role in the early identification and management of sarcopenia, facilitating timely diagnosis and intervention. This study aims to evaluate the prevalence of sarcopenia and its associated factors among individuals aged 40 and above attending a family medicine outpatient clinic. METHODS A cross-sectional study was conducted in a family medicine outpatient clinic, including participants aged 40 and above. Participants underwent handgrip strength measurements, calf circumference measurements, and a 4-m walking test. Based on the criteria of the European Working Group on Sarcopenia in Older People 2 (EGSWOP2), individuals with sarcopenia and those at risk of sarcopenia were identified. The Mini Nutritional Assessment (MNA) was used to assess nutritional status. Sociodemographic characteristics, comorbidities, and laboratory values were recorded. A comparison was made between individuals with normal muscle strength and those at risk of sarcopenia. RESULTS Among 213 individuals, 33 (15.4%) were at risk of sarcopenia (probable sarcopenia), and 12 (5.6%) were diagnosed with sarcopenia. There was a negative correlation observed between age and muscle strength (r=-0,339, p<0,001), and positive correlation was found between muscle strength and MNA score (r=0.301, p<0.001). Individuals with higher education and income levels exhibited higher muscle strength. Participants at risk of sarcopenia had higher prevalence rates of comorbidities such as diabetes mellitus (DM), chronic kidney disease, and cardiovascular disease (p=0.20, p<0.01, p=0.015, respectively). CONCLUSION Our study highlights the prevalence and associated factors of sarcopenia in individuals aged 40 and above emphasizing the need for screening and intervention strategies in primary care settings. The study findings support the role of primary care in addressing sarcopenia and improving patient outcomes.
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Affiliation(s)
- İrem Şenoymak
- Family Medicine, Uskudar State Hospital, Istanbul, TUR
| | - Memet T Egici
- Family Medicine, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, TUR
| | - Mustafa C Şenoymak
- Endocrinology and Metabolism, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, TUR
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2
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de Jong JCBC, Caspers MPM, Worms N, Keijzer N, Kleemann R, Menke AL, Nieuwenhuizen AG, Keijer J, Verschuren L, van den Hoek AM. Translatability of mouse muscle-aging for humans: the role of sex. GeroScience 2024; 46:3341-3360. [PMID: 38265577 PMCID: PMC11009184 DOI: 10.1007/s11357-024-01082-7] [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: 11/06/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024] Open
Abstract
Muscle-aging drives sarcopenia and is a major public health issue. Mice are frequently used as a model for human muscle-aging, however, research investigating their translational value is limited. In addition, mechanisms underlying muscle-aging may have sex-specific features in humans, but it is not yet assessed whether these are recapitulated in mice. Here, we studied the effects of aging on a functional, histological and transcriptional level at multiple timepoints in male and female mice (4, 17, 21 and 25 months), with particular emphasis on sex-differences. The effects of natural aging on the transcriptome of quadriceps muscle were compared to humans on pathway level. Significant loss of muscle mass occurred late, at 25 months, in both male (-17%, quadriceps) and female mice (-10%, quadriceps) compared to young control mice. Concomitantly, we found in female, but not male mice, a slower movement speed in the aged groups compared to the young mice (P < 0.001). Consistently, weighted gene co-expression network analysis revealed a stronger association between the aging-related reduction of movement and aging-related changes in muscle transcriptome of female compared to male mice (P < 0.001). In male, but not female mice, major distinctive aging-related changes occurred in the last age group (25 months), which highlights the necessity for careful selection of age using mice as a muscle-aging model. Furthermore, contrasting to humans, more aging-related changes were found in the muscle transcriptome of male mice compared to female mice (4090 vs. 2285 differentially expressed genes at 25 months, respectively). Subsequently, male mice recapitulated more muscle-aging related pathways characteristic for both male and female humans. In conclusion, our data show that sex has a critical effect on the mouse muscle-aging trajectory, although these do not necessarily reflect sex differences observed in the human muscle-aging trajectory.
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Affiliation(s)
- Jelle C B C de Jong
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands.
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands.
| | - Martien P M Caspers
- Department of Microbiology and Systems Biology, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Nicole Worms
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Nanda Keijzer
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Robert Kleemann
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Aswin L Menke
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | | | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Lars Verschuren
- Department of Microbiology and Systems Biology, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Anita M van den Hoek
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
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3
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Yen CH, Lee YW, Chang WJ, Lin PT. The Mini Nutritional Assessment combined with body fat for detecting the risk of sarcopenia and sarcopenic obesity in metabolic syndrome. Br J Nutr 2024; 131:1659-1667. [PMID: 38312003 DOI: 10.1017/s0007114524000369] [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] [Indexed: 02/06/2024]
Abstract
Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case-control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.
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Affiliation(s)
- Chi-Hua Yen
- School of medicine, Chung Shan Medical University, Taichung402367, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung402367, Taiwan
| | - Yi-Wen Lee
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
| | - Wei-Jung Chang
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
| | - Ping-Ting Lin
- Department of Nutrition, Chung Shan Medical University, Taichung402367, Taiwan
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung402367, Taiwan
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Zambrano Chaves JM, Lenchik L, Gallegos IO, Blankemeier L, Rubin DL, Willis MH, Chaudhari AS, Boutin RD. Abdominal CT metrics in 17,646 patients reveal associations between myopenia, myosteatosis, and medical phenotypes: a phenome-wide association study. EBioMedicine 2024; 103:105116. [PMID: 38636199 PMCID: PMC11031722 DOI: 10.1016/j.ebiom.2024.105116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Deep learning facilitates large-scale automated imaging evaluation of body composition. However, associations of body composition biomarkers with medical phenotypes have been underexplored. Phenome-wide association study (PheWAS) techniques search for medical phenotypes associated with biomarkers. A PheWAS integrating large-scale analysis of imaging biomarkers and electronic health record (EHR) data could discover previously unreported associations and validate expected associations. Here we use PheWAS methodology to determine the association of abdominal CT-based skeletal muscle metrics with medical phenotypes in a large North American cohort. METHODS An automated deep learning pipeline was used to measure skeletal muscle index (SMI; biomarker of myopenia) and skeletal muscle density (SMD; biomarker of myosteatosis) from abdominal CT scans of adults between 2012 and 2018. A PheWAS was performed with logistic regression using patient sex and age as covariates to assess for associations between CT-derived muscle metrics and 611 common EHR-derived medical phenotypes. PheWAS P values were considered significant at a Bonferroni corrected threshold (α = 0.05/1222). FINDINGS 17,646 adults (mean age, 56 years ± 19 [SD]; 57.5% women) were included. CT-derived SMI was significantly associated with 268 medical phenotypes; SMD with 340 medical phenotypes. Previously unreported associations with the highest magnitude of significance included higher SMI with decreased cardiac dysrhythmias (OR [95% CI], 0.59 [0.55-0.64]; P < 0.0001), decreased epilepsy (OR, 0.59 [0.50-0.70]; P < 0.0001), and increased elevated prostate-specific antigen (OR, 1.84 [1.47-2.31]; P < 0.0001), and higher SMD with decreased decubitus ulcers (OR, 0.36 [0.31-0.42]; P < 0.0001), sleep disorders (OR, 0.39 [0.32-0.47]; P < 0.0001), and osteomyelitis (OR, 0.43 [0.36-0.52]; P < 0.0001). INTERPRETATION PheWAS methodology reveals previously unreported associations between CT-derived biomarkers of myopenia and myosteatosis and EHR medical phenotypes. The high-throughput PheWAS technique applied on a population scale can generate research hypotheses related to myopenia and myosteatosis and can be adapted to research possible associations of other imaging biomarkers with hundreds of EHR medical phenotypes. FUNDING National Institutes of Health, Stanford AIMI-HAI pilot grant, Stanford Precision Health and Integrated Diagnostics, Stanford Cardiovascular Institute, Stanford Center for Digital Health, and Stanford Knight-Hennessy Scholars.
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Affiliation(s)
- Juan M Zambrano Chaves
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Leon Lenchik
- Department of Diagnostic Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Isabel O Gallegos
- Department of Computer Science, (IOG), Stanford University, Stanford, CA, USA
| | - Louis Blankemeier
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Daniel L Rubin
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Marc H Willis
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Akshay S Chaudhari
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Robert D Boutin
- Department of Radiology, Stanford University, Stanford, CA, USA.
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Calcaterra L, Abellan van Kan G, Steinmeyer Z, Angioni D, Proietti M, Sourdet S. Sarcopenia and poor nutritional status in older adults. Clin Nutr 2024; 43:701-707. [PMID: 38320461 DOI: 10.1016/j.clnu.2024.01.028] [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: 11/28/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. METHODS Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. RESULTS Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition. CONCLUSIONS In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.
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Affiliation(s)
- L Calcaterra
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France; Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - G Abellan van Kan
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France.
| | - Z Steinmeyer
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - D Angioni
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - M Proietti
- Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Sourdet
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
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Joulaei H, Keshani P, Kashfinejad SM, Foroozanfar Z, Mohsenpour MA, Fararouei M. To assess the contributing factors of nutritional and health status amongst elderlies residing in the nursing homes of fars province, Iran: A cross sectional study. Health Sci Rep 2024; 7:e1940. [PMID: 38455646 PMCID: PMC10918975 DOI: 10.1002/hsr2.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/17/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
Background and Aims In line with the global trend, the number of elderly is rising in Iran. It should be noted that the nutritional and health needs of these people, especially those living in nursing houses, are extremely significant. The present study aimed to identify the nutritional and health status and uncover their relationship with received care services by elderlies residing in nursing homes. Methods All 373 elderlies living in the nursing homes in Shiraz entered the study, and the requisite data were collected by references to elderlies' files, respective nurses, and elderlies themselves. Results The majority of the elderlies were at risk of malnutrition (62.5% of the total population, 55.4% of females, and approximately 44.6% of males). Elderlies with no insurance coverage mainly fell into the at-risk and malnutrition categories. There was a significant relationship between the needs assessment scores, reflecting the need for physical and psychological actions, and elderlies' malnutrition (odds ratio = 1.87, 95% confidence interval: 1.79-1.95). For each unit increase in the Physical and psychological need score, the odds of exposure to malnutrition (vs. nonmalnourished and at risk of malnutrition) was 1.87 times after adjustment for confounders. Conclusion The results of our study revealed that most of the elderlies living in the nursing homes of Shiraz had some levels of malnutrition such as at-risk for malnutrition (62.5%) and malnourished (18.9%). Based on these results, it is suggested that health policy-makers take practical steps toward promoting the nutritional care of old people and direct extra supervision to nursing homes and all healthcare provisions.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Mohammad Fararouei
- Department of EpidemiologyShiraz University of Medical SciencesShirazIran
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Di Lenarda L, Buoite Stella A, Ratti C, Ruggiero L, Bernard M, Cavarzerani LP, Canton G, Murena L. Assessing Muscle Mass in the Orthopedic Clinical Setting: Application of the Ultrasound Sarcopenia Index in Elderly Subjects with a Recent Femoral Fracture. Nutrients 2024; 16:711. [PMID: 38474844 PMCID: PMC10934151 DOI: 10.3390/nu16050711] [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: 02/12/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Sarcopenia poses a risk factor for falls, disability, mortality, and unfavorable postoperative outcomes. Recently, the Ultrasound Sarcopenia Index (USI) has been validated to assess muscle mass, and this study aimed to apply the USI in the clinical setting. METHODS This prospective observational study included 108 patients aged >65 years, hospitalized for proximal femoral traumatic fracture. Patients were divided into two groups based on anamnestic data: patients with independent walking (IW) and patients requiring walking aid (WA) before admission. All the participants received an ultrasound examination. Other parameters evaluated were handgrip strength, limb circumferences, nutrition (MNA), and activity of daily living (ADL) scores. RESULTS Fifty-six IW patients (83 ± 6 y; 38 females) and 52 WA patients (87 ± 7 y; 44 females) were recruited. The USI was significantly higher in the IW group compared to the WA group (p = 0.013, Cohen's d = 0.489). Significant correlations were found between the USI and other sarcopenia-associated parameters, such as handgrip strength, MNA, ADLs, other muscle ultrasound parameters, and limb circumferences. CONCLUSION The application of the USI in the orthopedic surgery setting is feasible and might support the diagnosis of sarcopenia when combined with other measures of strength and function.
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Affiliation(s)
- Luca Di Lenarda
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Alex Buoite Stella
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Chiara Ratti
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Luca Ruggiero
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Monica Bernard
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
| | - Luisa Priscamaria Cavarzerani
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Gianluca Canton
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Luigi Murena
- Orthopaedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy; (L.D.L.); (C.R.); (L.R.); (M.B.); (G.C.); (L.M.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Single-Cycle Master’s Degree Course in Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
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Yilmaz M, Atik-Altinok Y, Seyidoglu Yüksel D, Acarer A, Bozkurt D, Savas S, Sarac ZF, Akcicek F. Evaluation of sarcopenia and phase angle in elderly patients with Parkinson's Disease. Int J Neurosci 2024:1-8. [PMID: 38275120 DOI: 10.1080/00207454.2024.2310180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE To investigate sarcopenia and related factors and to determine the disease-specific phase angle (PhA) cut-off score in detecting sarcopenia in elderly patients with Parkinson's Disease (PD). METHODS This cross-sectional study was conducted with 89 participants. The Mini-Nutritional Assessment (MNA), the Eating Attitude Test-10 (EAT-10), the Physical Activity Scale for The Elderly (PASE) questionnaire and the Hoehn-Yahr scale have been used. Additionally, anthropometric measurements were performed. The diagnosis of sarcopenia was based on the new consensus published by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). PhA has been performed by Bioelectrical Impedance Analysis (BIA) with Tanita MC 780®. RESULTS The mean age was of the participants 68.9 ± 6.4 years, and 57.3% were male. The prevalence of sarcopenia was 12.3%. PhA, malnutrition, age, disease severity, low calf circumference (CC), low body mass index (BMI), the difference between the pre-diagnosis and current weight loss, dopaminergic treatment, and low PASE score were associated with sarcopenia. The cut-off value of the PhA in terms of the ability to identify sarcopenia was <4.5o with a sensitivity of 53.3% and a specificity of 93.2% (p = 0.001). When we grouped the PhA of the patients according to this cut-off score, it was seen that 14.6% of them were sarcopenic. Age, disease severity, PASE score and hand grip strength were significantly related to both sarcopenia and PhA. CONCLUSION It is important to be aware of sarcopenia and related factors at an early stage in Parkinson's patients. Because of disease-related symptoms, it may be more appropriate to use a disease-specific PhA cut-off score in the definition of sarcopenia.
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Affiliation(s)
- Merve Yilmaz
- Faculty of Health Science, Department of Nutrition and Dietetics, İzmir Tinaztepe University, İzmir, Turkey
| | | | | | - Ahmet Acarer
- Department of Neurology, Ege University of Medical Faculty, İzmir
| | - Devrim Bozkurt
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Sumru Savas
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Z Fulden Sarac
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Fehmi Akcicek
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
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9
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Alatas H, Serin Y, Arslan N. Nutritional Status and Risk of Sarcopenia among Hospitalized Older Adults Residing in a Rural Region in Turkey. Ann Geriatr Med Res 2023; 27:293-300. [PMID: 37691482 PMCID: PMC10772329 DOI: 10.4235/agmr.23.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/17/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND This study aimed to determine the prevalence of sarcopenia and its associated factors in community-dwelling older adults at risk of malnutrition based on the Mini Nutritional Assessment (MNA), Prognostic Nutritional Index (PNI), and Geriatric Nutritional Risk Index (GNRI). METHODS The study participants were 345 adults aged >65 years who visited Geriatric Internal Medicine outpatient clinics. The study included people without acute illness for whom the risk of malnutrition could be assessed and appropriate measurements taken. At the baseline visit, participants' data and measurements were gathered. The primary data included sociodemographic details, anthropometric measurements, malnutrition screening tests, and functional assessments. RESULTS The participants' mean age was 76.21±5.59 years, and 57.1% were men (n=97). The prevalence rate of sarcopenia was 45.5%. Compared to individuals without sarcopenia, those with it were older; had lower MNA, PNI, and GNRI scores; and had lower muscle mass, muscle strength, and lower leg circumferences (p<0.001). After adjusting for potential confounding factors, we found that sarcopenia, advanced age, male sex, high risk of malnutrition, calf circumference, and a low PNI score were all significantly associated with a low GNRI score (p<0.001). CONCLUSION Sarcopenia was significantly associated with advanced age, male sex, and high risk of malnutrition. Patients' nutritional and functional status should always be assessed for therapeutic interventions and lifestyle changes.
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Affiliation(s)
- Hacer Alatas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Turkey
| | - Yeliz Serin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Nurgül Arslan
- Department of Nutrition and Dietetics, Ataturk Faculty of Health Sciences, Dicle University, Diyarbakir, Turkey
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10
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Alfaro-Alvarado FA, Rosas-Barrientos JV, Ocharan-Hernández ME, Díaz-Chiguer D, Vargas-De-León C. Association between Sarcopenia and Poor Glycemic Control in Older Adults with Type 2 Diabetes Mellitus. Diseases 2023; 11:175. [PMID: 38131980 PMCID: PMC10743183 DOI: 10.3390/diseases11040175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Aging is associated with a decrease in muscle mass. Insulin resistance and hyperglycemia accelerate muscle loss, leading to a deterioration in strength, muscle mass, and physical capacity in older adults. This study was conducted to determine the association between sarcopenia and poor glycemic control in older adults with type 2 diabetes mellitus (T2D). METHODS A cross-sectional study was carried out in older adults with T2D in geriatric outpatient clinics. Sarcopenia was diagnosed as per the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. According to glycosylated hemoglobin (HbA1c) levels, participants were classified into glycemic control (HbA1c ≤ 7.5%) and poor glycemic control (HbA1c ≥ 7.5%) groups. RESULTS Older adults with sarcopenia were found to have poor glycemic control compared to adults without sarcopenia (62.3% vs. 47.9%, p = 0.007). Logistic regression analysis showed an association between poor glycemic control and the presence of sarcopenia (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.17-2.75) and low muscle mass (OR: 1.73, 95% CI: 1.07-2.73). CONCLUSIONS Poor glycemic control is associated with the presence of sarcopenia and low muscle mass, which highlights the need to implement better treatment strategies in order to reduce the loss of muscle mass.
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Affiliation(s)
- Fabián Alonso Alfaro-Alvarado
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
- Clínica Hospital No. 24, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad Guzmán 49097, Mexico
| | - José Vicente Rosas-Barrientos
- Hospital Regional 1° de Octubre, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Ciudad de México 07760, Mexico;
| | - María Esther Ocharan-Hernández
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
| | - Dylan Díaz-Chiguer
- Dirección Normativa de Salud, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Ciudad de México 06030, Mexico;
| | - Cruz Vargas-De-León
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (F.A.A.-A.); (M.E.O.-H.)
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico
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11
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Shadmand Foumani Moghadam MR, Shahraki Jazinaki M, Rashidipour M, Rezvani R, Pezeshki P, Ghayour Mobarhan M, Hosseini Z. Mini Nutrition Assessment-Short Form score is associated with sarcopenia even among nourished people - A result of a feasibility study of a registry. Aging Med (Milton) 2023; 6:264-271. [PMID: 37711256 PMCID: PMC10498828 DOI: 10.1002/agm2.12257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 09/16/2023] Open
Abstract
Objectives This study aims to identify a new barrier to the use of the Mini-Nutrition Assessment Short-Form (MNA-SF), which is a malnutrition assessment tool for the risk assessment of sarcopenia in a nourished population. Methods The MNA-SF was completed, and individuals with a score of > 11 were considered nourished in this cross-sectional feasibility study of a registry. Sarcopenia was assessed in 766 healthy, nourished adults (33.4% men, 64.9 ± 7.1 years) based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Results The MNA-SF scores for non-sarcopenia, pre-, confirmed, and severe sarcopenia were 13.59 ± 0.69, 13.73 ± 0.60, 12.64 ± 0.74, and 12.5 ± 0.71, respectively. The higher MNA-SF score association with pre-sarcopenia [odds ratio (OR): 1.41, 95% confidence interval (CI): 1.06-1.86, P = 0.02], confirmed sarcopenia (OR = 0.25, 95% CI: 0.13-0.49, P < 0.001), and severe sarcopenia (OR = 0.20, 95% CI: 0.09-0.46, P < 0.001) was as significant as in the MNA-SF categories. Individuals with a score = 13 (compared with 14), had a higher risk of confirmed sarcopenia (OR = 10.07, 95% CI: 1.92-52.71, P = 006) and severe sarcopenia (OR = 12.09, 95% CI: 1.24-117.50, P = 0.032). Individuals with a score of 12 had a higher risk of confirmed sarcopenia (OR = 30.94, 95% CI: 4.25-103.02, P < 0.001) and severe sarcopenia (OR = 35.90, 95% CI: 4.25-303.07, P = 0.001) compared with subjects with a score of 14. The models also showed that MNA-SF < 13 could predict sarcopenia. Conclusion There was a significant association between MNA-SF and confirmed and severe sarcopenia in nourished people. Sarcopenia assessment in people with MNA-SF < 13 can be beneficial. Developing a tool to identify the risk of malnutrition and sarcopenia at the same time based on MNA-SF can be considered.
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Affiliation(s)
| | - Mostafa Shahraki Jazinaki
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mina Rashidipour
- Department of Health and NutritionIslamic Azad University, Science And Research BranchTehranIran
| | - Reza Rezvani
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Parnian Pezeshki
- Department of Food Science and TechnologyVarastegan Institute for Medical SciencesMashhadIran
| | - Majid Ghayour Mobarhan
- Department of Nutrition Science, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Zohre Hosseini
- Department of Nutrition ScienceVarastegan Institute for Medical SciencesMashhadIran
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12
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Ghzaiel I, Zarrouk A, Pires V, de Barros JPP, Hammami S, Ksila M, Hammami M, Ghrairi T, Jouanny P, Vejux A, Lizard G. 7β-Hydroxycholesterol and 7-ketocholesterol: New oxidative stress biomarkers of sarcopenia inducing cytotoxic effects on myoblasts and myotubes. J Steroid Biochem Mol Biol 2023; 232:106345. [PMID: 37286110 DOI: 10.1016/j.jsbmb.2023.106345] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/21/2023] [Accepted: 06/04/2023] [Indexed: 06/09/2023]
Abstract
Aging is a complex biological process which can be associated with skeletal muscle degradation leading to sarcopenia. The aim of this study consisted i) to determine the oxidative and inflammatory status of sarcopenic patients and ii) to clarify the impact of oxidative stress on myoblasts and myotubes. To this end, various biomarkers of inflammation (C-reactive protein (CRP), TNF-α, IL-6, IL-8, leukotriene B4 (LTB4)) and oxidative stress (malondialdehyde, conjugated dienes, carbonylated proteins and antioxidant enzymes: catalase, superoxide dismutase, glutathione peroxidase) as well as oxidized derivatives of cholesterol formed by cholesterol autoxidation (7-ketocholesterol, 7β-hydroxycholesterol), were analyzed. Apelin, a myokine which contributes to muscle strength, was also quantified. To this end, a case-control study was conducted to evaluate the RedOx and inflammatory status in 45 elderly subjects (23 non-sarcopenic; 22 sarcopenic) from 65 years old and higher. SARCopenia-Formular (SARC-F) and Timed Up and Go (TUG) tests were used to distinguish between sarcopenic and non-sarcopenic subjects. By using red blood cells, plasma and/or serum, we observed in sarcopenic patients an increased activity of major antioxidant enzymes (superoxide dismutase, glutathione peroxidase, catalase) associated with lipid peroxidation and protein carbonylation (increased level of malondialdehyde, conjugated dienes and carbonylated proteins). Higher levels of 7-ketocholesterol and 7β-hydroxycholesterol were also observed in the plasma of sarcopenic patients. Significant differences were only observed with 7β-hydroxycholesterol. In sarcopenic patients comparatively to non-sarcopenic subjects, significant increase of CRP, LTB4 and apelin were observed whereas similar levels of TNF-α, IL-6 and IL-8 were found. The increased plasma level of 7-ketocholesterol and 7β-hydroxycholesterol in sarcopenic patients led us to study the cytotoxic effect of these oxysterols on undifferentiated (myoblasts) and differentiated (myotubes) murine C2C12 cells. With the fluorescein diacetate and sulforhodamine 101 assays, an induction of cell death was observed both on undifferentiated and differentiated cells: the cytotoxic effects were less pronounced with 7-ketocholesterol. In addition, IL-6 secretion was never detected whatever the culture conditions, TNF-α secretion was significantly increased on undifferentiated and differentiated C2C12 cells treated with 7-ketocholesterol- and 7β-hydroxycholesterol, and IL-8 secretion was increased on differentiated cells. 7-ketocholesterol- and 7β-hydroxycholesterol-induced cell death was strongly attenuated by α-tocopherol and Pistacia lentiscus L. seed oil both on myoblasts and/or myotubes. TNF-α and/or IL-8 secretions were reduced by α-tocopherol and Pistacia lentiscus L. seed oil. Our data support the hypothesis that the enhancement of oxidative stress observed in sarcopenic patients could contribute, especially via 7β-hydroxycholesterol, to skeletal muscle atrophy and inflammation via cytotoxic effects on myoblasts and myotubes. These data bring new elements to understand the pathophysiology of sarcopenia and open new perspectives for the treatment of this frequent age-related disease.
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Affiliation(s)
- Imen Ghzaiel
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France; Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Amira Zarrouk
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia; Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia.
| | - Vivien Pires
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France
| | | | - Sonia Hammami
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Mohamed Ksila
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France; Laboratory of Neurophysiology, Cellular Physiopathology and Valorisation of BioMolecules, LR18ES03, Department of Biology, Faculty of Sciences, University Tunis-El Manar, Tunis 2092, Tunisia
| | - Mohamed Hammami
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Taoufik Ghrairi
- Université de Bourgogne, Lipidomic Platform, 21000 Dijon, France
| | - Pierre Jouanny
- Geriatric Internal Medicine Department (Champmaillot), University Hospital Center, Université de Bourgogne, 21000 Dijon, France
| | - Anne Vejux
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France
| | - Gérard Lizard
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France.
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13
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Massimino E, Izzo A, Castaldo C, Ferretti E, Rivellese AA, Della Pepa G. Risk of Sarcopenia and Associated Factors in Older Adults with Type 2 Diabetes: An Exploratory Cross-Sectional Study. Healthcare (Basel) 2023; 11:2081. [PMID: 37510524 PMCID: PMC10380017 DOI: 10.3390/healthcare11142081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Evidence on the risk of sarcopenia and associated factors in older adults with type 2 diabetes (T2D) is lacking. We evaluate (1) the proportion of patients at risk of sarcopenia in older adults with T2D; and (2) the factors associated with the risk of sarcopenia. METHODS We conducted a cross-sectional study on T2D patients over 65 years referred to our outpatient clinic and who carried out the yearly complication assessment visit. Eligible patients were administered questionnaires during phone interviews for the risk evaluation of sarcopenia (SARC-F), the risk evaluation of malnutrition (Mini Nutritional Assessment Short Form (MNA®-SF)), the adherence to the Mediterranean diet (MEDI-quest), and the evaluation of physical activity (the International Physical Activity Questionnaire short form). RESULTS A total of 138 patients were included in the study, and 12 patients (8.7% (95% CI 4.6-14.7)) were at risk of sarcopenia. The mean SARC-F score was significantly higher in women compared with men (2.1 ± 1.8 vs. 0.9 ± 1.4, respectively; p < 0.001). The majority of patients identified at risk of sarcopenia compared with those not at risk were women (75% vs. 30%, respectively; p = 0.003), had a higher proportion of neuropathy (50% vs. 19%, respectively; p = 0.027), a lower mean MNA®-SF score (11.6 ± 1.5 vs. 13.0 ± 1.4, respectively; p = 0.001), a lower mean MEDI-quest score (5.2 ± 1.5 vs. 5.9 ± 1, respectively; p = 0.037), and were more inactive (92% vs. 61%, respectively; p = 0.032). CONCLUSIONS In a sample of older adults with T2D, the risk of sarcopenia was identified in 8.7% (95% CI: 4.6-14.7) of the sample, and the main factors associated were female gender, neuropathy, a lower MNA®-SF score, low adherence to the Mediterranean diet, and low physical activity.
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Affiliation(s)
- Elena Massimino
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Anna Izzo
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Carmen Castaldo
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Erica Ferretti
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, National Research Council-CNR, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
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14
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de Jong JCBC, Caspers MPM, Keijzer N, Worms N, Attema J, de Ruiter C, Lek S, Nieuwenhuizen AG, Keijer J, Menke AL, Kleemann R, Verschuren L, van den Hoek AM. Caloric Restriction Combined with Immobilization as Translational Model for Sarcopenia Expressing Key-Pathways of Human Pathology. Aging Dis 2023; 14:937-957. [PMID: 37191430 DOI: 10.14336/ad.2022.1201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/01/2022] [Indexed: 05/17/2023] Open
Abstract
The prevalence of sarcopenia is increasing while it is often challenging, expensive and time-consuming to test the effectiveness of interventions against sarcopenia. Translational mouse models that adequately mimic underlying physiological pathways could accelerate research but are scarce. Here, we investigated the translational value of three potential mouse models for sarcopenia, namely partial immobilized (to mimic sedentary lifestyle), caloric restricted (CR; to mimic malnutrition) and a combination (immobilized & CR) model. C57BL/6J mice were calorically restricted (-40%) and/or one hindleg was immobilized for two weeks to induce loss of muscle mass and function. Muscle parameters were compared to those of young control (4 months) and old reference mice (21 months). Transcriptome analysis of quadriceps muscle was performed to identify underlying pathways and were compared with those being expressed in aged human vastus lateralis muscle-biopsies using a meta-analysis of five different human studies. Caloric restriction induced overall loss of lean body mass (-15%, p<0.001), whereas immobilization decreased muscle strength (-28%, p<0.001) and muscle mass of hindleg muscles specifically (on average -25%, p<0.001). The proportion of slow myofibers increased with aging in mice (+5%, p<0.05), and this was not recapitulated by the CR and/or immobilization models. The diameter of fast myofibers decreased with aging (-7%, p<0.05), and this was mimicked by all models. Transcriptome analysis revealed that the combination of CR and immobilization recapitulated more pathways characteristic for human muscle-aging (73%) than naturally aged (21 months old) mice (45%). In conclusion, the combination model exhibits loss of both muscle mass (due to CR) and function (due to immobilization) and has a remarkable similarity with pathways underlying human sarcopenia. These findings underline that external factors such as sedentary behavior and malnutrition are key elements of a translational mouse model and favor the combination model as a rapid model for testing the treatments against sarcopenia.
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Affiliation(s)
- Jelle C B C de Jong
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
- Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Martien P M Caspers
- Department of Microbiology and Systems Biology, The Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Nanda Keijzer
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Nicole Worms
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Joline Attema
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Christa de Ruiter
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Serene Lek
- Clinnovate Health UK Ltd, Glasgow, United Kingdom
| | | | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Aswin L Menke
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Robert Kleemann
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Lars Verschuren
- Department of Microbiology and Systems Biology, The Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Anita M van den Hoek
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
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15
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Pradelli L, Zaniolo O, Sanfilippo A, Lezo A, Riso S, Zanetti M. Prevalence and economic cost of malnutrition in Italy: A systematic review and metanalysis from the Italian Society of Artificial Nutrition and Metabolism (SINPE). Nutrition 2023; 108:111943. [PMID: 36669368 DOI: 10.1016/j.nut.2022.111943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/14/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Disease-related malnutrition (DRM) is a major public health issue with dramatic consequences on outcomes. However, in Italy a comprehensive and updated overview on national prevalence, in both the adult and pediatric populations, and its burden on the health care environment, is missing. The aim of this systematic literature review and meta-analysis was to identify and summarize the available evidence regarding the prevalence of DRM in Italy from pediatric to adult and older ages, and to project its global costs on the health care system. METHODS We performed a systematic literature search for articles on epidemiology of DRM in Italy published up to June 2021. Studies reporting data on the prevalence of DRM in community-dwelling individuals with chronic diseases, nursing home patients, and hospitalized patients (medical, surgery, and oncology patients), were selected for inclusion. Methodological quality of the studies was assessed by two independent reviewers using published criteria. An epidemiologic meta-analysis to obtain an aggregate estimate of prevalence of DRM was performed and a model for estimating the cost of illness, based on the application of epidemiologic results to official national hospitalization data, and attribution of relevant unit costs in the national context was constructed. RESULTS Sixty-seven studies reporting on the prevalence of DRM in Italian populations were included in the final selection; meta-analytical pooling yields mean prevalence estimates of about 50% and 30% in adult and pediatric hospitalized populations, respectively, with even higher findings for residents of long-term care facilities. Modeled projections of DRM-attributable yearly economic effects on the Italian health care system exceed 10 billion € in base case analysis, with the most optimistic estimate still exceeding 2.5 billion €. CONCLUSION Although comparable in magnitude to data from previous studies in analogous international settings, the diffusion and effects of DRM in the Italian setting is impressive. Increased awareness of these data and proactive fostering of clinical nutrition services are warranted, as prompt identification and treatment of malnutrition have been shown to effectively improve clinical and economic results.
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Affiliation(s)
| | | | | | - Antonella Lezo
- Clinical Nutrition Unit, Children's Hospital "Regina Margherita," AOU Città della Salute e della Scienza, Turin, Italy
| | - Sergio Riso
- Clinical Nutrition and Dietetic Unit - "Maggiore della Carità" University Hospital, Novara, Italy
| | - Michela Zanetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
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16
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Trinca V, Keller H. Nutrition Risk Is Associated with 3-Year Strength and Performance Indicators among Older Adults in the Canadian Longitudinal Study on Aging. J Nutr Health Aging 2023; 27:868-877. [PMID: 37960910 DOI: 10.1007/s12603-023-1980-3] [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: 04/10/2023] [Accepted: 07/17/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Determine if nutrition risk, as measured by SCREEN-8 is predictive of 3-year strength and performance indicators among community-living older adults after adjusting for key demographic and health variables. Sex-stratified analyses were also determined. DESIGN Cohort study with baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging (CLSA). PARTICIPANTS Participants 55 years and older at baseline were included (n = 22,502); those who reported nasogastric or abdominal tube feeding at either timepoint were excluded (n = 26). The final sample of participants available for analyses slightly varied depending on completion of the three outcome variables. List-wise deletion was used for nutrition risk and covariates to arrive at the sample available for analysis (n = 17,250). MEASUREMENTS The valid and reliable SCREEN-8 tool was used to measure nutrition risk. The minimum and maximum score of SCREEN-8 is 0 and 48, respectively, with lower scores indicating greater nutrition risk. Baseline SCREEN-8 score was used in analyses. Grip strength, chair rise test time and gait speed assessed at the 3-year follow-up were the strength and performance outcomes. Criteria outlined by the European Working Group on Sarcopenia in Older People 2 were used to determine low performance for grip strength (<27 kg for males and <16 kg for females), chair rise test time (>15 seconds) and gait speed (≤0.8 m/s). RESULTS Half of participants were female (49.4%) and mean age was 66.7 years (SD 7.9). Mean SCREEN-8 score was 39.2 (SD 6.0). Low grip strength, chair rise test performance and gait speed were found in 18.5%, 19.6% and 29.3% of participants, respectively. After adjusting for covariates (e.g., sex, age, education), SCREEN-8 score was significantly associated with grip strength (F = 11.21, p = .001; OR = 0.98, CI [0.97, 0.99]), chair rise time (F = 5.97, p = .015; OR = 0.99, CI [0.97, 0.997]), and gait speed (F = 9.99, p = .002; OR = 0.98, CI [0.97, 0.99]). Similar interpretation was seen in sex-stratified analyses, although chair rise time was not significant. Age, body mass index, Life Space Index Score and self-rated health were consistently associated with all outcome measures. CONCLUSION Nutrition risk, as measured by SCREEN-8, significantly predicted 3-year strength and performance measures. Greater nutrition risk is associated with an increased odds of low performance on grip strength, chair rise test, and gait speed. Future research should implement nutrition risk screening in primary care settings with subsequent assessment and treatment for at risk clients to determine if nutrition interventions implemented post screening can delay age-related losses in strength and performance.
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Affiliation(s)
- V Trinca
- Vanessa Trinca, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1,
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17
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Lai TF, Liao Y, Hsueh MC, Yen HY, Park JH, Chang JH. Substituting sedentary time with physical activity in youngest-old to oldest-old community-dwelling older adults: Associations with body composition. Front Public Health 2022; 10:837213. [PMID: 36523577 PMCID: PMC9746713 DOI: 10.3389/fpubh.2022.837213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 11/07/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Several studies have suggested that physical activity and sedentary behavior are strongly and independently associated with body composition and obesity. However, few studies have investigated whether substituting sedentary time with moderate-to-vigorous physical activity is associated with body composition in older adults, especially among those older than 75 years. Methods This study examined the associations between replacing sedentary time with physical activity and obesity indices in a sample of 199 community-dwelling older Taiwanese adults (52.3% women; 80.6 ± 7.0 years). Physical activity and sedentary behavior were measured using the triaxial accelerometer (GT3X+, ActiGraph). Body composition indices were computed through a bioelectrical impedance analysis of body fat percentage and appendicular skeletal muscle mass index. Waist circumference and body mass index were measured by trained personnel. Isotemporal substitution analyses estimated these associations after adjusting for sociodemographic characteristics and nutritional status. Results The study showed that substituting 30 min of sedentary behavior per day with moderate-to-vigorous physical activity was associated with lower body fat percentage (B = -1.408, 95% CI = -2.55, -0.264), body mass index (B = -0.681, 95% CI = -1.300, -0.061), and waist circumference (B = -2.301, 95% CI = -4.062, -0.539) after adjusting for covariates. Substituting 30 min of light physical activity per day with moderate-to-vigorous physical activity was associated with lower waist circumference (B = -2.230, 95% CI = -4.173, -0.287) after adjusting for covariates. Stratified analyses indicated that associations were stronger in youngest-old older adults, and in older adults with a normal nutritional status (vs. underweight status). Discussion These findings confirm the importance of reducing sedentary behavior and increasing moderate-to-vigorous physical activity among older adults to improve their physical health, as well as highlighting the importance of taking into account nutritional status and age group.
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Affiliation(s)
- Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Master's Program of Transition and Leisure Education for Individuals With Disabilities, University of Taipei, Taipei, Taiwan
| | - Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,*Correspondence: Jong-Hwan Park
| | - Jae Hyeok Chang
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Busan, South Korea,Jae Hyeok Chang
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Milewska M, Przekop Z, Szostak-Węgierek D, Chrzanowska M, Raciborski F, Traczyk I, Sińska BI, Samoliński B. Prevalence of Risk of Sarcopenia in Polish Elderly Population—A Population Study. Nutrients 2022; 14:nu14173466. [PMID: 36079726 PMCID: PMC9459963 DOI: 10.3390/nu14173466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 01/04/2023] Open
Abstract
Sarcopenia in the elderly population is a public health challenge, and there are few data on its prevalence in Europe. In this study, we investigated the prevalence of sarcopenia in the elderly Polish population and its association with the level of obesity and co-existing diseases. We conducted a population-based cross-sectional study involving 823 men and 1177 women aged 65 years and older, randomly selected from the population living in the territory of the Republic of Poland between 2017 and 2020. We analyzed the results of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Risk of sarcopenia was assessed with the simple questionnaire to rapidly diagnose sarcopenia (SARC-F), and sarcopenic obesity risk was defined as the combination of anthropometry and SARC-F results. In addition, we collected disease data with an author questionnaire. The prevalence of risk of sarcopenia was 18.6% (22.3% in women and 13.2% in men), and its incidence significantly increased with age in both sexes. The risk of sarcopenic obesity was more common in women than in men, and it was higher in the older age group, except for sarcopenic obesity diagnosed by the WHR criteria. The group of elderly with concomitant diseases had a higher risk of developing sarcopenia, which emphasizes the need to monitor sarcopenia when concomitant diseases are diagnosed. In both groups, risk of sarcopenia was associated with motor and respiratory system diseases, type 2 diabetes, and neurological diseases. This study highlights that the risk of sarcopenia in the elderly population affects women to a greater extent than men. It is important to identify the elderly at risk of sarcopenia in routine clinical practice to develop long-term prevention strategies.
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Affiliation(s)
- Magdalena Milewska
- Department of Clinical Dietetics, Faculty of Health and Science, Medical University of Warsaw, 01-445 Warszawa, Poland
| | - Zuzanna Przekop
- Department of Clinical Dietetics, Faculty of Health and Science, Medical University of Warsaw, 01-445 Warszawa, Poland
- Correspondence: ; Tel.: +48-22-57-20-931
| | - Dorota Szostak-Węgierek
- Department of Clinical Dietetics, Faculty of Health and Science, Medical University of Warsaw, 01-445 Warszawa, Poland
| | - Mariola Chrzanowska
- Department of Prevention of Environmental Hazards and Allergology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
- Department of Econometrics and Statistics, Institute of Economics and Finance, Warsaw University of Life Sciences, 02-787 Warszawa, Poland
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warszawa, Poland
| | - Beata Irena Sińska
- Department of Econometrics and Statistics, Institute of Economics and Finance, Warsaw University of Life Sciences, 02-787 Warszawa, Poland
| | - Bolesław Samoliński
- Department of Prevention of Environmental Hazards and Allergology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warszawa, Poland
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Association between food insecurity and probable sarcopenia: Data from the 2011–2014 National Health and nutrition examination survey. Clin Nutr 2022; 41:1861-1873. [DOI: 10.1016/j.clnu.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 01/23/2023]
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Chen X, Han P, Yu X, Zhang Y, Song P, Liu Y, Liu J, Tang J, Zhang Y, Zhao Y, Zheng J, Chu L, Wang HB, Guo Q. Sarcopenia and coronary heart disease synergistically increase the risk of new onset depressive symptoms in older adults. BMC Geriatr 2021; 21:731. [PMID: 34952569 PMCID: PMC8709956 DOI: 10.1186/s12877-021-02710-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Coronary heart disease (CHD), sarcopenia and depression are common disorders that markedly impair quality of life and impose a huge financial burden on society. They are also frequently comorbid, exacerbating condition and worsening prognosis. This study aimed to investigate the additive effects of CHD and sarcopenia on the risk of new onset depressive symptoms in older adults. Methods The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9 ± 5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline. Results We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.78, 95% confidence interval (CI) = 1.05–3.02], sarcopenia alone (OR = 2.79, 95% CI = 1.26–6.22), and co-occurring (OR = 7.19, 95% CI = 2.75–18.81) had higher risk of depressive symptoms than the normal group after adjusting for the covariates. Conclusions CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.
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Affiliation(s)
- Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, 300070, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, 300070, China
| | - Peiyu Song
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, 300070, China
| | - Yuewen Liu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Jinghuan Liu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Jiawei Tang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Yisong Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Yong Zhao
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Jiejiao Zheng
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Lixi Chu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China
| | - Hong Bing Wang
- Department of Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai, 200040, China.
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China.
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Malnutrition, assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria but not by the mini nutritional assessment (MNA), predicts the incidence of sarcopenia over a 5-year in the SarcoPhAge cohort. Aging Clin Exp Res 2021; 33:1507-1517. [PMID: 33991331 DOI: 10.1007/s40520-021-01880-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The capacity of malnutrition screening to predict the onset of sarcopenia is unknown. AIM Our first objective is to explore the association between the screening of malnutrition and the incidence of sarcopenia and then, to assess the added value of the diagnosis of malnutrition to predict sarcopenia over a 5-year follow-up. METHODS Malnutrition was screened at baseline according to the MNA short-form (MNA-SF) and long-form (MNA-LF) and was diagnosed by the GLIM definition. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Kaplan-Meier analysis and adjusted Cox regression were performed to explore the association between nutritional status and the incidence of sarcopenia. RESULTS A total of 418 participants were analyzed (median age 71.7 years (67.7 - 76.8), 60% women) for our first objective. Among them, 64 (15.3%) became sarcopenic during the follow-up period. In the adjusted model, the incidence of sarcopenia was nonsignificantly associated with the risk of malnutrition for both forms of the MNA (MNA-SF: HR of 1.68 (95% CI 0.95 - 2.99); MNA-LF: HR of 1.67 (95% CI 0.86 - 3.26)). However, among the 337 participants for which a GLIM assessment was possible and in which 46 participants became sarcopenic, malnourished subjects had a higher risk than well-nourished participants of developing sarcopenia after 5 years, with an adjusted HR of 3.19 (95% CI 1.56 - 6.50). CONCLUSION A full diagnosis of malnutrition seems more useful than a simple malnutrition screening to predict the incidence of sarcopenia over 5 years.
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Affiliation(s)
- Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium.
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, University Hospital of Liège, SportS2, 4000, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
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Buchman AS, Leurgans SE, Wang T, Schnaider-Beeri M, Agarwal P, Dawe RJ, Delbono O, Bennett DA. Motor function is the primary driver of the associations of sarcopenia and physical frailty with adverse health outcomes in community-dwelling older adults. PLoS One 2021; 16:e0245680. [PMID: 33529220 PMCID: PMC7853482 DOI: 10.1371/journal.pone.0245680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/06/2021] [Indexed: 12/25/2022] Open
Abstract
Background This study tested the hypothesis that sarcopenia and its constituent components, reduced lean muscle mass and impaired motor function, are associated with reduced survival and increased risk of incident disabilities. Methods 1466 community-dwelling older adults underwent assessment of muscle mass with bioelectrical impedance analysis (BIA), grip strength, gait speed and other components of physical frailty and annual self-report assessments of disability. We used Cox proportional hazards models that controlled for age, sex, race, education and height to examine the associations of a continuous sarcopenia metric with the hazard of death and incident disabilities. Results Mean baseline age was about 80 years old and follow-up was 5.5 years. In a proportional hazards model controlling for age, sex, race, education and baseline sarcopenia, each 1-SD higher score on a continuous sarcopenia scale was associated with lower hazards of death (HR 0.70, 95%CI [0.62, 0.78]), incident IADL (HR 0.80,95%CI [0.70, 0.93]), incident ADL disability (HR 0.80 95%CI [71, 91]) and incident mobility disability (HR 0.81, 95%CI [0.70, 0.93]). Further analyses suggest that grip strength and gait speed rather than muscle mass drive the associations with all four adverse health outcomes. Similar findings were observed when controlling for additional measures used to assess physical frailty including BMI, fatigue and physical activity. Conclusions Motor function is the primary driver of the associations of sarcopenia and physical frailty with diverse adverse health outcomes. Further work is needed to identify other facets of muscle structure and motor function which together can identify adults at risk for specific adverse health outcomes.
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Affiliation(s)
- Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States of America
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States of America
- * E-mail:
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States of America
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States of America
| | - Tianhao Wang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States of America
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States of America
| | - Michal Schnaider-Beeri
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Joseph Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America
| | - Robert J. Dawe
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States of America
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States of America
| | - Osvaldo Delbono
- Section of Gerontology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States of America
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States of America
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort. Nutrients 2021; 13:nu13020407. [PMID: 33525324 PMCID: PMC7910934 DOI: 10.3390/nu13020407] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).
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Affiliation(s)
- Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Department of Sport Rehabilitation Sciences, University of Liège, 4000 Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, University Hospital of Liège, 4000 Liège, Belgium
- Correspondence: ; Tel.: +32-43-66-3230
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (L.L.); (C.B.); (J.-Y.R.); (M.L.)
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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SANTANA MDP, FIGUEIREDO NM, CHOCIAY JUNIOR S, SILVA TA, SEIXAS RAM, LUCHESI BM. Factors associated with nutritional risk and appetite loss in long-aged older people. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To analyze the factors that are associated with the nutritional risk and appetite loss of long-aged older people with two assessment instruments. Methods A cross-sectional and quantitative study was developed in Três Lagoas, a city in the Brazilian state of Mato Grosso do Sul. The household data collection was conducted with 87 long-aged older adults (≥90 years) living in the community. The risk of malnutrition, malnutrition, and the risk of weight loss were the dependent variables, assessed by the Simplified Nutritional Appetite Questionnaire and by the Mini-Nutritional Assessment - Short Form. The association with independent sociodemographic, general health, psychological, cognitive, and physical variables was analyzed using logistic regressions. Results Most of the older adults were female (55.2%), with an average age of 93.3 years, and 1.4 years of schooling. According to the Simplified Nutritional Appetite Questionnaire, 34.5% of the older individuals were at risk of losing weight. As for the results of the Mini-Nutritional Assessment, 19.5% were classified as malnourished, and 39.1% at risk of malnutrition. A greater nutritional risk in both instruments was associated with the individual's poorer self-perceived health, lower calf circumference, and presence of depressive symptoms. The greater the number of medications used, the lower the chance of weight loss. The agreement between the two instruments was low. Conclusion There was an association connecting malnutrition and appetite/weight loss with lower calf circumference, worse self-perceived health status, and presence of depressive symptoms. These results can assist in interventions planning to reduce the nutritional risk and improve the life quality of older adults.
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Prevalence and risk factors of primary sarcopenia in community-dwelling outpatient elderly: a cross-sectional study. Sci Rep 2020; 10:19551. [PMID: 33177536 PMCID: PMC7658996 DOI: 10.1038/s41598-020-75250-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/13/2020] [Indexed: 01/01/2023] Open
Abstract
No previous study has investigated the prevalence and risk factors for primary sarcopenia in outpatient setting. This study aims to evaluate the prevalence and factors associated with primary sarcopenia in outpatient elderly. Additionally, we compared the severity of sarcopenia based on the 2014 and 2019 Asian Working Group for Sarcopenia (AWGS) criteria. This cross-sectional study was performed in 330 subjects aged over 60 years in an outpatient setting. The muscle strength, muscle performance and muscle mass were assessed using the handheld dynamometer, 6-m gait speed, and bioelectrical impedance analysis, respectively. The prevalence of sarcopenia was 10% as per the 2014 and 2019 AWGS criteria. The development of sarcopenia was positively correlated with the age with an odds ratio (OR) of 6.87 [95% confidence interval (CI) 1.63–28.88] in the middle-old group (70–79 years), and 13.71 (95%CI 3.66–51.41; p = 0.009) in the very old group (≥ 80 years). Prefrailty and low physical activity were significantly associated with sarcopenia with an OR of 4.75 (95%CI 1.90—11.89) in prefrailty, 15.35 (95%CI 1.69–139.47) in the middle activity group, and 17.99 (95%CI 1.95–165.73) in the lowest activity group. In conclusion, primary sarcopenia was found in one-tenth of outpatient elderly. Age, prefrailty, and low activity were independent factors associated with sarcopenia.
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What Are the Risk Factors for Malnutrition in Older-Aged Institutionalized Adults? Nutrients 2020; 12:nu12092857. [PMID: 32961917 PMCID: PMC7551464 DOI: 10.3390/nu12092857] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/28/2020] [Accepted: 09/15/2020] [Indexed: 01/05/2023] Open
Abstract
Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited from nursing homes in Italy and completed a detailed multidimensional geriatric evaluation. All the data analyses were completed using Stata Version 15.1. The study included 246 participants with an age range of 50 to 102 (80.4 ± 10.5). The sample was characterised by a high degree of cognitive and functional impairment, disability, and poor health and nutritional status (according to Mini Nutritional Assessment (MNA), 38.2% were at risk for malnutrition and 19.5% were malnourished). Using a stepwise linear regression model, age (B = −0.043, SE = 0.016, p = 0.010), depression (B = −0.133, SE = 0.052, p = 0.011), disability (B = 0.517, SE = 0.068, p < 0.001), and physical performance (B = −0.191, SE = 0.095, p = 0.045) remained significantly associated with the malnutrition risk in the final model (adjusted R-squared = 0.298). The logistic regression model incorporating age, depression, disability, and physical performance was found to have high discriminative accuracy (AUC = 0.747; 95%CI: 0.686 to 0.808) for predicting the risk of malnutrition. The results of the study confirm the need to assess nutritional status and to investigate the presence of risk factors associated with malnutrition in order to achieve effective prevention and plan a better intervention strategy.
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The prevalence and risk factors for sarcopenia in older adults and long-living older adults. Arch Gerontol Geriatr 2020; 89:104089. [DOI: 10.1016/j.archger.2020.104089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/31/2022]
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Alemán-Mateo H, López-Teros MT, Ruiz-Valenzuela RE, Ramírez-Torres M, Urquidez-Romero R. Sarcopenia: Influence of Regional Skeletal Muscle Cutoff Points and Fat-Free Mass in Older Mexican People-A Pilot Study. Curr Gerontol Geriatr Res 2020; 2020:8037503. [PMID: 32549890 PMCID: PMC7281843 DOI: 10.1155/2020/8037503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/20/2020] [Accepted: 04/29/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Variation in the prevalence of sarcopenia is related to the skeletal muscle index cutoff points applied. The objective of this pilot study was to examine the recruitment process for testing different sarcopenia definitions (ASMI cutoffs) in older Mexican adults. It explored whether the prevalence of sarcopenia decreased by applying ethnic- and gender-specific, DXA-derived appendicular skeletal muscle index (ASMI)-cutoff points in the definitions, as well as some associated factors in a sample of community-dwelling older Mexican people. METHODS This is a pilot feasibility study that included a convenience sample of 217 community-dwelling older adults. Volunteers underwent DXA measurements and an assessment of functional status based on hand grip strength and physical performance. Six definitions were formed based on the 2010 EWGSOP criteria, but using different cutoff points for each of the three components, including regional cutoff points for ASMI derived from young Mexican adults. Several risk factors for sarcopenia were also assessed. RESULTS The prevalence of sarcopenia varied according to the different definitions applied. The lowest level was found with the definition that applied regional ASMI-cutoff points (p < 0.01). The sarcopenic older adults had significant lower body weight, fat mass, and fat-free mass (FFM) than the nonsarcopenic subjects. The risk of sarcopenia increased with age and low FFM (p < 0.001). CONCLUSION The present study demonstrates the feasibility of the main study, and our data support the notion that using regional ASMI cutoff points resulted in a low prevalence of sarcopenia. Therefore, it is preferable to estimate the prevalence of this condition using ethnic- and gender-specific cutoff points and to explore associated factors such as low FFM.
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Affiliation(s)
- Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria C.P. 83304, Hermosillo, Sonora, Mexico
| | - Miriam T. López-Teros
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, C.P. 01219, Ciudad de México, Distrito Federal, Mexico
| | - Roxana E. Ruiz-Valenzuela
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria C.P. 83304, Hermosillo, Sonora, Mexico
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México-Tijuana. Av. Centro Universitario 2501, Playas de Tijuana, C.P. 22500, Tijuana, Baja California, Mexico
| | - Maribel Ramírez-Torres
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria C.P. 83304, Hermosillo, Sonora, Mexico
- Coordinación de Nutrición Humana, Universidad Estatal de Sonora, Av. Ley Federal del Trabajo, Col. Apolo, C.P. 83100, Hermosillo, Sonora, Mexico
| | - René Urquidez-Romero
- Departamento de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Ave. Plutarco Elías Calles #1210, Col. Fovissste Chamizal. Ciudad Juárez, Chihuahua, Mexico
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Olgar Y, Billur D, Tuncay E, Turan B. MitoTEMPO provides an antiarrhythmic effect in aged-rats through attenuation of mitochondrial reactive oxygen species. Exp Gerontol 2020; 136:110961. [PMID: 32325093 DOI: 10.1016/j.exger.2020.110961] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/16/2020] [Accepted: 04/03/2020] [Indexed: 01/08/2023]
Abstract
The death prevalence from cardiovascular disease is significantly high in elderly-populations, while mitochondrial-aging plays an important in abnormal function of vital organs through high mitochondrial ROS production. Mitochondria have a unique mode of action by providing ATP production and modulating the cytosolic Ca2+-signaling and maintain the redox status of cardiomyocytes. There is an aging-associated impairment in oxidative phosphorylation which causes a marked dysregulation of mitochondrial biogenesis. Therefore, we aimed to examine whether a mitochondria-targeting antioxidant, MitoTEMPO, can directly provide a cardioprotective effect on ventricular cardiomyocyte function under in vitro conditions. The MitoTEMPO-treatment (0.1 μM for 4-h) of aged-ventricular cardiomyocytes (from 24-mo-old rats), compared to those of the adults (from 8-mo-old rats) markedly augmented not only the depressed biochemical parameters but also the ultrastructure of mitochondria. It also provided marked protective action against increased mitochondrial superoxide formation and Bnip3 overexpression, which both markedly induce depolarized mitochondrial potential, increase reactive oxygen species, mitochondrial swelling and fission, and accelerate mitochondrial turnover via autophagy. Furthermore, it provided marked protection against spontaneous action potentials, via shortening the prolonged action potential duration, at most, through recovery in depressed K+-channel currents. Moreover, we determined significant recovery in the depressed intracellular Ca2+-changes under electrical stimulation in MitoTEMPO-treated the aged-cardiomyocytes. Overall, we provided important information associated with an antiarrhythmic action, thereby controlling cytosolic and mitochondrial Ca2+-handling, implying its possible protective role of mitochondria-targeting antioxidant-treatment during aging.
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Affiliation(s)
- Yusuf Olgar
- Departments of Biophysics, Ankara University, School of Medicine, Ankara, Turkey
| | - Deniz Billur
- Histology-Embryology, Ankara University, School of Medicine, Ankara, Turkey
| | - Erkan Tuncay
- Departments of Biophysics, Ankara University, School of Medicine, Ankara, Turkey
| | - Belma Turan
- Departments of Biophysics, Ankara University, School of Medicine, Ankara, Turkey.
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Zhang XL, Zhang Z, Zhu YX, Tao J, Zhang Y, Wang YY, Ke YY, Ren CX, Xu J, Zhang XY. Comparison of the efficacy of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in recognizing sarcopenia and predicting its mortality. Eur J Clin Nutr 2020; 74:1029-1037. [DOI: 10.1038/s41430-020-0621-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
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Abstract
Modifications of lean mass are a frequent critical determinant in the pathophysiology and progression of heart failure (HF). Sarcopenia may be considered one of the most important causes of low physical performance and reduced cardiorespiratory fitness in older patients with HF. Sarcopenia is frequently misdiagnosed as cachexia. However, muscle wasting in HF has different pathogenetic features in sarcopenic and cachectic conditions. HF may induce sarcopenia through common pathogenetic pathways such as hormonal changes, malnutrition, and physical inactivity; mechanisms that influence each other. In the opposite way, sarcopenia may favor HF development by different mechanisms, including pathological ergoreflex. Paradoxically, sarcopenia is not associated with a sarcopenic cardiac muscle, but the cardiac muscle shows a hypertrophy which seems to be “not-functional.” First-line agents for the treatment of HF, physical activity and nutritional interventions, may offer a therapeutic advantage in sarcopenic patients irrespective of HF. Thus, sarcopenia is highly prevalent in patients with HF, contributing to its poor prognosis, and both conditions could benefit from common treatment strategies based on pharmacological, physical activity, and nutritional approaches.
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Bittencourt DCD, Schieferdecker MEM, Macedo DS, Biesek S, Silveira Gomes AR, Rabito EI. Phase Angle Reflects Loss of Functionality in Older Women. J Nutr Health Aging 2020; 24:251-254. [PMID: 32115604 DOI: 10.1007/s12603-020-1324-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study verified if the phase angle (PA) formed by the resistance (R) and reactance (Xc) obtained from bioimpedance (BIA) might be a useful tool to identify functionality. DESIGN AND PARTICIPANTS It was conducted a cross-sectional study with 152 women ≥ 65 years old from the community. MEASUREMENTS weight, height, body mass index (BMI), calf circumference (CC), hand grip strength (HGS), gait speed (GS), fat free mass (FFM), body fat (BF), PA with R and Xc from the BIA were measured. Spearman's and Pearson's correlations and the odds ratio (OR) were performed using the IBM SPSS software version 22.0. RESULTS Sixty-four percent (n=98) women are with PA below the reference. Negative moderate significant correlation was found between PA and age (r =- 0.440*; p<0.001). Moderate significant correlation was observed between PA and GS (r = 0.484**; p<0.001). Weak significant correlation was found between PA and HGS (r = 0.177*; p = 0.029). Odds ratio (OR) demonstrated that individuals with PA above the mean value have 4.77 times more chances of having increased GS (confidence interval 2.40-9.48; 95%). Women aged below the mean value have 4.02 times more chances of having higher PA (confidence interval 2.02-7.99; 95%). Younger aged women showed 4.02 times more chances of having higher PA (confidence interval 2.02-7.99; 95%). CONCLUSIONS Phase angle can be associated with functional tests, such as gait speed and hand grip strength, in older women.
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Affiliation(s)
- D C D Bittencourt
- Estela Iraci Rabito. Department of Nutrition, Federal University of Paraná. Lothário Meissner, Avenue, Curitiba, Paraná, Brazil. Zip Code: 80060-000. Fone number: +554133604008.
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Martín-Sánchez FJ, Cuesta Triana F, Rossello X, Pardo García R, Llopis García G, Caimari F, Vidán MT, Ruiz Artacho P, González Del Castillo J, Llorens P, Herrero P, Jacob J, Gil V, Fernández Pérez C, Gil P, Bueno H, Miró Ò, Matía Martín P, Rodríguez Adrada E, Santos MC, Salgado L, Brizzi BN, Docavo ML, Del Mar Suárez-Cadenas M, Xipell C, Sánchez C, Aguiló S, Gaytan JM, Jerez A, Pérez-Durá MJ, Berrocal Gil P, López-Grima ML, Valero A, Aguirre A, Pedragosa MÀ, Piñera P, LázaroAragues P, Sánchez Nicolás JA, Rizzi MA, Herrera Mateo S, Alquezar A, Roset A, Ferrer C, Llopis F, Álvarez Pérez JM, López Diez MP, Richard F, Fernández-Cañadas JM, Carratalá JM, Javaloyes P, Andueza JA, Sevillano Fernández JA, Romero R, Merlo Loranca M, Álvarez Rodríguez V, Lorca MT, Calderón L, Soy Ferrer E, Manuel Garrido J, Martín Mojarro E. Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments. Eur J Intern Med 2019; 65:69-77. [PMID: 31076345 DOI: 10.1016/j.ejim.2019.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/19/2019] [Accepted: 04/23/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to determine the impact of risk of malnutrition on 30-day mortality risk among older patients who attended in Emergency Departments (EDs) for AHF. MATERIAL AND METHODS We performed a secondary analysis of the OAK-3 Registry including all consecutive patients ≥65 years attending in 16 Spanish EDs for AHF. Risk of malnutrition was defined by the Mini Nutritional Assessment Short Form (MNA-SF) < 12 points. Unadjusted and adjusted logistic regression models were used to assess the association between risk of malnutrition and 30-day mortality. RESULTS We included 749 patients (mean age: 85 (SD 6); 55.8% females). Risk of malnutrition was observed in 594 (79.3%) patients. The rate of 30-day mortality was 8.8%. After adjusting for MEESSI-AHF risk score clinical categories (model 1) and after adding all variables showing a significantly different distribution among groups (model 2), the risk of malnutrition was an independent factor associated with 30-day mortality (adjusted OR by model 1 = 3.4; 95%CI 1.2-9.7; p = .020 and adjusted OR by model 2 = 3.1; 95%CI 1.1-9.0; p = .033) compared to normal nutritional status. CONCLUSIONS The risk of malnutrition assessed by the MNA-SF is associated with 30-day mortality in older patients with AHF who were attended in EDs. Routine screening of risk of malnutrition may help emergency physicians in decision-making and establishing a care plan.
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Affiliation(s)
- Francisco Javier Martín-Sánchez
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Federico Cuesta Triana
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Guillermo Llopis García
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Francisca Caimari
- Department of Endocrinology, University College London, Hospitals NHS Foundation Trust, London, UK
| | - María Teresa Vidán
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, Madrid, Spain
| | - Pedro Ruiz Artacho
- Department of Internal Medicine, Clínica Universitaria de Navarra, Madrid, Spain
| | - Juan González Del Castillo
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - Pere Llorens
- Emergency Department-UCE-UHD, Hospital General Universitario de Alicante, Alicante, Spain
| | - Pablo Herrero
- Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Gil
- Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Cristina Fernández Pérez
- Universidad Complutense de Madrid, Madrid, Spain; Preventive Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pedro Gil
- Universidad Complutense de Madrid, Madrid, Spain; Department of Geriatric Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Héctor Bueno
- Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Cardiology, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Òscar Miró
- Emergency Department, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Pilar Matía Martín
- Universidad Complutense de Madrid, Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alex Roset
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Carles Ferrer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Ferrán Llopis
- Hospital Universitari de Bellvitge, Barcelona, Spain
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Nasimi N, Dabbaghmanesh MH, Sohrabi Z. Nutritional status and body fat mass: Determinants of sarcopenia in community-dwelling older adults. Exp Gerontol 2019; 122:67-73. [PMID: 31022445 DOI: 10.1016/j.exger.2019.04.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/07/2019] [Accepted: 04/17/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sarcopenia is defined as the old age syndrome characterized by profound decline in muscle mass and function. This study aimed to investigate the prevalence of sarcopenia and its risk factors in older adults. METHODS Totally, 501 older people aged 65 years and older were recruited. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia (AWGS). For obtaining Skeletal Muscle mass Index (SMI), body composition was evaluated using Bioelectrical Impedance Analysis (BIA). Muscle strength and physical performance were measured by Handgrip Strength (HGS) and Gait Speed (GS), respectively. Nutritional status, physical activity level, and biochemical indicators were assessed, as well. RESULTS The prevalence of sarcopenia was 20.8%. Multiple logistic regression models of the predictors of decline in the components of sarcopenia showed that older age, low Body Mass Index (BMI), and serum albumin level were associated with a higher risk of low SMI. Low serum albumin level and older age were also predictive of low HGS. Besides, old age, high body fat mass, and low BMI were the risk factors of low GS. Conversely, increased Calf Circumference (CC) was protective against low SMI and GS. Finally, older age, male gender, low BMI, decreased mini-nutritional assessment score, low serum albumin level, and high body fat were associated with a higher risk of sarcopenia, whereas higher CC reduced its risk. CONCLUSION The prevalence of sarcopenia is high among elderly individuals. This study underlined that sarcopenia might develop in older adults with impaired nutritional status and high body fat mass. Further studies could evaluate the effects of appropriate nutritional interventions on sarcopenia management and prevention.
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Affiliation(s)
- Nasrin Nasimi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Shiraz Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Sohrabi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Lelli D, Calle A, Pérez LM, Onder G, Morandi A, Ortolani E, Colominas M, Pedone C, Inzitari M. Nutritional Status and Functional Outcomes in Older Adults Admitted to Geriatric Rehabilitations: The SAFARI Study. J Am Coll Nutr 2019; 38:441-446. [PMID: 30676263 DOI: 10.1080/07315724.2018.1541427] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Evidence about the role of nutritional status (NS) on functional outcomes (FO) after rehabilitation in older adults is scarce. Our aim was to analyze the association between NS and FO in older adults admitted to geriatric rehabilitation units. Methods: The Sarcopenia And Function in Aging Rehabilitation (SAFARI) multicenter study enrolled patients aged ≥65 years admitted to geriatric rehabilitation units in Italy and Spain. FO were absolute and relative functional gain (AFG-RFG) in Barthel Index (BI) at 1 and 3 months after admission. The association between NS (Mini Nutritional Assessment-Short Form) and FO was explored using linear regression and mixed models, adjusted for potential confounders. Analyses were then stratified for diagnosis at admission. Results: We included 415 patients (mean age 81.4 years [SD: 7.7]; 67% female; 9.4% malnourished [MN], 42.7% at risk of malnutrition [RM], and 48% well nourished [WN]). Admission diagnoses were hip fracture (39.5%), elective orthopedic surgery (EOS) (29.5%), and stroke (31%). In an adjusted linear mixed model, MN and RM participants had lower BI compared to WN (MN: β: -8.47, p = 0.023; RM: β: -5.22, p = 0.031), and differences between groups remained stable over time. After stratification for admission diagnosis, only MN patients admitted after EOS had worse FO, both at 30 days (AFG: β adjusted: -13.54, p < 0.001; RFG: β: -32, p < 0.001) and 3 months (AFG: β adjusted: -17.79, p < 0.001; RFG: β: -26.77, p = 0.002). Conclusions: In our sample, poor NS is associated with worse BI in older adults admitted to geriatric rehabilitation units; in patients undergoing EOS, MN is associated with worse FO. Our results documented for the first time the importance of assessing nutritional status before EOS.
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Affiliation(s)
- Diana Lelli
- a Area di Geriatria , Università Campus Bio-Medico di Roma , Rome , Italy
| | - Alicia Calle
- b Parc Sanitari Pere Virgili , Barcelona , Spain.,c Vall d'Hebrón Institute of Research , Barcelona , Spain.,d Department of Medicine , Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Laura Mónica Pérez
- b Parc Sanitari Pere Virgili , Barcelona , Spain.,c Vall d'Hebrón Institute of Research , Barcelona , Spain
| | - Graziano Onder
- e Centro Medicina dell'Invecchiamento , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Alessandro Morandi
- f Department of Rehabilitation and Aged Care of the Fondazione Camplani , Ancelle Hospital , Cremona , Italy
| | - Elena Ortolani
- e Centro Medicina dell'Invecchiamento , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Miriam Colominas
- b Parc Sanitari Pere Virgili , Barcelona , Spain.,c Vall d'Hebrón Institute of Research , Barcelona , Spain
| | - Claudio Pedone
- a Area di Geriatria , Università Campus Bio-Medico di Roma , Rome , Italy
| | - Marco Inzitari
- b Parc Sanitari Pere Virgili , Barcelona , Spain.,c Vall d'Hebrón Institute of Research , Barcelona , Spain.,d Department of Medicine , Universitat Autònoma de Barcelona , Barcelona , Spain
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Liguori I, Russo G, Aran L, Bulli G, Curcio F, Della-Morte D, Gargiulo G, Testa G, Cacciatore F, Bonaduce D, Abete P. Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging 2018; 13:913-927. [PMID: 29785098 PMCID: PMC5957062 DOI: 10.2147/cia.s149232] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength - a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors - in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed.
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Affiliation(s)
- Ilaria Liguori
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gennaro Russo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Luisa Aran
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giulia Bulli
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Francesco Curcio
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - David Della-Morte
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
| | - Gaetano Gargiulo
- Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy
| | - Gianluca Testa
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Azienda Ospedaliera dei Colli, Monaldi Hospital, Heart Transplantation Unit, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
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