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Nishimoto K, Tsutsumimoto K, Nakakubo S, Kiuchi Y, Misu Y, Ohata T, Shimada H. Association between physical, cognitive, and social activities with the incident of sarcopenia among community-dwelling older adults: a 4-year longitudinal study. Eur Geriatr Med 2024:10.1007/s41999-024-00985-0. [PMID: 39060781 DOI: 10.1007/s41999-024-00985-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/24/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE The purpose of the present study was to comprehensively examine the association between inadequate physical activity (PA), cognitive activity (CA), and social activity (SA) and the development of sarcopenia. METHODS We conducted a two-wave survey. In the first-wave survey, we asked participants five questions for each of the three categories-PA, CA, and SA. The low-activity group was defined as those who fell into the decline category for one or more of the five questions. In both Wave 1 and Wave 2, we assessed the sarcopenia status of our participants. The revised definition of the European Working Group on Sarcopenia in Older People 2 was used to determine sarcopenia, and the Asian Working Group for Sarcopenia criteria were used for cut-off points for muscle mass, grip strength, and walking speed. RESULTS In the second wave, we were able to follow 2,530 participants (mean age 75.0 ± 4.7 years, 47.8% men). A multivariable logistic regression showed that low-PA participants face a higher risk of incident sarcopenia, both before and after multiple imputations (odds ratio [OR] 1.62, 95% confidence interval (CI) 1.22-2.15 before imputation; OR 1.62, 95% CI 1.21-2.18 after imputation); the low-SA group also showed a higher risk of incident sarcopenia both before and after multiple imputations (OR 1.31, 95% CI 1.05-1.64 before imputation; OR 1.33, 95% CI 1.07-1.65 after imputation). CONCLUSION Each low PA and SA independently led to incident sarcopenia late in life. Encouraging not only PA, but also SA, may be effective to prevent sarcopenia among older adults.
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Affiliation(s)
- Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan.
- Medical Science Division, Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, 3-1-1 Asahi, Matsumoto City, Nagano Prefecture, 390-8621, Japan.
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
- Graduate School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima Prefecture, 890-8544, Japan
| | - Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
| | - Tomoka Ohata
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
- Graduate School of Medicine, School of Health Sciences, Nagoya University, Aichi, 1-1-20 Daiko Minami, Higashi-ward, Nagoya City, Nagoya Prefecture, 461-8673, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan
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Macêdo SGGF, de Souza Macêdo PR, Barbosa WS, Maciel ÁCC. Use of the Ishii Test for screening sarcopenia in older adults: a systematic review with meta-analysis of diagnostic test accuracy (DTA) studies. BMC Geriatr 2024; 24:609. [PMID: 39014328 PMCID: PMC11253494 DOI: 10.1186/s12877-024-05155-2] [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: 01/02/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND The Ishii Test is recommended by the European Working Group on Sarcopenia in Older People (EWGSOP2), however the use of this technique is still little explored in the clinical context and the scientific literature. OBJECTIVE We aimed to verify the use of the Test of Ishii in screening for sarcopenia in older adults. METHODS We searched three electronic databases and two reviewers independently screened and assessed the studies. Studies with older adults (60 years or more) of both genders, no year or language restriction and which aimed to evaluate sarcopenia using the Ishii Test and another diagnostic criteria were selected. A summary of the ROC curve, sensitivity and specificity were performed using the MedCalc and SPSS software programs, respectively. RESULTS A total of 3,298 references were identified in the database, 278 by manually searching, and finally 11 studies were included for the review. The screening test showed good sensitivity and specificity in both genders. All studies showed values above the considered value for the Area Under the Curve (AUC) results, without discriminating power (0.500). Four studies used the original values, and five studies developed a new cut-off point. A summary of the AUC curve showed the diamond close to one, indicating that the Ishii test has good performance for screening sarcopenia (I2=83,66%; p<0.001; 95%CI: 69.38 to 91.28 for men; and I2=60.04%; p<0.001; 95%CI: 13.06 to 81.63 for women). CONCLUSION The Ishii Test can be considered a useful tool for the early identification of sarcopenia in older adults. However, further studies are still needed to understand the behavior of this screening tool. TRIAL REGISTRATION CRD42023424392.
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Affiliation(s)
- Sabrina Gabrielle Gomes Fernandes Macêdo
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil.
| | - Pedro Rafael de Souza Macêdo
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
| | - Weslley Sales Barbosa
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
| | - Álvaro Campos Cavalcanti Maciel
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
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Liu L, Zhang Y, Shi Y, Wu L, Meng L, Zhao T. The bidirectional relationship between sarcopenia and disability in China: a longitudinal study from CHARLS. Front Public Health 2024; 12:1309673. [PMID: 38774050 PMCID: PMC11106476 DOI: 10.3389/fpubh.2024.1309673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Objectives Sarcopenia and disability represent significant concerns impacting the health of older people. This study aimed to explore the bidirectional relationship between sarcopenia and disability in Chinese older people. Methods This study recruited older people ≥60 years old from the China Health and Retirement Longitudinal Study. In phase I, the study analyzed the relation between disability and subsequent sarcopenia using multinomial logistic regression models. Conversely, in phase II, the study assessed whether sarcopenia was associated with future disability using binary logistic regression models. Results In phase I, 65 (16.80%) new cases of possible sarcopenia, 18 (4.65%) cases of sarcopenia, and 9 (2.33%) cases of severe sarcopenia were observed in the disabled older people and 282 (10.96%) new cases of possible sarcopenia, 97 (3.77%) cases of sarcopenia, 35 (1.36%) cases of severe sarcopenia were observed in the older people without disability. The OR (95% CI) for sarcopenia in older disabled individuals compared to those without disability was 1.61 (1.25-2.07). Adjusting for all covariates in 2011, the OR (95% CI) value for disabled individuals vs. those without disability was 1.35 (1.02-1.79). Subgroup analyses showed that disabled participants aged < 80 years were more likely to have sarcopenia (OR = 1.42, 95% CI: 1.07-1.89), and the risk of sarcopenia did not differ significantly between sex subgroups. In phase II, 114 cases (33.83%) in the possible sarcopenia patients, 85 cases (28.91%) in the sarcopenia patients, 23 cases (35.94%) in the severe sarcopenia patients, and 501 cases (16.10%) in the individuals without sarcopenia showed symptoms of disability. The OR (95% CI) for disability was 2.66 (2.08-3.40) in the possible sarcopenia patients, 2.12 (1.62-2.77) in the sarcopenia patients, and 2.92 (1.74-4.91) in the severe sarcopenia patients compared with the no sarcopenia patients. After adjusting for all covariates in 2011, the OR (95% CI) values were 2.21 (1.70-2.85) in the possible sarcopenia patients, 1.58 (1.14-2.19) in the sarcopenia patients, and 1.99 (1.14-3.49) in the severe sarcopenia patients, as compared to the older people without sarcopenia. Subgroup analyses showed that compared with men, women with possible sarcopenia had a higher risk of disability (OR = 2.80, 95% CI: 1.98-3.97). In addition, participants aged < 80 years with sarcopenia or severe sarcopenia s were more likely to have disability (OR = 2.13, 95% CI: 1.52-2.98; OR = 2.98, 95% CI: 1.60-5.54). Conclusion The occurrence of disability increase the risk of sarcopenia in the older people, and baseline sarcopenia predicts the future disability in older people.
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Affiliation(s)
| | - Yan Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Shi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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Schluessel S, Huemer MT, Peters A, Drey M, Thorand B. Sarcopenic obesity using the ESPEN and EASO consensus statement criteria of 2022 - Results from the German KORA-Age study. Obes Res Clin Pract 2023; 17:349-352. [PMID: 37633820 DOI: 10.1016/j.orcp.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE The recent consensus statement of ESPEN and EASO recommends reviewing existing datasets to assess the prevalence of sarcopenic obesity based on the new definition and diagnostic criteria. Therefore, this study aimed to determine the prevalence of sarcopenic obesity in a population-based study and to assess the association of this new definition with clinical traits. METHODS The KORA (Cooperative Health Research in the Region of Augsburg)-Age baseline examination (2008/2009) comprised 1079 participants aged 65 years and older from southern Germany. Sarcopenic obesity was defined in 998 participants (mean age 75.6 years, 498 women) with complete data according to the 2022 ESPEN and EASO algorithm, which includes reduced handgrip strength, reduced skeletal muscle mass per weight, and elevated fat mass. Body composition was measured using bioelectrical impedance analysis. Associations between sarcopenic obesity and physical activity, disability, multimorbidity, and polypharmacy were assessed using logistic regression analysis. RESULTS The overall prevalence of sarcopenic obesity was 4.5 % (5.0 % in men, 4.0 % in women). Sarcopenic obesity was associated with disability (2.87 [CI 1.84-4.48]), multimorbidity (≥ 2 comorbidities; 2.59 [CI 1.23-5.46]), polypharmacy (≥ 5 drugs; 1.96 [CI 1.05-3.63]), cognitive impairment (3.03 [CI 1.51-6.06]) and arthritis (2.66 [CI 1.39-5.07]) after adjusting for age, sex and marital status. CONCLUSION Sarcopenic obesity is prevalent in the older German population and is associated with several clinical traits. Future longitudinal studies are needed to further elucidate whether the observed associations could be causal.
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Affiliation(s)
- Sabine Schluessel
- Department of Medicine IV, University Hospital, Ludwig Maximilian University Munich, Ziemssenstraße 5, 80336 Munich, Germany.
| | - Marie-Theres Huemer
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany; Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig-Maximilians University of Munich, Marchioninistraße 15, 81377 Munich, Germany; German Center for Diabetes Research (DZD), partner site Munich-Neuherberg, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany; German Center for Cardiovascular Disease Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Michael Drey
- Department of Medicine IV, University Hospital, Ludwig Maximilian University Munich, Ziemssenstraße 5, 80336 Munich, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), partner site Munich-Neuherberg, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
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Farsijani S, Cauley JA, Peddada SD, Langsetmo L, Shikany JM, Orwoll ES, Ensrud KE, Cawthon PM, Newman AB. Relation Between Dietary Protein Intake and Gut Microbiome Composition in Community-Dwelling Older Men: Findings from the Osteoporotic Fractures in Men Study (MrOS). J Nutr 2023; 152:2877-2887. [PMID: 36205552 PMCID: PMC9839986 DOI: 10.1093/jn/nxac231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Little is known about the association of specific nutrients, especially proteins, on age-related gut dysbiosis. OBJECTIVES To determine the associations between the quantity and sources (vegetable and animal) of dietary protein intake and gut microbiome composition in community-dwelling older men. METHODS We performed a cross-sectional analysis on 775 older men from the Osteoporotic Fractures in Men Study (MrOS) (age 84.2 ± 4.0 y) with available dietary information and stool samples at visit 4 (2014-2016). Protein intake was estimated from a brief FFQ and adjusted to total energy intake. The gut microbiome composition was determined by 16S (v4) sequencing (processed by DADA2 and SILVA). A total of 11,534 amplicon sequence variants (ASVs) were identified and assigned to 21 phyla with dominance of Firmicutes (45%) and Bacteroidetes (43%). We performed α-diversity, β-diversity, and taxa abundance (by Analysis of Compositions of Microbiomes with Bias Correction [ANCOM-BC]) to determine the associations between protein intake and the gut microbiome. RESULTS Median protein intake was 0.7 g/(kg body weight · d). Participants with higher energy-adjusted protein intakes had higher Shannon and Chao1 α-diversity indices (P < 0.05). For β-diversity analysis, participants with higher protein intakes had a different center in weighted and unweighted UniFrac Principal Co-ordinates Analysis (PCoA) compared with those with lower intake (P < 0.05), adjusted for age, race, education, clinical center, batch number, fiber and energy intake, weight, height, and medications. Similarly, higher protein consumptions from either animal or vegetable sources were associated with higher gut microbiome diversity. Several genus-level ASVs, including Christensenellaceae, Veillonella, Haemophilus, and Klebsiella were more abundant in participants with higher protein intakes, whereas Clostridiales bacterium DTU089 and Desulfovibrio were more abundant in participants with lower protein intake (Bonferroni corrected P < 0.05). CONCLUSIONS We observed significant associations between protein intake and gut microbiome diversity in community-living older men. Further studies are needed to elucidate the mediation role of the gut microbiome on the relation between protein intake and health outcomes in older adults.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shyamal D Peddada
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Lisa Langsetmo
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, MN, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric S Orwoll
- Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kristine E Ensrud
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, University of California San Francisco, San Francisco, CA, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
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Fernandes S, Rodrigues da Silva E, New York B, Macedo P, Gonçalves R, Camara S, Larco R, Maciel A. Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review. J Nutr Health Aging 2022; 26:452-460. [PMID: 35587757 DOI: 10.1007/s12603-022-1788-6] [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: 11/29/2022]
Abstract
BACKGROUND Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. OBJECTIVES this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. METHODS In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages. RESULTS 19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world. CONCLUSION It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.
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Affiliation(s)
- S Fernandes
- Sabrina Fernandes, Universidade Federal do Rio Grande do Norte, Brazil,
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Nozoe M, Kubo H, Kanai M, Yamamoto M. Relationships between Pre-Stroke SARC-F Scores, Disability, and Risk of Malnutrition and Functional Outcomes after Stroke-A Prospective Cohort Study. Nutrients 2021; 13:nu13103586. [PMID: 34684587 PMCID: PMC8537569 DOI: 10.3390/nu13103586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was the modified Rankin Scale (mRS) 3 months after stroke. The relationship between SARC-F scores and poor functional outcomes was examined using a logistic regression analysis. Furthermore, the applicability of SARC-F scores to the assessment of poor functional outcomes was analyzed based on the area under the receiver operating curve (ROC). Eighty-one out of the 324 patients enrolled in the present study (25%) had poor functional outcomes (mRS ≥ 4). The results of the multivariate analysis revealed a correlation between SARC-F scores (OR = 1.29, 95% CI = 1.05–1.59, p = 0.02) and poor functional outcomes. A cut-off SARC-F score ≥ 4 had low-to-moderate sensitivity (47.4%) and high specificity (87.3%). The present results suggest that the measurement of pre-stroke SARC-F scores is useful for predicting the outcomes of stroke patients.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
- Correspondence: ; Tel.: +81-78-413-3584
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
| | - Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
| | - Miho Yamamoto
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
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Le X, Wei Y, Hao D, Shan L, Li X, Shi Q, Ding D, Cheng X, Lim HLE, Ng BY. Psychometric Properties of the Chinese Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia. Calcif Tissue Int 2021; 109:415-422. [PMID: 33991208 DOI: 10.1007/s00223-021-00859-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022]
Abstract
A quality of life questionnaire specific to sarcopenia (SarQoL®) was successfully developed. There is a huge demand for translation and validation in Chinese. The aim of this study was to translate the SarQoL® into Chinese and investigate its psychometric properties. The translation and cross-cultural adaptation process recommended by the developers of the initial questionnaire was followed. A total of 159 participants were investigated. The translation process consists of five steps: (1) two bilinguals independently translate initial English to Chinese; (2) synthesize the two translations into one; (3) backward translations; (4) expert committee review and (5) test of the pre-final version. The validation consists of three parts: (1) validity (discriminative power, construct validity); (2) reliability (internal consistency, test-retest reliability) and (3) floor and ceiling effects. There was no difficulty in translation process. Regarding the validity, good discriminant validity {quality of life for sarcopenic subjects [35.56 (29.73-42.70)] vs. non-sarcopenic ones [73.22 (60.09-82.90)], p < 0.001} and consistent construct validity [high correlations (spearman's r) of SarQoL® with generic Short Form-36 version 2 questionnaire (0.250 to 0.824) and EuroQoL-5-Dimension questionnaire (- 0.114 to - 0.823)] were found in SarQoL®. Regarding reliability, high internal consistency (Cronbach's alpha coefficient was 0.867) and excellent test-retest reliability (intraclass coefficient correlation was 0.997, 95% CI 0.994-0.998) were found. No ceiling/floor effect was reflected. A valid SarQoL® questionnaire is now available for Chinese population. It can provide a better understanding of the sarcopenia disease burden and serve as a therapeutic outcome indicator in research.
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Affiliation(s)
- Xiaofeng Le
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Yao Wei
- Department of Geriatrics, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China.
| | - Lequn Shan
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Xiaoli Li
- Department of Geriatrics, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Qifang Shi
- School of Nursing, Xi'an Jiaotong University, No. 28, Xianning West road, Xi'an, 710048, Shaanxi, China
| | - Ding Ding
- Faculty of Humanities and Social Sciences, Xi'an Jiaotong University, No. 28, Xianning West road, Xi'an, 710048, Shaanxi, China
| | - Xiang Cheng
- General Office, Shaanxi Bureau of National Food and Strategic Reserves Administration, No. 369, ChangYing West road, Xi'an, 710012, Shaanxi, China
| | - Hwee Ling Eileen Lim
- Spatial and Furniture Design, Nanyang Academy of Fine Arts' 14, Visenze Pte Ltd, Blk 67 Ayer Rajah Crescent, Singapore, 139950, Singapore
| | - Bao Yi Ng
- Chemistry, National University of Singapore, No. 21, Lower Kent Ridge Road, Singapore, 119077, Singapore
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Abstract
Die Sarkopenie beschreibt einen generalisierten Verlust von Muskelkraft, -masse und -funktion. Sie geht mit reduzierter Lebensqualität und erhöhter Mortalität einher. Zur Identifizierung gefährdeter Patienten in der Primärversorgung dient der Screeningfragebogen für Sarkopenie (SARC-F), welcher fünf Funktionsbereiche des alltäglichen Lebens erfasst. Im Fall einer relevanten Einschränkung sollte die Messung der Handkraft mithilfe eines Dynamometers und/oder die Beinkraft mithilfe des Chair-Rising-Test erfolgen. Bei pathologischen Ergebnissen sollte der relative Skelettmuskelindex z. B. per Dual-Röntgen-Absorptiometrie bestimmt werden. Unterschreitet dieser den geschlechtsspezifischen Grenzwert, ist die Diagnose einer Sarkopenie zu stellen. Bei normwertiger Muskelmasse liegt eine Präsarkopenie vor. In beiden Fällen sollten die Ursachen abgeklärt und eine Therapie begonnen werden. Eine Verlaufsuntersuchung wird zur Differenzierung zwischen akuter und chronischer Sarkopenie und zur Beurteilung der Krankheitsprogression empfohlen.
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Hofmeister F, Baber L, Ferrari U, Hintze S, Jarmusch S, Krause S, Meinke P, Mehaffey S, Neuerburg C, Tangenelli F, Schoser B, Drey M. Late-onset neuromuscular disorders in the differential diagnosis of sarcopenia. BMC Neurol 2021; 21:241. [PMID: 34172001 PMCID: PMC8229316 DOI: 10.1186/s12883-021-02264-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022] Open
Abstract
Background Sarcopenia is the age-related loss of muscle mass and strength. Undiagnosed late-onset neuromuscular disorders need to be considered in the differential diagnosis of sarcopenia. Aim Based on emblematic case reports and current neuromuscular diagnostic guidelines for three common late-onset neuromuscular disorders, a differential diagnostic approach for geriatric patients presenting with a sarcopenic phenotype is given. Methods Patients over 65 years of age with sarcopenia, amyotrophic lateral sclerosis, inclusion body myositis and myotonic dystrophy type 2 were recruited. All patients were assessed for sarcopenia based on the revised European consensus definition. Patients with neuromuscular diseases were diagnosed according to the revised El Escorial criteria and the European neuromuscular centre criteria. Phenotypes and diagnostic criteria for all patients were summarized including their specific histopathological findings. Results All patients with neuromuscular diseases were positively screened for sarcopenia and classified as severe sarcopenic by means of assessment. The clinical phenotype, the evolution pattern of weakness and muscle atrophy combined with laboratory finding including electromyography could unquestionably distinguish the diseases. Discussion Neuromuscular disorders can manifest beyond the age of 65 years and misdiagnosed as sarcopenia. The most common diseases are inclusion body myositis, amyotrophic lateral sclerosis and myotonic dystrophy type 2. A diagnostic work-up for neuromuscular diseases ensures their correct diagnosis by clinical-, electrophysiological, histopathological, and genetic work-up. Conclusions In geriatric patients with a focal or asymmetrical muscular weakness and atrophy, sarcopenia assessment should be extended with patient’s history of disease course. Furthermore, concomitant diseases, analysis of serum creatine kinase, electrophysiological examination, and in selected patients muscle biopsy and gene analysis is needed to rule out a late-onset neuromuscular disorder.
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Affiliation(s)
- Fabian Hofmeister
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Baber
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany
| | - Uta Ferrari
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Hintze
- Department of Neurology, Friedrich-Baur-Institute, University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Jarmusch
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany
| | - Sabine Krause
- Department of Neurology, Friedrich-Baur-Institute, University Hospital, LMU Munich, Munich, Germany
| | - Peter Meinke
- Department of Neurology, Friedrich-Baur-Institute, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Mehaffey
- Department of General-, Trauma- and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Carl Neuerburg
- Department of General-, Trauma- and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Fabiana Tangenelli
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, University Hospital, LMU Munich, Munich, Germany
| | - Michael Drey
- Department of Medicine IV, Geriatrics, University Hospital, LMU Munich, Munich, Germany.
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Sarcopenia and Malnutrition Screening in Female Osteoporosis Patients-A Cross-Sectional Study. J Clin Med 2021; 10:jcm10112344. [PMID: 34071858 PMCID: PMC8198508 DOI: 10.3390/jcm10112344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
Sarcopenia and malnutrition are important determinants of increased fracture risk in osteoporosis. SARC-F and MNA-SF are well-established questionnaires for identifying patients at risk for these conditions. We sought to evaluate the feasibility and potential added benefit of such assessments as well as the actual prevalence of these conditions in osteoporosis patients. We conducted a cross-sectional, single-center study in female osteoporosis patients ≥ 65 years (SaNSiBaR-study). Results of the sarcopenia (SARC-F) and malnutrition (MNA-SF) screening questionnaires were matched with a functional assessment for sarcopenia and data from patients’ medical records. Out of 107 patients included in the analysis, a risk for sarcopenia (SARC-F ≥ 4 points) and a risk for malnutrition (MNA-SF ≤ 11 points) was found in 33 (30.8%) and 38 (35.5%) patients, respectively. Diagnostic overlap with coincident indicative findings in both questionnaires was observed in 17 patients (16%). As compared to the respective not-at-risk groups, the mean short physical performance battery (SPPB) score was significantly reduced in both patients at risk for sarcopenia (7.0 vs. 10.9 points, p < 0.001) and patients at risk for malnutrition (8.7 vs. 10.5 points, p = 0.005). Still, confirmed sarcopenia according to EWGSOP2 criteria was present in only 6 (6%) of all 107 patients, with only 3 of them having an indicative SARC-F score. Bone mineral density was not significantly different in any of the at-risk groups at any site. In summary, applying SARC-F and MNA-SF in osteoporosis patients appears to be a complementary approach to identify individuals with functional deficits.
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[Osteosarcopenia]. Internist (Berl) 2021; 62:505-512. [PMID: 33860809 DOI: 10.1007/s00108-021-01025-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
Osteoporosis is nowadays understood as an increased risk of fractures, with bone density measurement by dual-energy X‑ray absorptiometry (DXA) being a useful diagnostic criterion and a potent fracture predictor; however, especially in geriatric patients the result is often falsely negative, so that the diagnosis, indications for treatment and treatment selection should be based on an overall clinical evaluation of the individual situation. Sarcopenia is defined as a geriatric syndrome characterized by a generalized loss of skeletal mass and muscle function. Sarcopenia is associated with an increased likelihood of adverse outcomes including falls, fractures, disability and mortality. Since 2018 it is possible in Germany to encode sarcopenia in the International Statistical Classification of Diseases and Related Health Problems, 10th revision, German modification (ICD-10-GM, M62.50). In the case of a high fracture risk and indications for the presence of sarcopenia, the whole body composition should be assessed by DXA within the framework of the measurement of bone mineral density. In the treatment of osteosarcopenia non-pharmacological measures must be initiated in addition to pharmacological measures. It is particularly important to clarify and if necessary to resolve the cause of falls resulting in fractures as well as to regularly reevaluate the treatment goals.
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Ferrari U, Schmidmaier R, Jung T, Reincke M, Martini S, Schoser B, Bidlingmaier M, Drey M. IGF-I/IGFBP3/ALS Deficiency in Sarcopenia: Low GHBP Suggests GH Resistance in a Subgroup of Geriatric Patients. J Clin Endocrinol Metab 2021; 106:e1698-e1707. [PMID: 33378445 DOI: 10.1210/clinem/dgaa972] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Definition of etiological subgroups of sarcopenia may help to develop targeted treatments. insulin like growth factor-I (IGF-I), Insulinlike growth factor binding protein 3 (IGFBP3), and acid labile subunit (ALS) build a ternary complex that mediates growth hormone (GH) effects on peripheral organs, such as muscle. Low GH binding protein (GHBP) as a marker of GH receptor number would hint toward GH resistance. OBJECTIVE We aimed to analyze the association of IGF-I, IGFBP3, and ALS with sarcopenia. STUDY PARTICIPANTS AND SETTING A total of 131 consecutively recruited patients of a geriatric ward were included in a single-center cross-sectional analysis; the nonsarcopenic patients served as controls. METHODS Measures included sarcopenia status by hand-grip strength measurement and Skeletal Muscle Index (SMI); IGF-I, IGFBP3, ALS, GH, GHBP; body mass index (BMI); Activity of Daily Living (ADL); Mini-Mental State Examination (MMSE); routine laboratory parameters; and statistical regression modeling. RESULTS Compared with controls, sarcopenic patients did not differ regarding age, sex, ADL, MMSE, C-reactive protein, glomerular filtration rate, and albumin serum concentrations. However, sarcopenic patients had significantly lower IGF-I, IGFBP3, and ALS. IGF-I and ALS associated significantly with sarcopenia and low hand-grip strength, even after adjustment for age, sex, BMI, and albumin, but not with low SMI. GHBP serum was low in sarcopenic patients, but normal in geriatric patients without sarcopenia. Over 60% of patients with IGF-I/ALS deficiency patients showed GH resistance. CONCLUSIONS Our data suggest that in geriatric patients, low IGF-I/IGFBP3/ALS could be evaluated for causative connection of the sarcopenia spectrum. Low GHBP points toward potential GH resistance as one possible explanation of this deficiency.
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Affiliation(s)
- Uta Ferrari
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Ralf Schmidmaier
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Jung
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Martin Reincke
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Martini
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | | | - Michael Drey
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
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Kemp VL, Piber LDS, Ribeiro AP. Can physical activity levels and relationships with energy expenditure change the clinical aspects of sarcopenia and perceptions of falls among elderly women? Observational cross-sectional study. SAO PAULO MED J 2021; 139:285-292. [PMID: 33978131 PMCID: PMC9625012 DOI: 10.1590/1516-3180.2020.0602.r1.0402021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/04/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Physical activity (PA) is an effective strategy for managing sarcopenia in the elderly, but few studies have addressed PA levels regarding age-related changes. OBJECTIVE To ascertain the effects of elderly women's PA levels on sarcopenia, physical performance, handgrip strength and perception of the risk of falling, and their relationship with energy expenditure. DESIGN AND SETTING Observational cross-sectional study conducted in the southern region of the city of São Paulo, Brazil. METHODS Forty-seven elderly women were evaluated and divided into three groups: low PA (n = 13); moderate PA (n = 16); and high PA (n = 18). Their PA levels were investigated through the International Physical Activity Questionnaire (IPAQ); sarcopenia index, through dual-energy radiological absorptiometry; physical performance through the Timed Up & Go test; handgrip strength, using a digital dynamometer; and perception of the risk of falling, through the Fall Risk Awareness Questionnaire. RESULTS High PA level indicated higher skeletal muscle mass index, physical performance and IPAQ score, compared with low and moderate PA levels. Multiple linear regression analysis showed that higher IPAQ energy expenditure at high and moderate PA levels was a good predictor of higher physical performance and increased perception of the risk of falling. CONCLUSION Elderly women classified as having high PA level showed improvements in sarcopenia, handgrip strength, physical performance and perception of the risk of falling. The IPAQ energy expenditure of the elderly women with high and moderate PA levels was a good predictor of physical performance and improved perception of the risk of falling.
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Affiliation(s)
- Vitório Luís Kemp
- MD, MSc. Orthopedic and Sport Medicine Physician, Postgraduate Health Science Department, Medical School, Universidade Santo Amaro (UNISA), São Paulo (SP), Brazil.
| | - Leonardo de Souza Piber
- MD, MSc. Professor, Medical School, Universidade Santo Amaro (UNISA), São Paulo (SP), Brazil; and Attending Physician at Department of Radiology and Imaging, Center for Diagnostic Medicine, São Paulo (SP), Brazil.
| | - Ana Paula Ribeiro
- MD, PhD. Professor and Coordinator of the Biomechanics and Musculoskeletal Rehabilitation Laboratory, Postgraduate Health Science Department, Medical School, Universidade Santo Amaro (UNISA), São Paulo (SP), Brazil; and Postdoctoral Student, Medical School, Universidade de São Paulo (USP), São Paulo (SP), Brazil.
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Shimada H, Tsutsumimoto K, Doi T, Lee S, Bae S, Nakakubo S, Makino K, Arai H. Effect of Sarcopenia Status on Disability Incidence Among Japanese Older Adults. J Am Med Dir Assoc 2020; 22:846-852. [PMID: 33232685 DOI: 10.1016/j.jamda.2020.10.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/23/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The updated definition of sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP2) recommends both low muscle mass and quality to diagnose sarcopenia; concurrent poor physical performance is considered indicative of severe sarcopenia; however, the relationship between the revised definition and disability incidence among Japanese older adults is unclear. Therefore, we aimed to examine the associations between EWGSOP2-defined sarcopenia and disability incidence among community-dwelling older Japanese adults. DESIGN Nationwide study. SETTING AND PARTICIPANTS We included 4561 individuals aged ≥65 years and enrolled in the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS). METHODS Skeletal muscle mass was assessed using a bioimpedance analysis device; handgrip strength and walking speed were measured as physical performance indicators. We used the Asian Working Group for Sarcopenia cutoffs to define low muscle mass and poor physical performance. We stratified all participants into nonsarcopenia, sarcopenia, and severe sarcopenia groups. Disability incidence was prospectively determined over 49 months using data extracted from the Japanese long-term care insurance system. RESULTS The prevalence of sarcopenia and severe sarcopenia was 3.4% and 1.7%, respectively. Participants with any form of sarcopenia were at a higher risk of disability [hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.27-2.49]. Although participants with severe sarcopenia showed a higher risk of disability (HR 2.00, 95% CI 1.32-3.02), there was no significant disability risk in the sarcopenia group (HR 1.54, 95% CI 0.97-2.46). Grip strength (HR 0.96, 95% CI 0.94-0.98) and walking speed (HR 0.19, 95% CI 0.12-0.30) negatively correlated with disability incidence. CONCLUSIONS AND IMPLICATIONS Severe sarcopenia, involving low muscle mass and poor physical performance, might increase disability risk in older adults, as opposed to low muscle mass alone. Further studies are needed to determine whether sarcopenia without poor physical performance increases disability risk.
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Affiliation(s)
- Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
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Tsutsumimoto K, Doi T, Nakakubo S, Kim M, Kurita S, Ishii H, Shimada H. Association between anorexia of ageing and sarcopenia among Japanese older adults. J Cachexia Sarcopenia Muscle 2020; 11:1250-1257. [PMID: 32190984 PMCID: PMC7567148 DOI: 10.1002/jcsm.12571] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/10/2020] [Accepted: 02/25/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Malnutrition plays an essential role in the mechanism of pathogenesis for sarcopenia. In late life, both food consumption and energy intakes decline. One of key factors for reduced energy intakes is anorexia of ageing. The aim of this study is to examine the association between anorexia of ageing and sarcopenia among community-dwelling elderly Japanese individuals. METHODS This uses population-based, cross-sectional cohort study of elderly Japanese individuals. Anorexia of ageing was assessed via a simplified nutritional appetite questionnaire. Handgrip strength and walking speed were tested, and skeletal muscle mass was assessed using a bio-impedance analysis device. Subjects with sarcopenia were defined as those who met the criteria of the Asian Working Group for Sarcopenia. The association between anorexia of ageing and sarcopenia was then analysed via multiple regression analysis. RESULTS In total, 9,496 elderly Japanese individuals were evaluated (mean age 74.1 ± 5.4 years; male, 47.0%). The prevalence of anorexia of ageing was 9.8% (n = 927) in the present study. The prevalence of sarcopenia in men was 1.1%, 1.8%, 6.1%, 10.1%, and 21.2% and was 1.6%, 3.3%, 3.6%, 4.8%, and 7.4% in women aged 65-69, 70-74, 75-79, 80-84, and 85 years and older, respectively. The prevalence of anorexia also showed an age-dependent increase in both sexes (P < 0.001, respectively). The prevalence of anorexia in men was 8.3%, 6.3%, 9.8%, 13.6%, and 12.9% and was 7.9%, 9.4%, 10.5%, 17.6%, and 17.1% in women aged 65-69, 70-74, 75-79, 80-84, and 85 years and older, respectively. In multivariable logistic regression model adjusted for the covariates except for albumin, anorexia of ageing was independently associated with sarcopenia (OR: 1.45, 95% CI: 1.07 to 1.95; P = 0.015). This significant association remained even after adjusting for all covariates including nutritional status (OR: 1.42, 95% CI: 1.06 to 1.92, P = 0.020). CONCLUSIONS Anorexia of ageing is associated with sarcopenia among Japanese elderly individuals. Further studies are needed to determine whether a causal association exists between anorexia and sarcopenia.
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Affiliation(s)
- Kota Tsutsumimoto
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takehiko Doi
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sho Nakakubo
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Minji Kim
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Satoshi Kurita
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hideaki Ishii
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyuki Shimada
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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Abstract
Sarcopenia is characterized by a generalized loss of muscle function, strength and mass and is codable in Germany since 2018 in the ICD-10-GM (M62.50). For screening in primary care, it is possible to determine muscle function and strength by means of a sarcopenia questionnaire (SARC-F) as a self-filler with 5 questions of restrictions. With an increased score of 4 and higher, an examination of the musculature and a determination of the skeletal muscle mass index should be performed via dual energy X-ray absorption measurement (DXA) or bioelectric impedance analysis (BIA).If hand and/or leg strength is limited, the patient has probable sarcopenia and, according to the current revised version of the European consensus on sarcopenia, therapy can already be started and the cause clarified. A DXA or BIA examination confirms the diagnosis of sarcopenia by a lowered skeletal muscle index. A follow-up examination is recommended to differentiate between acute or chronic sarcopenia and to assess the progression of the disease. The severity of the disease is defined by additional examinations such as gait speed, timed up and go test (TUG) and/or short physical performance battery (SPPB). Patients with sarcopenia suffer from increasing immobility and disability and have an increased risk of falls, fractures and mortality. Frequently, co-morbidities should be clarified in all affected patients.
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18
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German Version of SARC-F: Translation, Adaption, and Validation. J Am Med Dir Assoc 2020; 21:747-751.e1. [DOI: 10.1016/j.jamda.2019.12.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
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Sarcoscore: A Novel Approach for Assessing Sarcopenia and Functional Disability in Older Adults. J Clin Med 2020; 9:jcm9030692. [PMID: 32143446 PMCID: PMC7141295 DOI: 10.3390/jcm9030692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022] Open
Abstract
Sarcopenia is associated with instrumental activities of daily living (IADL) and basic activities of daily living (BADL) disabilities. We developed an index for assessing sarcopenia degree (sarcoscore) and compared it to the Asian Working Group for Sarcopenia (AWGS) criteria. Principal component analyses of walking speed, handgrip strength, and skeletal muscle index were performed to develop a sarcoscore using 3088 Japanese population-based cross-sectional data. During the nine-year follow-up, 278 of 2571 and 88 of 2341 participants developed IADL and BADL disabilities, respectively. Adjusted Cox proportional hazards regression models showed that the sarcoscore criteria, defined as proportional to the sarcopenia prevalence diagnosed by the AWGS criteria, had higher hazard ratios (HRs) and 95% confidence interval (CI) for disability onset than the AWGS criteria (IADL disability: 2.19 (1.64-2.93) vs 1.79 (1.32-2.43), BADL disability: 4.28 (2.63-6.96) vs 3.22 (1.97-5.27)). The adjusted HRs for IADL and BADL disabilities were reduced by 4% and 8% per point increase in the sarcoscore, respectively. The sarcoscore assessed the degree of sarcopenia and had a satisfactory performance for predicting functional disabilities in older Japanese adults, suggesting its usefulness as a complementary composite marker for clinical diagnosis.
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Krenovsky JP, Bötzel K, Ceballos-Baumann A, Fietzek UM, Schoser B, Maetzler W, Ferrari U, Drey M. Interrelation between Sarcopenia and the Number of Motor Neurons in Patients with Parkinsonian Syndromes. Gerontology 2020; 66:409-415. [PMID: 32088717 DOI: 10.1159/000505590] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/23/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Pathogenesis in a subgroup of sarcopenic patients seems to be based on a reduced number of motor neurons. This study aimed at investigating the overlap between sarcopenia and neurodegeneration, as reflected by a low number of motor neurons in patients with Parkinsonian syndromes (PS). METHODS The motor unit number index (MUNIX) of the hypothenar muscle was used to assess the number and size (MUSIX) of motor units (MUs) in patients with idiopathic Parkinson disease (iPD, n = 53), patients with atypical Parkinsonian syndrome (aPS, n = 21), and a control group (n = 30). Mean age of participants was 70.3 years and 54.1% were female. Skeletal muscle mass by bioelectrical impedance analysis, hand-grip strength and gait speed were measured. Based on these assessments, sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. RESULTS Sarcopenia criteria were met by 10 patients with PS (13.5%). The study group had significantly lower MUNIX values than the control group (109 [SD ±39.1] vs. 129 [SD ±45.1]; p = 0.020) even after adjustment for age and sex. Three of the 5 sarcopenic iPD patients (75%) had pathological low MUNIX values (<80). DISCUSSION/CONCLUSION Sarcopenia is a frequent comorbidity in PS. The pathologically low MUNIX values found in 75% of our sarcopenic iPD patients provides further support for the existence of a neurodegenerative overlap syndrome with a reduced number of MUs potentially leading to sarcopenia. This finding warrants further evaluation.
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Affiliation(s)
- Jan-Peter Krenovsky
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany,
| | - Kai Bötzel
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Andres Ceballos-Baumann
- Schön Klinik München Schwabing, Department of Neurology and Clinical Neurophysiology, Munich, Germany
| | - Urban M Fietzek
- Schön Klinik München Schwabing, Department of Neurology and Clinical Neurophysiology, Munich, Germany
| | - Benedikt Schoser
- Friedrich Baur Institute at the Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Uta Ferrari
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Michael Drey
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
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Papadopoulou SK, Tsintavis P, Potsaki P, Papandreou D. Differences in the Prevalence of Sarcopenia in Community-Dwelling, Nursing Home and Hospitalized Individuals. A Systematic Review and Meta-Analysis. J Nutr Health Aging 2020; 24:83-90. [PMID: 31886813 DOI: 10.1007/s12603-019-1267-x] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sarcopenia is an age-related disease which leads to a decline in muscle mass and function and is one of the most important health issues in elderly people with a high rate and variety of adverse outcomes. OBJECTIVE The current systematic review and meta-analysis study was carried out to estimate the overall prevalence of sarcopenia in both males and females in different regions around the world and to show the major differences in its occurrence among different populations. DESIGN A systematic review and meta-analysis of studies published in PubMed (Medline) and Scopus. PARTICIPANTS Community dwelling, nursing home and hospitalized older adults aged over 60 years. MEASUREMENTS Sarcopenia was defined by the major validated diagnostic criteria, such as the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia (AWGS) and the International Working Group on Sarcopenia (IWGS). The model used was the random effect model for estimating the prevalence of sarcopenia. The sex-specific prevalence of sarcopenia as well as 95% CI (Confidence interval) were calculated using MetaXL (version 5.3). Heterogeneity assessment was carried out by subgroup analysis. RESULTS We included 41 studies with a total of 34955 participants. The prevalence of sarcopenia in community-dwelling individuals in the included studies were 11% (95% CI: 8-13%) in men and 9% (95% CI: 7-11%) in women. The prevalence of sarcopenia in nursing-home individuals in the included studies were 51% (95% CI: 37-66%) in men and 31% (95% CI: 22-42%) in women and in hospitalized individuals were 23% (95%, CI: 15-30%) in men and 24% (95% CI: 14-35%) in women. CONCLUSIONS Despite the differences encountered between the studies, regarding diagnostic tools used to measure of muscle mass, different regions around the world and different populations and clinical settings, this systematic review revealed that a significant proportion of old people has sarcopenia (major in nursing homes), even in populations healthy in general. However, sarcopenia is caused by the aging progress, early diagnosis and individualized care, including physical activity and nutrition, can prevent some adverse outcomes in all populations.
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Affiliation(s)
- S K Papadopoulou
- Dimitrios Papandreou, PhD, M.Ed, MS, RDN, Professor of Nutrition and Dietetics Department of Health Sciences, CNHS, Abu Dhabi, UAE,
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Conzade R, Grill E, Bischoff-Ferrari HA, Ferrari U, Horsch A, Koenig W, Peters A, Thorand B. Vitamin D in Relation to Incident Sarcopenia and Changes in Muscle Parameters Among Older Adults: The KORA-Age Study. Calcif Tissue Int 2019; 105:173-182. [PMID: 31069442 DOI: 10.1007/s00223-019-00558-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/25/2019] [Indexed: 01/06/2023]
Abstract
Effects of low serum 25OHD on age-related changes in muscle mass and function remain unclear. Our aims were to explore associations of baseline 25OHD levels with prevalent and incident sarcopenia and changes in muscle parameters, and to examine the role of parathyroid hormone (PTH) therein. Cross-sectional (n = 975) and prospective analyses (n = 702) of older adults aged 65-93 years participating in the KORA-Age study. Sarcopenia was defined using the 2010 European Working Group on Sarcopenia in Older People (EWGSOP) criteria as low muscle mass combined with low grip strength or low physical performance. Associations with baseline 25OHD were examined in multiple regression analyses. Low vitamin D status was linked to increased odds of prevalent sarcopenia. Over three years, low baseline 25OHD < 25 vs. ≥ 50 nmol/L were associated with greater loss of muscle mass and increased time for the Timed Up and Go test. The risk for developing incident sarcopenia was not significantly elevated in individuals with low baseline 25OHD but when including death as combined outcome alongside incident sarcopenia, there was a strong positive association in multivariable analysis [OR (95% CI) 3.19 (1.54-6.57) for 25OHD < 25 vs. ≥ 50 nmol/L]. There was no evidence for a PTH-mediating effect. Low baseline 25OHD levels were associated with unfavorable changes in muscle mass and physical performance, but not with incident sarcopenia. Future randomized trials are needed to assess causality and to address the issue of competing risks such as mortality in older cohorts.
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Affiliation(s)
- Romy Conzade
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig Maximilian University of Munich, 81377, Munich, Germany
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University of Zurich and University Hospital Zurich, 8091, Zurich, Switzerland
| | - Uta Ferrari
- Department of Medicine IV, University Hospital, Ludwig Maximilian University of Munich, 80336, Munich, Germany
| | - Alexander Horsch
- Department of Computer Science, UiT - The Arctic University of Norway, 9037, Tromsø, Norway
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, 80636, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80802, Munich, Germany
- Institute of Epidemiology and Biostatistics, University of Ulm, 89081, Ulm, Germany
| | - Annette Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany
| | - Barbara Thorand
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany.
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Sarcopenia and Low Serum Albumin Level Synergistically Increase the Risk of Incident Disability in Older Adults. J Am Med Dir Assoc 2019; 20:90-93. [DOI: 10.1016/j.jamda.2018.06.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 01/06/2023]
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Application of morphometrics as a predictor for survival in female patients with breast cancer spinal metastasis: a retrospective cohort study. Spine J 2018; 18:1798-1803. [PMID: 29550605 DOI: 10.1016/j.spinee.2018.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/27/2018] [Accepted: 03/09/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The current standard of care for prediction of survival of cancer staging is based on TNM staging. However, for patients with spinal metastasis, who all have identical stage IV disease, identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. Analytical morphometrics enables physicians to quantify patient frailty by measuring lean muscle mass. Morphometrics also predicts survival in patients with lung cancer metastases to the spine. PURPOSE Our study evaluates whether morphometrics is predictive of survival in patients with breast cancer spinal metastasis. DESIGN This is an observational retrospective cohort study. PATIENT SAMPLE This study includes female patients with breast cancer spinal metastases and patients who have undergone stereotactic body radiation therapy. OUTCOME MEASURES Overall survival was the primary outcome measure. METHODS Morphometric measurements of the psoas muscle were taken using computed tomography scans of the lumbar spine. We then stratified patients into tertiles based on the psoas muscle area. RESULTS We identified 118 patients, with a median survival of 104 days (95% confidence interval [CI]=73-157 days). Overall survival was not associated with age, chemotherapy, or number of levels radiated. Patients in the lowest tertile of psoas size had significantly shorter survival compared with the highest tertile (68 days versus 148 days, hazard ratio 1.76 [95% CI=1.08-2.89], p=.024). The shorter survival was also true for the lowest tertile versus the middle tertile (68 days versus 167 days, hazard ratio 1.95 [95% CI=1.19-3.19], p=.007). Kaplan-Meier survival curves were used to visually illustrate the differences in survival between different tertiles. CONCLUSIONS Morphometric analysis of the psoas muscle size in patients with breast cancer metastases to the spine was effective in identifying patients at risk of shorter survival. Further research is needed to validate these results, as well as to see if these methodologies can be applied to other cancer histologies.
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Zakaria HM, Elibe E, Macki M, Smith R, Boyce-Fappiano D, Lee I, Griffith B, Siddiqui F, Chang V. Morphometrics predicts overall survival in patients with multiple myeloma spine metastasis: A retrospective cohort study. Surg Neurol Int 2018; 9:172. [PMID: 30210905 PMCID: PMC6122282 DOI: 10.4103/sni.sni_383_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/30/2018] [Indexed: 12/23/2022] Open
Abstract
Background Treatment strategies for spinal metastases for myeloma range from conservative measures (radiation and chemotherapy) to invasive (surgical). Identifying better predictors of overall survival (OS) would help in surgical decision making. Analytic morphometrics has been shown to predict survival in oncologic patients, and our study evaluates whether morphometrics is predictive of survival in patients with multiple myeloma (MM) spinal metastases. Methods For this observational retrospective cohort study, we identified 46 patients with MM spinal metastases who had undergone stereotactic body radiation therapy. OS was the primary outcome measure. Morphometric analysis of the psoas muscle was performed using computed tomography scans of the lumbar spine. Results OS was statistically correlated with age (P = 0.025), tumor burden (P = 0.023), and number of levels radiated (P = 0.029), but not with gender. Patients in the lowest tertile of average psoas size had significantly shorter survival compared to the highest tertile, hazard ratio (HZ) 6.87 (95% CI = 1.65-28.5, P = 0.008). When calculating the psoas size to vertebral body ratio and correlating this measure to OS, the lowest tertile again had significantly shorter OS compared to the highest tertile, HZ 6.87 (95% CI = 1.57-29.89, P = 0.010); the middle tertile also showed significantly shorter OS compared to the highest tertile, HZ 5.07 (95% CI = 1.34-19.10, P = 0.016). Kaplan-Meier survival curves were used to visually illustrate the differences in survival between different tertiles (Log-rank test P = 0.006). Conclusions Morphometric analysis successfully predicts long-term survival in patients with MM. More research is needed to validate these results and to see if these methodologies can be applied to other cancer histologies.
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Affiliation(s)
- Hesham Mostafa Zakaria
- Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Erinma Elibe
- Department of Radiation Oncology, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Mohammad Macki
- Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Richard Smith
- Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - David Boyce-Fappiano
- Department of Radiation Oncology, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Ian Lee
- Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Brent Griffith
- Department of Radiology, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Farzan Siddiqui
- Department of Radiation Oncology, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
| | - Victor Chang
- Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, Michigan, USA
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26
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Zakaria HM, Massie L, Basheer A, Elibe E, Boyce-Fappiano D, Shultz L, Lee I, Griffith B, Siddiqui F, Chang V. Application of Morphometrics as a Predictor for Survival in Patients with Prostate Cancer Metastasis to the Spine. World Neurosurg 2018; 114:e913-e919. [DOI: 10.1016/j.wneu.2018.03.115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 02/06/2023]
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Reid N, Healy GN, Gianoudis J, Formica M, Gardiner PA, Eakin EE, Nowson CA, Daly RM. Association of sitting time and breaks in sitting with muscle mass, strength, function, and inflammation in community-dwelling older adults. Osteoporos Int 2018; 29:1341-1350. [PMID: 29479645 DOI: 10.1007/s00198-018-4428-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 02/06/2018] [Indexed: 12/11/2022]
Abstract
UNLABELLED The mechanisms through which excessive sitting time impacts health are important to understand. This study found that each hour of sitting per day was not associated with physical function, although associations with poor body composition were observed. Reducing sitting time for improved weight management in older adults needs further exploration. INTRODUCTION To examine the association of sitting time and breaks in sitting time with muscle mass, strength, function, and inflammation in older Australians. METHODS Data from the thigh-worn activPAL3™ monitor (7-day continuous wear) was used to derive time spent sitting (hours) and total number of sit-stand transitions per day. Body composition (dual energy X-ray absorptiometry), lower-body muscle strength, function (timed up-and-go [TUG], 4-m gait speed, four square step test, 30-second sit-to-stand), and serum inflammatory markers (interleukin-[IL-6], IL-8, IL-10, tumor necrosis factor-alpha [TNF-α], and adiponectin) were measured. Multiple regression analyses, adjusted for age, sex, ethnicity, education, employment status, marital status, number of prescription medications, smoking status, vitamin D, and stepping time, were used to assess the associations. RESULTS Data from 123 community-dwelling older adults (aged 65-84 years, 63% female) were used. Total daily sitting time was associated with lower percentage lean mass (β [95%CI], - 1.70% [- 2.30, - 1.10]) and higher total body fat mass (2.92 kg [1.94, 3.30]). More frequent breaks in sitting time were associated with a 45% reduced risk of having pre-sarcopenia (OR = 0.55; 95% CI 0.34, 0.91; model 1), defined as appendicular lean mass divided by BMI. No significant associations were observed for sitting time or breaks in sitting with measures of muscle strength, function, or inflammation. CONCLUSION In older community-dwelling adults, greater sitting time was associated with a lower percentage lean mass, while more frequent breaks in sitting time were associated with lower odds of having pre-sarcopenia. This suggests that reducing sedentary time and introducing frequent breaks in sedentary time may be beneficial for improving body composition in healthy older adults.
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Affiliation(s)
- N Reid
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, Queensland, 4006, Australia.
| | - G N Healy
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, Queensland, 4006, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- School of Physiotherapy, Curtin University, Perth, Australia
| | - J Gianoudis
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - M Formica
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - P A Gardiner
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Mater Research Institute, The University of Queensland, South Brisbane, Australia
| | - E E Eakin
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, Queensland, 4006, Australia
| | - C A Nowson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - R M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Australia
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Kiefer LS, Fabian J, Lorbeer R, Machann J, Storz C, Kraus MS, Wintermeyer E, Schlett C, Roemer F, Nikolaou K, Peters A, Bamberg F. Inter- and intra-observer variability of an anatomical landmark-based, manual segmentation method by MRI for the assessment of skeletal muscle fat content and area in subjects from the general population. Br J Radiol 2018; 91:20180019. [PMID: 29658780 DOI: 10.1259/bjr.20180019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Changes in skeletal muscle composition, such as fat content and mass, may exert unique metabolic and musculoskeletal risks; however, the reproducibility of their assessment is unknown. We determined the variability of the assessment of skeletal muscle fat content and area by MRI in a population-based sample. METHODS A random sample from a prospective, community-based cohort study (KORA-FF4) was included. Skeletal muscle fat content was quantified as proton-density fat fraction (PDFF) and area as cross-sectional area (CSA) in multi-echo Dixon sequences (TR 8.90 ms, six echo times, flip angle 4°) by a standardized, anatomical landmark-based, manual skeletal muscle segmentation at level L3 vertebra by two independent observers. Reproducibility was assessed by intraclass correlation coefficients (ICC), scatter and Bland-Altman plots. RESULTS From 50 subjects included (mean age 56.1 ± 8.8 years, 60.0% males, mean body mass index 28.3 ± 5.2) 2'400 measurements were obtained. Interobserver agreement was excellent for all muscle compartments (PDFF: ICC0.99, CSA: ICC0.98) with only minor absolute and relative differences (-0.2 ± 0.5%, 31 ± 44.7 mm2; -2.6 ± 6.4% and 2.7 ± 3.9%, respectively). Intra-observer reproducibility was similarly excellent (PDFF: ICC1.0, 0.0 ± 0.4%, 0.4%; CSA: ICC1.0, 5.5 ± 25.3 mm2, 0.5%, absolute and relative differences, respectively). All agreement was independent of age, gender, body mass index, body height and visceral adipose tissue (ICC0.96-1.0). Furthermore, PDFF reproducibility was independent of CSA (ICC0.93-0.99). Conclusions: Quantification of skeletal muscle fat content and area by MRI using an anatomical landmark-based, manual skeletal muscle segmentation is highly reproducible. Advances in knowledge: An anatomical landmark-based, manual skeletal muscle segmentation provides high reproducibility of skeletal muscle fat content and area and may therefore serve as a robust proxy for myosteatosis and sarcopenia in large cohort studies.
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Affiliation(s)
- Lena Sophie Kiefer
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany
| | - Jana Fabian
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany
| | - Roberto Lorbeer
- 2 Department of Radiology, Ludwig-Maximilian-University Hospital , Munich , Germany
| | - Jürgen Machann
- 3 Department of Diagnostic and Interventional Radiology, Section of Experimental Radiology, University of Tuebingen , Tuebingen , Germany.,4 Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tuebingen , Tuebingen , Germany.,5 German Center for Diabetes Research (DZD) , Neuherberg , Germany
| | - Corinna Storz
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany
| | - Mareen Sarah Kraus
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany
| | - Elke Wintermeyer
- 6 BG Trauma Center, University of Tuebingen , Tuebingen , Germany
| | - Christopher Schlett
- 7 Department of Radiology, Diagnostic and Interventional Radiology, University of Heidelberg , Heidelberg , Germany
| | - Frank Roemer
- 8 Department of Radiology, University of Erlangen-Nuremberg , Erlangen , Germany
| | - Konstantin Nikolaou
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany
| | - Annette Peters
- 9 German Center for Cardiovascular Disease Research (DZHK e.V.) , Munich , Germany.,10 Institute for Cardiovascular Prevention, Ludwig-Maximilian-University-Hospital , Munich , Germany.,11 Institute of Epidemiology II, Helmholtz Zentrum Munich, German Research Center for Environmental Health , Neuherberg , Germany
| | - Fabian Bamberg
- 1 Department of Diagnostic and Interventional Radiology, University of Tuebingen , Tuebingen , Germany.,9 German Center for Cardiovascular Disease Research (DZHK e.V.) , Munich , Germany
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Churilov I, Churilov L, MacIsaac RJ, Ekinci EI. Systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation. Osteoporos Int 2018; 29:805-812. [PMID: 29455250 DOI: 10.1007/s00198-018-4381-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
UNLABELLED Sarcopenia is associated with poor function and increased risk of falls and disability. This work reports a systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation. Sarcopenia is found to be present in approximately 50% of rehabilitation patients and its prevalence may vary with admission diagnosis. PURPOSE To conduct a systematic review and meta-analysis of reported prevalence of sarcopenia in post acute inpatient rehabilitation. METHODS Systematic review conducted according to PRISMA guidelines (PROSPERO registration number CRD42016054135). Databases searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register, and CINAHL. Studies considered the following: published January 1988-February 2017. Key terms are as follows: "sarcopenia" AND "inpatient rehabilitation" OR "rehabilitation" AND/OR "prevalence". Abstracts and subsequently full studies reporting sarcopenia prevalence in adults admitted to rehabilitation reviewed irrespective of design, provided sarcopenia diagnosis included at least assessment of muscle mass. Random effect meta-analysis was conducted. Methodological quality assessment: Agency for Healthcare Research and Quality, US Department of Health and Human Services tool (MORE tool); Joanna Briggs Institute Prevalence Critical Appraisal Tool. RESULTS Four hundred twenty-six studies identified during initial search, 399 excluded after reviewing titles and abstracts, 21 full text articles reviewed, and six studies met inclusion criteria. Patient populations: after hip fracture (five studies), general deconditioning (one study). Identified sarcopenia prevalence ranged from 0.28 to 0.69. Pooled sarcopenia prevalence obtained with random effect meta-analysis: 0.56 (95% CI 0.46-0.65), heterogeneity I2 = 92.9%. Main quality shortcomings: lack of reporting of inter- and intra-rater reliability, lack of generalizability to other rehabilitation populations. CONCLUSIONS Original research examining sarcopenia prevalence in inpatient rehabilitation is scarce. Patient populations studied to date are not representative of general rehabilitation population with regard to both age and admission diagnoses. Sarcopenia may be present in approximately half of rehabilitation patients and its prevalence may vary with admission diagnosis.
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Affiliation(s)
- I Churilov
- Department of Rehabilitation, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.
| | - L Churilov
- Statistics and Decision Analysis Academic Platform, Melbourne Brain Centre, The Florey Institute of Neuroscience and Mental Health, 245 Burgundy St, Heidelberg, Victoria, 3084, Australia
| | - R J MacIsaac
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia
| | - E I Ekinci
- Department of Medicine, The University of Melbourne, Austin Health, Burgundy St, Heidelberg, Victoria, 3084, Australia
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