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Berg HB, Alavi DT, Beichmann B, Pesonen M, Henriksen C, Paur I, Bøhn SK, Lauritzen PM, Blomhoff R, Henriksen HB. The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients. Clin Nutr ESPEN 2024; 60:17-23. [PMID: 38479906 DOI: 10.1016/j.clnesp.2024.01.001] [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: 10/06/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS Low muscle strength, low muscle mass, and sarcopenia have a negative impact on health outcomes in colorectal cancer (CRC) patients. Different diagnostic modalities are used to identify these conditions but it is unknown how well the modalities agree. The aim of this study was to compare different diagnostic modalities by means of calculating the proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients, and to investigate the agreement for sarcopenia between the various modalities. METHODS Men and women participating in the Norwegian Dietary Guidelines and colorectal cancer Survival (CRC-NORDIET) study were included in the analyses. Cut-off values for low muscle strength, low muscle mass, and sarcopenia were defined according to the second consensus set by the European Working Group on Sarcopenia in Older People (EWGSOP2). The diagnostic modalities used to assess muscle strength were handgrip strength and the sit-to-stand test. For muscle mass, computed tomography, dual-energy X-ray absorptiometry (DXA), multi-frequency bioelectrical impedance analysis (MF-BIA), and single-frequency BIA (SF-BIA) were applied. Cohen's kappa was calculated to determine the agreement for low muscle strength and confirmed sarcopenia between diagnostic modalities. RESULTS Five hundred and three men and women (54 % men, mean age of 66 (range 50-80) years old) were included in the analysis. As much as 99 % (n = 70) of the population was identified with low muscle mass by MF-BIA, while the other modalities identified 9-49 % as having low muscle mass. Handgrip strength identified a lower proportion of low muscle strength as compared with the sit-to-stand test (4 % vs. 8 %). When applying various combinations of diagnostic modalities for low muscle strength and low muscle mass, the proportion of sarcopenia was found to be between 0.3 and 11.4 %. There was relatively poor agreement between the different diagnostic modalities with Cohen's Kappa ranging from 0.0 to 0.55, except for the agreement between SF-BIASergi and MF-BIASergi, which was 1. CONCLUSION The proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients varied considerably depending on the diagnostic modalities used. Further studies are needed to provide modality-specific cut-off values, adjusted to sex, age and body size.
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Affiliation(s)
- Hedda Beate Berg
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Dena Treider Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Benedicte Beichmann
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Maiju Pesonen
- Oslo Centre for Biostatistics & Epidemiology (OCBE), Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Christine Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Norwegian Advisory Unit on Disease-related Undernutrition, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Siv Kjølsrud Bøhn
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, P.O. Box 5003 NO-1432 Ås, Norway.
| | - Peter Mæhre Lauritzen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo and Department of Life Sciences and Health, Oslo Metropolitan University, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
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Rodriguez-Cobo L, Diaz-SanMartin G, Algorri JF, Fernandez-Viadero C, Lopez-Higuera JM, Cobo A. Design and Verification of Integrated Circuitry for Real-Time Frailty Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 24:29. [PMID: 38202891 PMCID: PMC10780560 DOI: 10.3390/s24010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024]
Abstract
In this study, a new wireless electronic circuitry to analyze weight distribution was designed and incorporated into a chair to gather data related to common human postures (sitting and standing up). These common actions have a significant impact on various motor capabilities, including gait parameters, fall risk, and information on sarcopenia. The quality of these actions lacks an absolute measurement, and currently, there is no qualitative and objective metric for it. To address this, the designed analyzer introduces variables like Smoothness and Percussion to provide more information and objectify measurements in the assessment of stand-up/sit-down actions. Both the analyzer and the proposed variables offer additional information that can objectify assessments depending on the clinical eye of the physicians.
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Affiliation(s)
| | - Guillermo Diaz-SanMartin
- Photonics Engineering Group, Universidad de Cantabria, 39005 Santander, Spain
- Department Communications Engineering, University of the Basque Country, 48013 Bilbao, Spain
| | - Jose Francisco Algorri
- CIBER-BBN, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Photonics Engineering Group, Universidad de Cantabria, 39005 Santander, Spain
- Instituto de Investigacion Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Carlos Fernandez-Viadero
- Instituto de Investigacion Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
- Psychiatry Service, Marqués de Valdecilla University Hospital, 39011 Santander, Spain
| | - Jose Miguel Lopez-Higuera
- CIBER-BBN, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Photonics Engineering Group, Universidad de Cantabria, 39005 Santander, Spain
- Instituto de Investigacion Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Adolfo Cobo
- CIBER-BBN, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Photonics Engineering Group, Universidad de Cantabria, 39005 Santander, Spain
- Instituto de Investigacion Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
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Cavalheiro A, Afonso S, Silva M, Ramalhão N, Machado J, Magalhães S. Evaluation of Probable Sarcopenia's Prevalence in Hospitalized Geriatric Patients Using Ishii's Score. Cureus 2023; 15:e49158. [PMID: 38130551 PMCID: PMC10733612 DOI: 10.7759/cureus.49158] [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: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sarcopenia is defined as a progressive loss of skeletal muscle mass and strength related to age and comorbidities. Worldwide sarcopenia's prevalence varies between 10-40%, being associated with functional impairment, lower quality of life, and higher mortality. Sarcopenia can be estimated based on age, calf circumference, and handgrip strength (Ishii's formula). Early diagnosis is essential because treatment with nutritional support and rehabilitation programs can prevent complications. The aim of the study was to assess the prevalence of probable sarcopenia in hospitalized patients using Ishii's score and possible associated risk factors. METHODS We developed an observational prospective study in a medicine inpatient ward of a Central Hospital. We applied Ishii's formula to the patients admitted to the medical ward in December 2021 and January 2022. Patients should be aged 60 or above and able to collaborate with the tests. One year later, we analyzed re-hospitalization and mortality rates. Patients with edema of the lower limbs, who were not able to follow instructions, and who were admitted exclusively for symptomatic treatment were excluded. RESULTS Our final sample was 49 patients (55% males, mean age 78 ± 8.88 years). Only one patient had a previous diagnosis of sarcopenia. Estimated sarcopenia´s prevalence was 73.5% N=36), higher in men and people with three or more comorbidities. In the sarcopenic group, 77% had some degree of functional dependency and positive markers for malnutrition. After one year of follow-up, we found a higher mortality rate in the sarcopenic group (44.4% against 7.6%) and a higher number of re-hospitalizations (1.03 hospitalizations per patient, against 0.31). CONCLUSIONS Our data showed that the prevalence of probable sarcopenia is high, but this pathology is still underdiagnosed. Traditional diagnosis is complex in some hospital settings and a simple tool such as Ishii's score can help to improve diagnostic rates. We suggest screening all patients at admission to provide early rehabilitation and nutritional support.
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Affiliation(s)
- Ana Cavalheiro
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Sara Afonso
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Marta Silva
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Nuno Ramalhão
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - João Machado
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Sandra Magalhães
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
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Bahat G, Bozkurt ME, Ozkok S, Kilic C, Karan MA. The longitudinal associations of sarcopenia definitions with functional deterioration: a comparative study. Aging Clin Exp Res 2023; 35:2089-2099. [PMID: 37486546 DOI: 10.1007/s40520-023-02498-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Probable sarcopenia is a predictor of functional limitation in older adults. However, whether standard thresholds recommended by guides, or population-specific thresholds better predict impairment in functionality is an issue that needs to be enlightened. We aimed to study the associations of probable sarcopenia identified by the use of EWGSOP2 and population-specific thresholds with deterioration in functionality at follow-up and give prevalences of probable sarcopenia with different thresholds in older outpatients admitted to a tertiary health center. METHODS In this retrospective, longitudinal follow-up study, we assessed handgrip strength (HGS) at the admission with a Jamar hand-dynamometer and diagnosed probable sarcopenia with standard and population-specific thresholds, i.e., 27 kg/16 kg, and 35 kg/20 kg in males/females, respectively. We evaluated activities of daily living (ADL) and instrumental ADL (IADL), with Katz and Lawton scales, at the admission and follow-up. To study whether probable sarcopenia was a predictor of impaired functionality, we defined two models for Cox regression analysis. We performed adjustments for age, sex, and nutritional status (assessed by Mini-Nutritional Assessment-Short Form) in Model 1 and defined Model 2 by adding low gait speed and frailty to the variables in Model 1. RESULTS Among a total of 1970 patients, 195 had follow-up of median 560 days. The mean age was 75.5 ± 5.5, and 142 (72.8%) were female. In the basal evaluation, the prevalences of probable sarcopenia defined by the standard cut-offs and by population-specific cut-offs were 8.7% and 35.4%, respectively. In univariate analyses (Kaplan-Meier log-rank test), probable sarcopenia by population-specific cut-offs, but not EWGSOP2-cut-offs, was associated with deteriorations in both ADL (p = 0.04) and IADL (p < 0.001). In multivariate analyses, only the probable sarcopenia identified by population-specific cut-offs was independently associated with impairment in IADL in both models [HR (95%CI) = 1.88 (1.07-3.30), and 1.9 (1.04-3.6); for Model 1 and Model 2, respectively)]. CONCLUSION Our findings suggested that the definition of probable sarcopenia identified by not standard, but population-specific thresholds more reliably predicted longitudinal deterioration of functionality in older outpatients. This finding might be considered as evidence supporting the use of population-specific cut-offs when the concern is sarcopenia diagnosis.
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Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey.
| | - Meris Esra Bozkurt
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Cihan Kilic
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, Istanbul, Turkey
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Juby A, Davis C, Minimaana S, Mager D. Observational cohort study of highly functioning community-dwelling older adults to assess their sarcopenic status, leisure physical activity, and quality of life over 12-months. Heliyon 2023; 9:e20078. [PMID: 37809471 PMCID: PMC10559810 DOI: 10.1016/j.heliyon.2023.e20078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background The prevalence of sarcopenia varies depending on the cohort evaluated, and the diagnostic criteria used. Older adults with sarcopenia report lower quality of life than their non-sarcopenic peers. Leisure physical activity is reported to have a variable effect on sarcopenic status. Most studies to date, have been done in "vulnerable" populations, with fewer done on independent community-dwelling older adults. None have been done in an Alberta, Canada population. Objectives To prospectively evaluate the sarcopenic status of independent community-dwelling older Albertan adults; whether this changed over 12-months; and any association with self-reported leisure activity or quality of life. Methods Independent community-dwelling older adults were invited to participate in a 12-month observational study. Assessments were done at baseline, 6 and 12-months for physical function (TUG, SPPB, gait speed, Tinetti, grip strength), muscle mass (DXA, arm and calf circumference), body fat (skinfold, DXA), reported daily exercise (aerobic, resistance), quality of life (EQ5D), and laboratory parameters. European Working Group on Sarcopenia in Older People (EWGSOP) definitions of sarcopenic status were used. Results All 50 participants (11 male), were independent of all basic activities of daily living at baseline, and most instrumental activities (some needed assistance with driving or finances). They had an average age of 75.8 (67-90) years, with average MMSE and MoCA cognitive scores of 28.1/30 (20-30) and 24.8/30 (14-30) respectively. Eight participants dropped out prior to their first DXA test. Of the remaining 42, 17 participants (5 male) fulfilled the EWGSOP revised criteria for probable, pre-sarcopenia, or sarcopenia, giving a rate of baseline total sarcopenia of 40.5% in this community-dwelling sample. The majority were pre-sarcopenic (28.6%), and sarcopenia was present only in 7.1%. The total sarcopenia group had a lower BMI (25.6 ± 5.1 versus 29 ± 5, p = 0.01), less body fat by skinfold measurement (36.4 ± 6.5 versus 39.3 ± 8.1, p = 0.01) and lower mid-calf (35.6 ± 3.2 versus 37.6 ± 3.4, p = 0.04) and mid-arm (29.1 ± 2.5 versus 31.9 ± 3.5, p = 0.02) circumferences when compared to their non-sarcopenic peers. After 12-months, 39 participants remained in the study. Of these, the sarcopenic status of 7 improved, 10 declined, with the remaining 56% not changing. There were no statistically significant differences in baseline laboratory parameters between the groups, including 25(OH)D status. But, of the status decliners, 40% had suboptimal 25(OH)D at baseline. Self-reported leisure activity (both total time and frequency) was not associated with sarcopenic status at 12-months. EuroQol -5D was not associated with sarcopenic status. Conclusions The rate of sarcopenia was 7.1%, but the total rate of pre, probable and sarcopenia in this highly functioning, community-dwelling older adult cohort was 40.5%. In the majority (75%), there was either no change, or an improvement, in their sarcopenic status over 12-months. There was no association identified with self-reported leisure activity or quality of life in this cohort.
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Affiliation(s)
- A.G. Juby
- Department of Medicine, Division of Geriatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - C.M.J. Davis
- Faculty of Kinesiology, University of Alberta, Edmonton, Alberta, Canada
| | - S. Minimaana
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - D.R. Mager
- Faculty of Agriculture, Food and Nutrition Sciences, University of Alberta, Edmonton, Alberta, Canada
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Barazzoni R, Cederholm T, Zanetti M, Gortan Cappellari G. Defining and diagnosing sarcopenia: Is the glass now half full? Metabolism 2023; 143:155558. [PMID: 37031950 DOI: 10.1016/j.metabol.2023.155558] [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: 02/24/2023] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
Low muscle mass and function exert a substantial negative impact on quality of life, health and ultimately survival, but their definition, identification and combination to define sarcopenia have suffered from lack of universal consensus. Methodological issues have also contributed to incomplete agreement, as different approaches, techniques and potential surrogate measures inevitably lead to partly different conclusions. As a consequence: 1) awareness of sarcopenia and implementation of diagnostic procedures in clinical practice have been limited; 2) patient identification and evaluation of therapeutic strategies is largely incomplete. Significant progress has however recently occurred after major diagnostic algorithms have been developed, with common features and promising perspectives for growing consensus. At the same time, the need for further refinement of the sarcopenia concept has emerged, to address its increasingly recognized clinical heterogeneity. This includes potential differential underlying mechanisms and clinical features for age- and disease-driven sarcopenia, and the emerging challenge of sarcopenia in persons with obesity. Here, we will review existing algorithms to diagnose sarcopenia, and major open methodological issues to assess skeletal muscle mass and function under different clinical conditions, in order to highlight similarities and differences. Potential for consensus on sarcopenia diagnosis as well as emerging new challenges will be discussed.
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Affiliation(s)
- Rocco Barazzoni
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy.
| | - Tommy Cederholm
- Uppsala University and Karolinska University Hospital, Stockholm, Sweden
| | - Michela Zanetti
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Gianluca Gortan Cappellari
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
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Stuck AK, Tsai LT, Freystaetter G, Vellas B, Kanis JA, Rizzoli R, Kressig KS, Armbrecht G, Da Silva JAP, Dawson-Hughes B, Egli A, Bischoff-Ferrari HA. Comparing Prevalence of Sarcopenia Using Twelve Sarcopenia Definitions in a Large Multinational European Population of Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:205-212. [PMID: 36973929 DOI: 10.1007/s12603-023-1888-y] [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: 02/23/2023]
Abstract
OBJECTIVES Multinational prevalence data on sarcopenia among generally healthy older adults is limited. The aim of the study was to assess prevalence of sarcopenia in the DO-HEALTH European trial based on twelve current sarcopenia definitions. SETTING AND PARTICIPANTS This is an analysis of the DO-HEALTH study including 1495 of 2157 community-dwelling participants age 70+ years from Germany, France, Portugal, and Switzerland with complete measurements of the sarcopenia toolbox including muscle mass by DXA, grip strength, and gait speed. MEASUREMENTS The twelve sarcopenia definitions applied were Asian Working Group on Sarcopenia (AWGS1), AWGS2, Baumgartner, Delmonico, European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, EWGSOP2-lower extremities, Foundation for the National Institutes of Health (FNIH1), FNIH2, International Working Group on Sarcopenia in Older People (IWGS), Morley, and Sarcopenia Definitions and Outcomes Consortium (SDOC). RESULTS Mean age was 74.9 years (SD 4.4); 63.3% were women. Sarcopenia prevalence ranged between 0.7% using the EWGSOP2 or AWGS2 definition, up to 16.8% using the Delmonico definition. Overall, most sarcopenia definitions, including Delmonico (16.8%), Baumgartner (12.8%), FNIH1(10.5%), IWGS (3.6%), EWGSOP1 (3.4%), SDOC (2.0%), Morley (1.3%), and AWGS1 (1.1%) tended to be higher than the prevalence based on EWGSOP2 (0.7%). In contrast, the definitions AWGS2 (0.7%), EWGSOP2-LE (1.1%), FNIH2 (1.0%) - all based on muscle mass and muscle strength - showed similar lower prevalence as EWGSOP2 (0.7%). Moreover, most sarcopenia definitions did not overlap on identifying sarcopenia on an individual participant-level. CONCLUSION In this multinational European trial of community-dwelling older adults we found major discordances of sarcopenia prevalence both on a population- and on a participant- level between various sarcopenia definitions. Our findings suggest that the concept of sarcopenia may need to be rethought to reliably and validly identify people with impaired muscle health.
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Affiliation(s)
- A K Stuck
- Anna K. Stuck, Dr. med., Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, c/o Stadtspital Waid, Tièchestrasse 99, 8037 Zürich
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Valent D, Peball M, Krismer F, Lanbach A, Zemann S, Horlings C, Poewe W, Seppi K. Different assessment tools to detect sarcopenia in patients with Parkinson's disease. Front Neurol 2022; 13:1014102. [DOI: 10.3389/fneur.2022.1014102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022] Open
Abstract
IntroductionSarcopenia and Parkinson's disease are closely related diseases of the elderly population leading to progressive disability and nursing-dependent care.ObjectiveThe aim of this study was to estimate the prevalence of sarcopenia in PD patients with three different approaches: (1) the screening tool SARC-F, (2) EWGSOP-1 criteria, and (3) EWGSOP-2 criteria. Moreover, we aimed to evaluate the diagnostic accuracy of the screening tool SARC-F to detect sarcopenia according to the updated EWGSOP-2 criteria.MethodsEighty-one patients with Parkinson's disease aged 65 years and above were interviewed in a cross-sectional study at a tertiary referral center. All patients were screened with the SARC-F questionnaire and were evaluated for motor and non-motor symptoms, exercise, quality of life, and frailty. Muscle mass was assessed with bioelectrical impedance analysis, handgrip strength with a dynamometer, and gait speed was assessed with the 8-m walk test. EWGSOP-2 criteria were considered the gold standard to diagnose sarcopenia in our study.ResultsEighty-one patients were evaluated (mean age: 73.82; SD 5.30). The prevalence of sarcopenia was 28.4% according to the EWGSOP-2 criteria. The concordance between EWGSOP-2 and EWGSOP-1 was poor (weighted kappa of 0.361[95% 0.164–0.557]). The sensitivity of the SARC-F screening test for detecting sarcopenia was 60.9%. The corresponding AUC in the ROC curve analysis showed 0.598 (0.462, 0.734 CI). The item assessing strength was found to have the highest sensitivity (69.6%).ConclusionSarcopenia prevalence in patients with PD in Tirol, Austria is higher with EWGSOP-1 criteria compared to EWGSOP-2 criteria. The sensitivity and specificity of the SARC-F scale to detect sarcopenia in this population are poor.
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Trevisan C, Vetrano DL, Calvani R, Picca A, Welmer AK. Twelve-year sarcopenia trajectories in older adults: results from a population-based study. J Cachexia Sarcopenia Muscle 2022; 13:254-263. [PMID: 34846095 PMCID: PMC8818646 DOI: 10.1002/jcsm.12875] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/13/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The dynamic nature of sarcopenia, including possible transitions between its different stages, is currently unknown. We aimed to explore 12 year transitions through sarcopenia stages and identify factors associated with different sarcopenia trajectories in older adults. METHODS We included 3219 participants (aged ≥60 years, 35.8% men, 96.4% community-dwelling) from the SNAC-K study. No sarcopenia (normal muscle strength and mass), probable sarcopenia (low muscle strength and normal muscle mass), and sarcopenia (low muscle strength and mass) were assessed at baseline and up to 12 years. Such conditions were defined based on a modified version of the EWGSOP2 criteria with muscle strength evaluated through handgrip or chair stand tests, and muscle mass from calf circumference. We estimated 1, 5, and 10 year transition probabilities through continuous-time multistage Markov modelling. Sociodemographic, lifestyle, and medical factors associated with the likelihood of different transitions were evaluated with proportional intensity models, and the associations' strength was expressed as hazard ratio (HR) and 95% confidence interval (CI). RESULTS Participants with no sarcopenia had 10-year probabilities of 17.1% and 5.1% to develop probable sarcopenia and sarcopenia, and a 40.4% chance of not transitioning. Those with probable sarcopenia had similar 5-year chances of developing sarcopenia (10.3%) and reverting to no sarcopenia (10.7%). Participants with sarcopenia had chances to revert to probable sarcopenia ranging from 8.2% (at 5 years) to 4.7% (at 10 years), and a 70.9% chance of dying after 10 years. Older age (HR = 1.11, 95% CI: 1.07-1.14), male sex (HR = 1.84, 95% CI: 1.16-2.91), current smoking (HR = 1.84, 95% CI: 1.16-2.91), and higher number of chronic diseases (HR = 1.07, 95% CI: 1.00-1.14) were associated with sarcopenia development, while higher levels of physical activity (HR = 1.84, 95% CI: 1.19-2.84) and cognitive function (HR = 1.17, 95% CI: 1.05-1.31 per each 1-point increase in the Mini-Mental State Examination) were associated with subsequent higher reversion rates from probable sarcopenia to no sarcopenia (P < 0.05 for all). None of the explored characteristics were associated with sarcopenia reversion to healthier stages. CONCLUSIONS Sarcopenia appears to be a dynamic condition with possible two-way transitions between different sarcopenia stages, especially the earliest ones. Timely interventions to improve physical and cognitive function and better control individuals' chronic conditions could help counteract sarcopenia progression.
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Affiliation(s)
- Caterina Trevisan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy.,Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Riccardo Calvani
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anna Picca
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
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10
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Sørensen MZ, Jansen RB, Christensen TM, Holstein PE, Svendsen OL. Long-Term Changes in Sarcopenia and Body Composition in Diabetes Patients with and without Charcot Osteoarthropathy. J Diabetes Res 2022; 2022:3142307. [PMID: 35224105 PMCID: PMC8872651 DOI: 10.1155/2022/3142307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/03/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Charcot osteoarthropathy of the foot (COA) can currently only be treated using prolonged periods of immobilization of the affected extremity. Therefore, the hypothesis is that COA leads to altered body composition and increased sarcopenia. OBJECTIVE To investigate the changes over several years in sarcopenia, body composition, and fat distribution in diabetes patients with previous COA compared to diabetes patients without previous COA. METHODS Prospective observational clinical study. Twenty-one subjects were included and had two DXA scans done with mean 8.6-year intervals to compare changes in lean mass and fat distribution. The lean mass of limbs was used as an estimate of appendicular lean mass (aLM). Fat mass and aLM were then used to detect sarcopenic individuals using different methods. Results and Conclusions. As compared to baseline, both groups had significant loss of lean mass, and diabetics without COA had significant gain of total fat percentage. No statistically different prevalence of sarcopenia between the groups could be established. Likewise, no difference was found in total lean and fat mass changes. None of the groups had statistically significant changes of android fat distribution. As compared with published data on sarcopenia, people with diabetes might be more prone to sarcopenia than healthy individuals.
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Affiliation(s)
- Michael Zaucha Sørensen
- Department of Endocrinology, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
| | - Rasmus Bo Jansen
- Department of Endocrinology, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
| | - Tomas Møller Christensen
- Department of Endocrinology, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
| | - Per E. Holstein
- Copenhagen Center for Wound Healing, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
| | - Ole Lander Svendsen
- Department of Endocrinology, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
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11
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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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12
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Tsekoura M, Billis E, Matzaroglou C, Tsepis E, Gliatis J. Prevalence of probable sarcopenia in community-dwelling older Greek people. J Frailty Sarcopenia Falls 2021; 6:204-208. [PMID: 34950810 PMCID: PMC8649860 DOI: 10.22540/jfsf-06-204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
Objectives: The objective of this study was to assess the prevalence rate of probable sarcopenia and to determine the factors associated with it in older people living in Western Greece. Methods: Probable sarcopenia was estimated based on cut-off values for handgrip strength (HGS) as recommended by EWGSOP2. Information about socio-demographic, chronic diseases, fear of falls and lifestyle of the participants were also collected. HGS was assessed using a SAEHAN dynamometer. Calf circumference was assessed with inelastic tape. A logistic regression analysis was performed in order to determine associated risk factors. Results: The sample comprised 402 participants (292 women;110 men), with a mean age of 71.51±7.63 years. Overall, 25.4% of the elderly participants were diagnosed with probable sarcopenia (men:36.4%; women:21.2%). The findings of this study demonstrated that probable sarcopenia was positively associated with age (OR=0.14, 95% CI=0.008 to 0.200), gender (OR=-0.6, 95% CI=-0.700 to -0.530), Body mass Index (OR=0.01, 95% CI=-0.030 to -0.005), Skeletal muscle mass index (OR=0.05, 95% CI=0.030 to 0.080), calf circumference (OR=0.02, 95% CI=0.007 to 0.040), and comorbidities (OR=0.04, 95% CI=0.030 to 0.080). Conclusion: There was a 25.4% prevalence of probable sarcopenia in Greek elderly. The results highlight the importance of the detection of HGS and probable sarcopenia in older people in order to develop effective strategies of prevention and intervention of sarcopenia.
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Affiliation(s)
- Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Evdokia Billis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Charalampos Matzaroglou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Elias Tsepis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - John Gliatis
- Department of Medicine, School of Health Studies, University of Patras, Rio, Greece
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13
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Lampignano L, Bortone I, Castellana F, Donghia R, Guerra V, Zupo R, De Pergola G, Di Masi M, Giannelli G, Lozupone M, Panza F, Boeing H, Sardone R. Impact of Different Operational Definitions of Sarcopenia on Prevalence in a Population-Based Sample: The Salus in Apulia Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412979. [PMID: 34948590 PMCID: PMC8700814 DOI: 10.3390/ijerph182412979] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 12/25/2022]
Abstract
Background: In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP1) issued its first operational definition to diagnose sarcopenia. This was updated in 2019 with a revised sequence of muscle mass and muscle strength (EWGSOP2). The aim of the study was to investigate the impact of these different operational definitions on sarcopenia prevalence in a representative population-based sample. Methods: For each algorithm, the prevalence of sarcopenia-related categories was calculated and related to sociodemographic and lifestyle variables, anthropometric parameters, and laboratory biomarkers. The present analysis used data from the Salus in Apulia Study (Italy, 740 subjects, mean age 75.5 ± 5.9 years, 54% women). Results: The application of the EWGSOP1 adapted algorithm resulted in 85% [95% confidence intervals (CI): 82–88%] non-sarcopenic subjects, 10% (95% CI: 8–12%) pre-sarcopenic subjects, and 5% (95% CI: 3–7%) sarcopenic/severe sarcopenic subjects. The sarcopenia-related categories were inversely related to weight and body mass index (BMI), particularly in overweight/obese subjects, and these categories showed favorable metabolic biomarkers. The EWGSOP2 algorithm yielded 73% (95% CI: 69–76%) non-sarcopenic subjects, 24% (95% CI: 21–27%) probably sarcopenic subjects, and 4% (95% CI: 2–5%) sarcopenic subjects. Conclusions: The present study identified BMI as a potential confounder of the prevalence estimates of sarcopenia-related categories in population-based settings with different EWGSOP operational definitions.
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Affiliation(s)
- Luisa Lampignano
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Correspondence: (L.L.); (R.S.)
| | - Ilaria Bortone
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Fabio Castellana
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Rossella Donghia
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Vito Guerra
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Roberta Zupo
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Giovanni De Pergola
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari Aldo Moro, 70100 Bari, Italy
| | - Marta Di Masi
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Madia Lozupone
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70100 Bari, Italy;
| | - Francesco Panza
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Heiner Boeing
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Rodolfo Sardone
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Correspondence: (L.L.); (R.S.)
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14
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Dent E, Woo J, Scott D, Hoogendijk EO. Toward the recognition and management of sarcopenia in routine clinical care. NATURE AGING 2021; 1:982-990. [PMID: 37118343 DOI: 10.1038/s43587-021-00136-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/06/2021] [Indexed: 04/30/2023]
Abstract
Sarcopenia, the age-associated decline in skeletal muscle mass and function, is a major cause of functional decline and mortality in older adults. Despite its importance, sarcopenia often remains unrecognized and inadequately managed in routine clinical care. A major hinderance to its clinical integration is the variation in diagnostic tools for sarcopenia. Diagnostic tools include those of the European Working Group on Sarcopenia in Older People (versions 1 and 2), those of the Asian Working Group for Sarcopenia (versions 1 and 2), and that of the Sarcopenia Definition and Outcomes Consortium. The management decision process of sarcopenia warrants an evaluation of risk factors such as a sedentary lifestyle, inadequate exercise, poor nutritional intake, smoking, depression and living circumstances. Herein, we provide an evidence-based update of the prevention and management of sarcopenia and propose practical information to facilitate the disease's adoption into routine care.
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Affiliation(s)
- Elsa Dent
- Torrens University Australia, Adelaide, South Australia, Australia.
| | - Jean Woo
- Chinese University of Hong Kong, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, the Netherlands
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, the Netherlands
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15
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Wallengren O, Bosaeus I, Frändin K, Lissner L, Falk Erhag H, Wetterberg H, Rydberg Sterner T, Rydén L, Rothenberg E, Skoog I. Comparison of the 2010 and 2019 diagnostic criteria for sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP) in two cohorts of Swedish older adults. BMC Geriatr 2021; 21:600. [PMID: 34702174 PMCID: PMC8547086 DOI: 10.1186/s12877-021-02533-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores. Methods Two birth cohorts, 70 and 85-years-old (n = 884 and n = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below − 2.0 and − 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen’s kappa. All-cause mortality was analyzed with the Cox-proportional hazard model. Results Sarcopenia prevalence was 1.4–7.8% in 70-year-olds and 42–62% in 85 years-old’s, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9–1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P < 0.005). The prevalence was doubled (15.0 vs. 7.5%) using the − 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P < 0.001) in the 70-year-olds and 17.8% (P < 0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at − 2.5 T-score was associated with increased mortality (hazard ratio 2.4–2.8, P < 0.05) but not at T-score − 2.0. Conclusions The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02533-y.
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Affiliation(s)
- Ola Wallengren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Clinical Nutrition Unit, Sahlgrenska University hospital, Gothenburg, Sweden.
| | - Ingvar Bosaeus
- Clinical Nutrition Unit, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Kerstin Frändin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Hanna Wetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Lina Rydén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | | | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
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16
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Jacob L, Kostev K, Smith L, Oh H, López-Sánchez GF, Shin JI, Abduljabbar AS, Haro JM, Koyanagi A. Sarcopenia and Mild Cognitive Impairment in Older Adults from Six Low- and Middle-Income Countries. J Alzheimers Dis 2021; 82:1745-1754. [PMID: 34219725 DOI: 10.3233/jad-210321] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little is known about the relationship between sarcopenia and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). OBJECTIVE This study aimed to investigate this association among community-dwelling adults aged≥65 years from six LMICs. METHODS Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. These data were obtained in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010. Participants were considered to have sarcopenia if they had low skeletal muscle mass (i.e., lower skeletal mass index) and a weak handgrip strength. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression analysis was conducted to assess associations. RESULTS The final analytical sample consisted of 12,912 individuals aged≥65 years with preservation in functional abilities without stroke (mean [standard deviation] age 72.2 [10.8] years; 45.2% males). The overall prevalence of sarcopenia and MCI were 11.3% and 18.1%, respectively. After adjusting for potential confounders, there was a positive association between sarcopenia and MCI in all countries (i.e., odds ratio [OR] > 1) with the exception of South Africa, and the overall estimate was OR = 1.60 (95% confidence interval [CI] = 1.32-1.93) with a low level of between-country heterogeneity (I2 = 0.0%). CONCLUSION There was a positive association between sarcopenia and MCI in this sample of older adults living in LMICs. Causality should be assessed in future longitudinal research, while the utility of sarcopenia as a marker of MCI should also be investigated.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | | | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,King Saud University, Riyadh, Saudi Arabia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,ICREA, Barcelona, Spain
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17
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Sarcopenia in hospitalized geriatric patients: insights into prevalence and associated parameters using new EWGSOP2 guidelines. Eur J Clin Nutr 2020; 75:653-660. [PMID: 33060812 PMCID: PMC8035069 DOI: 10.1038/s41430-020-00780-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/10/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022]
Abstract
Background Data on prevalence of sarcopenia and its associated parameters in hospitalized geriatric patients are heterogeneous due to various definitions of the disease. The aim of this study was to determine the prevalence of sarcopenia using latest recommendations of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and to investigate associated parameters in patients admitted to acute geriatrics and geriatric rehabilitation. Methods In this cross-sectional single-centre study including 305 hospitalized geriatric patients, handgrip strength (pneumatic hand dynamometer) and muscle quantity (body impedance analysis) were assessed. Probable sarcopenia was defined by low handgrip strength, and the diagnosis was confirmed when both handgrip strength and muscle quantity were below cut-off points. Furthermore, parameters of the geriatric baseline examination were analyzed for association with probable and confirmed sarcopenia using logistic regression models. Results Median age of the study population was 84.0 years, and 65.6% were female. The prevalence of probable sarcopenia was 24.6% (CI 19.8–29.4%), and the prevalence of confirmed sarcopenia was 22.6% (CI 17.9–27.3%). Low calf circumference, low body mass index, cognitive impairment and an increased risk of malnutrition were found to be associated with confirmed sarcopenia. In contrast, only cognitive impairment was positively associated with probable sarcopenia. Conclusions Sarcopenia is highly prevalent in geriatric inpatients, and multiple parameters were found to be associated with the disease. To reduce negative clinical outcomes, our findings support the need for routinely performed admission examinations for prompt diagnosis of sarcopenia, and a timely start of treatment in hospitalized geriatric patients.
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18
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Nutritional Intervention to Prevent the Functional Decline in Community-Dwelling Older Adults: A Systematic Review. Nutrients 2020; 12:nu12092820. [PMID: 32942634 PMCID: PMC7551991 DOI: 10.3390/nu12092820] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
Aging is a global public health concern. From the age of 50, muscle mass, muscle strength and physical performance tend to decline. Sarcopenia and frailty are frequent in community-dwelling older adults and are associated with negative outcomes such as physical disability and mortality. Therefore, the identification of therapeutic strategies to prevent and fight sarcopenia and frailty is of great interest. This systematic review aims to summarize the impact of nutritional interventions alone or combined with other treatment(s) in older community-dwelling adults on (1) the three indicators of sarcopenia, i.e., muscle mass, muscle strength and physical performance; and (2) the hospitalization and readmission rates. The literature search was performed on Medline and included studies published between January 2010 and June 2020. We included randomized controlled trials of nutritional intervention alone or combined with other treatment(s) in community-living subjects aged 65 or older. In total, 28 articles were retained in the final analysis. This systematic review highlights the importance of a multimodal approach, including at least a combined nutritional and exercise intervention, to improve muscle mass, muscle strength and physical performance, in community-dwelling older adults but especially in frail and sarcopenic subjects. Regarding hospitalization and readmission rate, data were limited and inconclusive. Future studies should continue to investigate the effects of such interventions in this population.
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