Association of height loss with falls and sarcopenia in community-dwelling older women

Association between Height-Changing Scores and Risk of Sarcopenia Estimated from Anthropometric Measurements in Older Adults: A Cross-Sectional Study

Anthropometric assessments are commonly used to diagnose sarcopenia in older adults. However, the ongoing exploration of novel approaches aims to improve the early detection of sarcopenia. This study investigated the association between the height-changing score (HCS) and the risk of sarcopenia defined by anthropometric measurements in 340 older adults (mean age: 66.2 years). The HCS derived from the difference in height and demi-span equivalent height (DEH) was used as an indicator of declining height in the older adults. Multivariate logistic regression analysis revealed a significant association between the HCS and the risk of sarcopenia in both male and female older adults (OR = 1.146, 95% CI [1.021, 1.286], p = 0.021). In addition, income, BMI, and nutritional status were significantly associated with the risk of sarcopenia (OR = -1.933, 95% CI [0.271, 0.986], p = 0.045; OR = -2.099, 95% CI [0.386, 0.587], p < 0.001; OR = -1.443, 95% CI [0.555, 0.866], p = 0.001, respectively). The white blood cell count, lymphocyte count, and HDL cholesterol were blood biomarkers significantly correlated with calf circumference. It can be suggested that the HCS acts as an indicator and screening tool for sarcopenia risk in older adults, highlighting the potential impact of decreased height on muscle mass loss. Encouraging nutritional support can help mitigate the risk of sarcopenia.

Analysis of related factors for sarco-osteoporosis in middle-aged and elderly inpatients and development and validation of a nomogram

BACKGROUND

Sarco-osteoporosis is a skeletal muscle disease associated with aging and complex pathological factors. At present, there are few studies on the analysis of its related factors, and a nomogram to estimate the risk of sarco-osteoporosis in middle-aged and elderly patients is not available.

METHODS

A total of 386 patients admitted to our hospital from October 2021 to October 2022 were collected, and the general demographic data and clinical data of the patients were collected.386 subjects were enrolled in the study and randomly divided into training set and validation set at a ratio of 7:3. In the training set, the Least absolute shrinkage and selection operator(LASSO)regression technique was used to select the optimal predictive features, and multivariate logistic regression was used to screen the factors associated with sarco-osteoporosis, and a nomogram was constructed using meaningful variables from multivariate analysis. The performance of the nomograms was assessed and validated by Area Under Curve (AUC) and calibration curves.

RESULTS

There were no significant differences in baseline characteristic of individuals in training set and validation set, six variables with non-zero coefficients were screened based on LASSO regression in the training set. Multivariate logistic regression analysis showed that the related factors for sarco-osteoporosis in middle-aged and elderly inpatients included age (OR = 1.08, 95%CI 1.03 ∼ 1.14), regular exercise (OR = 0.29, 95%CI 0.15 ∼ 0.56), albumin (OR = 0.9, 95%CI 0.82 ∼ 0.98), height (OR = 0.93, 95%CI 0.88 ∼ 0.99) and lean mass index (OR = 0.66, 95%CI 0.52 ∼ 0.85), and a nomogram was constructed based on the above factors. AUC of nomogram were 0.868(95%CI 0.825 ∼ 0.912) in the training set and 0.737(95%CI 0.646 ∼ 0.828) in the validation set. Calibration curve analysis showed that the predicted probability of sarco-osteoporosis had high consistency with the actual probability, and the absolute error of the training set and verification set was 0.018 and 0.03, respectively.

CONCLUSIONS

Our research showed that the occurrence of sarco-osteoporosis was associated with age, regular exercise, albumin, height and lean mass index, and we have developed a nomogram that can be effectively used in the preliminary and in-depth risk prediction of sarco-osteoporosis in middle-aged and elderly hospitalized patients.

Age-Dependent Association of Height Loss with Incident Fracture Risk in Postmenopausal Korean Women

BACKGRUOUND

Height loss is a simple clinical measure associated with increased fracture risk. However, limited data exists on the association between height loss and fracture risk in postmenopausal Korean women. It is unknown whether this association varies with age.

METHODS

Data on height loss over a 6-year period were collected from a community-based longitudinal follow-up cohort (Ansung cohort of the Korean Genome and Epidemiology Study). Incident fractures were defined based on self-reported fractures after excluding those due to severe trauma or toes/fingers. The association between incident fractures and height loss was investigated using a Cox proportional hazards model.

RESULTS

During a median follow-up of 10 years after the second visit, 259/1,806 participants (median age, 64 years) experienced incident fractures. Overall, a 1 standard deviation (SD) decrease in height (1.6 cm/median 5.8 years) was associated with 9% increased risk of fracture (hazard ratio [HR], 1.09; P=0.037), which lost statistical significance after adjustment for covariates. When stratified into age groups (50-59, 60-69, 70 years or older), a 1 SD decrease in height remained a robust predictor of fracture in the 50 to 59 years age group after adjusting for covariates (adjusted hazard ratio [aHR], 1.52; P=0.003), whereas height loss was not an independent predictor of fracture in the 60 to 69 (aHR, 1.06; P=0.333) or the 70 years or older age groups (aHR, 1.05; P=0.700; P for interaction <0.05, for all).

CONCLUSION

Height loss during the previous 6 years was associated with an increased 10-year fracture risk in postmenopausal women in their 50s.

Does locomotive syndrome severity predict future fragility fractures in community-dwelling women with osteoporosis?

OBJECTIVES

We investigated whether the locomotive syndrome (LS) severity affects future fragility fractures in osteoporosis patients.

METHODS

In this retrospective cohort study, 315 women with osteoporosis (mean follow-up period, 2.8 years) were reviewed, of whom 244 were included in the analysis. At baseline, we obtained medical information, bone mineral density of the lumbar spine and femoral neck, and sagittal vertical axis. Additionally, LS risk was assessed using the two-step test, stand-up test, and 25-question geriatric locomotive function scale scores. The LS risk test results were used to classify LS severity, which was rated on a 4-point scale from stage 0 (robust) to 3 (worsening). Cox proportional hazards regression analysis was used to determine the association of the severity with future fragility fracture.

RESULTS

Fragility fractures occurred in 37 of 315 participants (11.8%). This study showed that sagittal vertical axis (hazard ratio = 1.014; 95% confidence interval, 1.005-1.023; p value = 0.003) and LS severity (hazard ratio =1.748; 95% confidence interval, 1.133-2.699; p = 0.012) were independent risk factors for incidence of fragility fracture.

CONCLUSIONS

This study revealed the LS severity to predicted fragility fractures. We suggested that the progression of LS associated with osteoporosis increases the fracture risk.

Relationships between sarcopenia, nutrient intake, and gut microbiota in Chinese community-dwelling older women

BACKGROUND

The relationship among gut microbiota, sarcopenia components, and influencing factors in female sarcopenic patients has been poorly investigated.

METHODS

Female participants completed questionnaires of physical activity and dietary frequency and were assessed for the presence of sarcopenia by the Asian Working Group of Sarcopenia 2019 (AWGS 2019) criteria. Fecal samples were collected from 17 sarcopenia and 30 non-sarcopenia subjects for 16S sequencing and short chain fatty acid (SCFA) detection.

RESULTS

The prevalence of sarcopenia was 19.20% among 276 participants. The dietary protein, fat, dietary fiber, vitamin B1, niacin, vitamin E, phosphorus, magnesium, iron, zinc, and cooper intake of sarcopenia were all remarkably low. In addition, the richness of gut microbiota (Chao1 and ACE indexes) was considerably reduced in sarcopenic patients, and the sarcopenic gut microbiota and its metabolite were decreased in Firmicutes/Bacteroidetes, Agathobacter, Dorea and Butyrate and were enriched in Shigella and Bacteroides. Correlation analysis showed that Agathobacter and Acetate were positively correlated with grip strength and gait speed, respectively, and Bifidobacterium was negatively correlated with grip strength and appendicular skeletal muscle index (ASMI). Moreover, the protein intake was positively related to Bifidobacterium.

CONCLUSIONS

This cross-sectional study revealed the alterations of gut microbiota composition, SCFA, and nutrient intake in women with sarcopenia and their relation to sarcopenic components. These results provide insights into further studies on the role of nutrition and gut microbiota in sarcopenia and its use as a therapeutic approach.

Height loss is associated with decreased kidney function: The Japan Specific Health Checkups (J-SHC) Study

AIM

Height loss that occurs with aging is a common phenomenon associated with musculoskeletal abnormalities, such as osteoporosis and sarcopenia. Notably, such height loss is also associated with poor outcomes, including cardiovascular disease and mortality. In this study, we investigated the relationship between height loss and kidney outcome.

METHODS

This longitudinal study includes data from the Japan Specific Health Checkups Study from 2008 to 2014. Height loss was estimated using the first three visits (visits 1-3), and kidney outcomes were evaluated using data from the following visits (visit 3 to the last visit). The annual height change for each participant was estimated using mixed-effects model, and participants were divided into five groups according to the quintile of the rate. The association between height change and the incidence of 1.5-fold increase in serum creatinine level from baseline was analyzed using Cox regression analysis. The decline rates of estimated glomerular filtration rate among the groups were compared using a mixed-effects model.

RESULTS

In total, 187 682 participants were included in the analyses. The median rate of height change was -0.11 cm/year. The adjusted hazard ratio (95% confidence interval) for 1.5-fold increase in serum creatinine level in participants with the steepest category of height decline (Q1; Quintile 1) was 1.45 (1.26-1.67) compared with the reference (Q4; Quintile 4). The decline of the estimated glomerular filtration rate in Q1 (-1.25 mL/min/1.73 m² /year) was significantly higher than that of the reference: Q4 (-0.92 mL/min/1.73 m² /year) (P for interaction <0.001).

CONCLUSION

Height loss is associated with a rapid decline in kidney function. Geriatr Gerontol Int 2023; ••: ••-••.

Height loss as an indicator of ageing through its association with frailty and sarcopenia: An observational cohort study

BACKGROUND

Height loss is associated with various health-related variables such as cardiovascular disease, osteoporosis, cognitive function, and mortality. We hypothesized that height loss can be used as an indicator of aging, and we assessed whether the degree of height loss for 2 years was associated with frailty and sarcopenia.

METHODS

This study was based on a longitudinal cohort, the Pyeongchang Rural Area cohort. The cohort included people aged 65 years or older, ambulatory, and living at home. We divided individuals according to the ratio of height change (height change for 2 years divided by height at 2 years from baseline): HL2 (<-2%), HL1 (-2%--1%), and REF (-1%≤). We compared the frailty index, diagnosis of sarcopenia after 2 years from baseline, and the incidence of a composite outcome (mortality and institutionalization).

RESULTS

In total, 59 (6.9%), 116 (13.5%), and 686 (79.7%) were included in the HL2, HL1, and REF groups, respectively. Compared with the REF group, groups HL2 and HL1 had a higher frailty index, and higher risks of sarcopenia and composite outcome. When groups HL2 and HL1 were merged, the merged group had higher frailty index (standardized B, 0.06; p = 0.049), a higher risk of sarcopenia (OR, 2.30; p = 0.006), and a higher risk of composite outcome (HR, 1.78; p = 0.017) after adjusting for age and sex.

CONCLUSIONS

Individuals with greater height loss were frailer, more likely to be diagnosed with sarcopenia and had worse outcomes regardless of age and sex.

Gait speed reference values in community-dwelling older adults - Cross-sectional analysis from the Rotterdam Study

BACKGROUND

Gait speed is a simple, inexpensive and clinically useful marker of physical function in older adults. We aimed to establish gait speed reference values for community-dwelling older adults. To this end, we further explored the association of age, sex and height with gait speed.

METHODS

This study included community-dwelling participants aged 50 years and over enrolled in the Rotterdam Study. Participants completed the gait protocol between 2009 and 2016. The mean gait speed was calculated for age and height groups, stratified by sex. Reference values for gait speed were calculated using a quantile regression model adjusted for sex, the non-linear effects of age and height, as well as the interaction between age and sex plus the interaction between age and height.

RESULTS

The study population included 4656 Dutch participants with a mean (standard deviation) age of 67.7 (9.5) years, comprising 2569 (55.2%) women. The mean height of the participants was 1.69 (0.10) meters and the mean gait speed was 1.20 (0.20) m/s. Gait speed was lower with older age and greater with taller stature, but the effect of height disappeared above the age of 80 years. Sex did not affect gait speed after accounting for age and height. Age-, sex-, and height-specific reference values for gait speed are available for use at https://emcbiostatistics.shinyapps.io/GaitSpeedReferenceValues/.

CONCLUSIONS

We found that height explains the commonly noted difference in usual gait speed between sexes and that neither height nor sex impacts gait speed in the very oldest adults. We developed reference values for usual gait speed in Western European community-dwelling older adults.