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Willey MC, Owen EC, Miller A, Glass N, Kirkpatrick T, Fitzpatrick D, Wilken J, Marsh JL, Reider L. Substantial Loss of Skeletal Muscle Mass Occurs After Femoral Fragility Fracture. J Bone Joint Surg Am 2023; 105:1777-1785. [PMID: 37738373 DOI: 10.2106/jbjs.23.00353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
BACKGROUND Femoral fragility fractures in older adults can result in devastating loss of physical function and independence. Skeletal muscle atrophy likely contributes to disability. The purpose of this study was to characterize the change in skeletal muscle mass, investigate the relationship with malnutrition and physical function, and identify risk factors for skeletal muscle loss. METHODS Adults ≥65 years of age who were treated with operative fixation of an isolated femoral fragility fracture were enrolled in this multicenter, prospective observational study. Skeletal muscle mass was assessed within 72 hours of admission using multifrequency bioelectrical impedance analysis, which was repeated at 6 weeks, 3 months, and 6 months. Sarcopenia was defined by sex-specific cutoffs for the appendicular skeletal muscle mass index. The Mini Nutritional Assessment was used to measure nutritional status at the time of injury. Physical function was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function domain. Linear mixed models were used to evaluate changes in skeletal muscle mass and PROMIS Physical Function scores over time and to evaluate factors associated with skeletal muscle mass changes. RESULTS Ninety participants (74% female) with a mean age of 77.6 ± 9.0 years were enrolled. At the time of injury, 30 (33%) were sarcopenic and 44 (49%) were at risk for malnutrition or had malnutrition. Older age was associated with lower skeletal muscle mass (age of ≥75 versus <75 years: least squares mean [and standard error], -3.3 ± 1.6 kg; p = 0.042). From the time of injury to 6 weeks, participants lost an average of 2.4 kg (9%) of skeletal muscle mass (95% confidence interval [CI] = ‒3.0 to ‒1.8 kg; p < 0.001). This early loss did not recover by 6 months (1.8 kg persistent loss compared with baseline [95% CI = ‒2.5 to ‒1.1 kg]; p < 0.001). Participants with normal nutritional status lost more skeletal muscle mass from baseline to 6 weeks after injury compared with those with malnutrition (1.3 kg more loss [standard error, 0.6 kg]; p = 0.036). A 1-kg decrease in skeletal muscle mass was associated with an 8-point decrease in the PROMIS Physical Function (model parameter estimate, 0.12 [standard error, 0.04]; p = 0.002). CONCLUSIONS We found that older adults with femoral fragility fractures lost substantial skeletal muscle mass and physical function. Participants with adequate baseline nutrition actually lost more muscle mass than those who were malnourished, indicating that future investigations of interventions to prevent muscle loss should focus on older adults regardless of nutritional status. LEVEL OF EVIDENCE Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Michael C Willey
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Erin C Owen
- Slocum Research and Education Foundation, Eugene, Oregon
| | - Aspen Miller
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Natalie Glass
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | | | - Jason Wilken
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - J Lawrence Marsh
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Lisa Reider
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Gross DC, Cheever CR, Batsis JA. Understanding the development of sarcopenic obesity. Expert Rev Endocrinol Metab 2023; 18:469-488. [PMID: 37840295 PMCID: PMC10842411 DOI: 10.1080/17446651.2023.2267672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION Sarcopenic obesity (SarcO) is defined as the confluence of reduced muscle mass and function and excess body fat. The scientific community is increasingly recognizing this syndrome, which affects a subgroup of persons across their lifespans and places them at synergistically higher risk of significant medical comorbidity and disability than either sarcopenia or obesity alone. Joint efforts in clinical and research settings are imperative to better understand this syndrome and drive the development of urgently needed future interventions. AREAS COVERED Herein, we describe the ongoing challenges in defining sarcopenic obesity and the current state of the science regarding its epidemiology and relationship with adverse events. The field has demonstrated an emergence of data over the past decade which we will summarize in this article. While the etiology of sarcopenic obesity is complex, we present data on the underlying pathophysiological mechanisms that are hypothesized to promote its development, including age-related changes in body composition, hormonal changes, chronic inflammation, and genetic predisposition. EXPERT OPINION We describe emerging areas of future research that will likely be needed to advance this nascent field, including changes in clinical infrastructure, an enhanced understanding of the lifecourse, and potential treatments.
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Affiliation(s)
- Danae C. Gross
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - C. Ray Cheever
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John A. Batsis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
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Braz de Oliveira MP, Moreira Padovez RDFC, Serrão PRMDS, Gomes Dos Santos J, Silva DCPD, Andrade LPD. Is physical exercise effective at improving body structure & function and activity outcomes in individuals with Mild Cognitive Impairment? a systematic review with quality of evidence assessment. Disabil Rehabil 2023; 45:575-587. [PMID: 35195496 DOI: 10.1080/09638288.2022.2040609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the effect of physical exercise on body structure & function and activity outcomes in individuals with Mild Cognitive Impairment (MCI). METHODS Six databases were searched from inception until January 2021. Randomized controlled trials (RCTs) comparing physical exercise with a control group were included. RESULTS Fourteen RCTs were included. Three types of physical exercise were identified: aerobic (AE), resistance (RE), and multimodal (ME). Regarding body structure & function outcomes, evidence for RE was very low and with effect for improvement in upper limb muscle strength and very low and without effect for lower limbs. For improvement in postural balance, evidence was very low and with effect with AE and very low and without effect with RE and ME. Evidence for cardiorespiratory function was very low and without effect with AE and RE. Regarding activity outcomes, evidence was low and without effect for mobility with AE and very low and without effect with RE and ME. CONCLUSIONS Physical exercise promoted improvements in body structure & function outcomes in individuals with MCI. Resistance exercise improvement upper limb muscle strength and AE enhanced postural balance. In contrast, physical exercise did not promote a significant benefit in activity outcomes.Implications for rehabilitationResults of this systematic review have shown that physical exercise promoted improvements in body structure & function outcomes in individuals with Mild Cognitive Impairment (MCI).Resistance exercise with elastic bands for approximately 60 minutes twice a week for a total of three months improved upper limb muscle strength.Aerobic exercise with walking for approximately 60 minutes twice per week for a total of six months enhanced postural balance.Considering the potential benefits identified in this systematic review, physical exercise can be recommended for individuals with MCI.We also highlight the importance of the use of the International Classification of Functioning, Disability and Health for rehabilitation planning.
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Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Physical Therapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, Brasil
| | | | | | - Julimara Gomes Dos Santos
- Department of Physical Education, Federal Institute of Education, Science and Technology of Mato Grosso, Advanced Campus Diamantino, Diamantino, Brazil
| | | | - Larissa Pires de Andrade
- Physical Therapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, Brasil
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Dubu J, Boyas S, Roland V, Landry S, Septans AL, Balavoine M, Bourgeois H, Pointreau Y, Denis F, Letellier C, Le Dû K. Physical Activity Program for the Survival of Elderly Patients With Lymphoma: Study Protocol for Randomized Phase 3 Trial. JMIR Res Protoc 2022; 11:e40969. [PMID: 36427234 PMCID: PMC9736768 DOI: 10.2196/40969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The practice of regular physical activity can reduce the incidence of certain cancers (colon, breast, and prostate) and improve overall survival after treatment by reducing fatigue and the risk of relapse. This impact on survival has only been demonstrated in active patients with lymphoma before and after treatment. As poor general health status reduces the chances of survival and these patients are most likely to also have sarcopenia, it is important to be able to improve their physical function through adapted physical activity (APA) as part of supportive care management. Unfortunately, APA is often saved for patients with advanced blood cancer. As a result, there is a lack of data regarding the impact of standardized regular practice of APA and concomitant chemotherapy as first-line treatment on lymphoma survival. OBJECTIVE This study aimed to assess the impact of a new and open rehabilitation program suitable for a frail population of patients treated for diffuse large B-cell lymphoma (DLBCL). METHODS PHARAOM (Physical Activity Program for the Survival of Elderly Patients with Lymphoma) is a phase 3 randomized (1:1) study focusing on a frail population of patients treated for DLBCL. The study will include 186 older adult patients with DLBCL (aged >65 years) receiving rituximab and chemotherapy. Overall, 50% (93/186) of patients (investigational group) will receive APA along with chemotherapy, and they will be supervised by a dedicated qualified kinesiologist. The APA program will include endurance and resistance training at moderate intensity 3 times a week during the 6 months of chemotherapy. The primary end point of this study will be event-free survival of the patients. The secondary end points will include the overall survival, progression-free survival, prevalence of sarcopenia and undernutrition, and patients' quality of life. This study will be conducted in accordance with the principles of the Declaration of Helsinki. RESULTS Recruitment, enrollment, and data collection began in February 2021, and 4 participants have been enrolled in the study as of July 2022. Data analysis will begin after the completion of data collection. Future outcomes will be published in peer-reviewed health-related research journals and presented at national congress, and state professional meetings. This publication is based on protocol version 1.1, August 3, 2020. CONCLUSIONS The PHARAOM study focuses on highlighting the benefits of APA intervention on survival during the period of first-line treatment of patients with DLBCL. This study could also contribute to our understanding of how an APA program can reduce complications such as sarcopenia in patients with lymphoma and improve their quality of life. By documenting the prevalence and relationship between sarcopenia and exercise load, we might be able to help physicians plan better interventions in the care of patients with DLBCL. TRIAL REGISTRATION ClinicalTrials.gov NCT04670029; https://clinicaltrials.gov/ct2/show/NCT04670029. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40969.
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Affiliation(s)
- Jonas Dubu
- ELSAN, Institut inter-regional de Cancerologie Jean Bernard, Le Mans, France
- Motricite Interactions Performance (MIP), UR4334, Le Mans Universite, Le Mans, France
- WeproM, Le Mans, France
| | - Sébastien Boyas
- Motricite Interactions Performance (MIP), UR4334, Le Mans Universite, Le Mans, France
| | - Virginie Roland
- Hematology Department, Centre Hospitalier de Perpignan, Perpignan, France
| | - Sébastien Landry
- ELSAN, Institut inter-regional de Cancerologie Jean Bernard, Le Mans, France
| | | | | | - Hugues Bourgeois
- ELSAN, Institut inter-regional de Cancerologie Jean Bernard, Le Mans, France
| | - Yoann Pointreau
- ELSAN, Institut inter-regional de Cancerologie Jean Bernard, Le Mans, France
| | - Fabrice Denis
- ELSAN, Institut inter-regional de Cancerologie Jean Bernard, Le Mans, France
- Institut National de la e-Santé, Le Mans, France
| | - Christophe Letellier
- CNRS UMR 6614 - CORIA, Rouen Normandie Universite, Saint Etienne du Rouvray, France
| | - Katell Le Dû
- Hematology Department, Confluent Private Hospital, Nantes, France
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Pereira CC, Pagotto V, de Oliveira C, Silveira EA. Sarcopenia and mortality risk in community-dwelling Brazilian older adults. Sci Rep 2022; 12:17531. [PMID: 36266412 PMCID: PMC9585028 DOI: 10.1038/s41598-022-22153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/10/2022] [Indexed: 01/13/2023] Open
Abstract
We estimated the impact of sarcopenia parameters on mortality risk and assessed its prevalence and associated factors in the older adults according to the European Working Group on Sarcopenia in Older People's 2010 (EWGSOP1) and 2018 (EWGSOP2) criteria. This was a 10-year follow-up cohort study. Low muscle mass (MM) was defined as low skeletal muscle mass index (SMI) using dual-energy X-ray absorptiometry (DXA), and low calf circumference (CC). Cox regression and the Kaplan-Meier method were performed. The prevalence of sarcopenia and associated factors were influenced by the MM measurement method and diagnostic criteria used [6.8% (SMI and EWGSOP2), 12.8% (CC and EWGSOP2; and SMI and EWGSOP1) and 17.4% (CC and EWGSOP1)]. While a low BMI was associated with sarcopenia regardless of the sarcopenia definitions, diabetes, and high TGs were associated with sarcopenia only when using the EWGSOP1 criteria. Low SMI increased mortality risk (EWGSOP1: HR = 2.01, 95% CI 1.03-3.92; EWGSOP2: HR = 2.07, 95% CI 1.05-4.06). The prevalence of sarcopenia was higher according to EWGSOP1 than EWGSOP2. A low BMI, diabetes, and high TGs were associated with sarcopenia. A low SMI doubled the risk of mortality in community-dwelling older adults.
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Affiliation(s)
- Cristina Camargo Pereira
- grid.411195.90000 0001 2192 5801Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil
| | - Valéria Pagotto
- grid.411195.90000 0001 2192 5801Postgraduate Program in Nursing, Faculty of Nursing, Federal University of Goiás (UFG), Goiania, Brazil
| | - Cesar de Oliveira
- grid.83440.3b0000000121901201Department of Epidemiology and Public Health, University College London, London, UK
| | - Erika Aparecida Silveira
- grid.411195.90000 0001 2192 5801Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil ,grid.83440.3b0000000121901201Department of Epidemiology and Public Health, University College London, London, UK
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SarQoL Questionnaire in Community-Dwelling Older Adults under EWGSOP2 Sarcopenia Diagnosis Algorithm: A New Screening Method? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148473. [PMID: 35886318 PMCID: PMC9324056 DOI: 10.3390/ijerph19148473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
This article is an observational and cross-sectional study that related the result obtained in the questionnaire for the evaluation of quality of life related to muscle mass (SarQoL) and the prevalence of sarcopenic pathology measured under the EWGSOP2 algorithm. Participants were 202 community-dwelling older adults living in Valencia, Spain. The prevalence of sarcopenia in men was 28.9%, while in women it was 26.2%. In the case of the SarQoL questionnaire, the mean score obtained for men was 75.5 and 72.6 for women, showing significant differences in both sexes between the results obtained by the group with and without sarcopenia. After the exhaustive data analysis, a high discriminative capacity for sarcopenic disease was found in the SarQoL questionnaire total score and in domains 2 (locomotion), 4 (functionality) and 5 (activities of daily living). In accordance with the existing controversy regarding the use of SARC-F as a screening method for sarcopenia, the authors pointed out the capacity of domain 2 (locomotion) in isolation as a possible screening method for this disease, exposing a high risk of suffering sarcopenia when scores in this domain were below 60 points. Further research is needed to develop new lines of research as these showed in this work, as well as new and easily applicable screening methods for sarcopenia in clinical practice, that allow a rapid detection of this disease in the community.
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Milte R, Petersen J, Boylan J, Henwood T, Hunter S, Lange B, Lawless M, Torode S, Lewis LK. Prevalence and determinants of physical frailty among people living in residential aged care facilities: a large-scale retrospective audit. BMC Geriatr 2022; 22:424. [PMID: 35568811 PMCID: PMC9107174 DOI: 10.1186/s12877-022-03101-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/26/2022] [Indexed: 12/01/2022] Open
Abstract
Background Physical frailty is associated with increased risk of falls, hospitalisation and mortality. There is a dearth of information on physical frailty of older adults living in residential aged care. This study aimed to describe physical frailty in aged care residents and investigate possible determinants of frailty. Method A retrospective audit of resident records was undertaken across 14 residential aged care facilities. Data were extracted on all consenting residents who had completed measures relating to frailty (Short Physical Performance Battery SPPB; grip strength). All data of the first record of measures were extracted, resident characteristics, and the time from admission to assessment. Summary statistics were completed. Differences between sub-groups were explored (Mann-Whitney U, Kruskall-Wallis Ranked tests). Associations between variables were explored with Chi-squared and Pearson correlations. Determinants of physical frailty were determined with linear regression analyses. Alpha (2-sided) was 0.05. Results Data were extracted for 1241 residents (67% female), with a mean age of 86.0 (7.6) years. Males had a significantly lower time from admission to assessment of frailty (p ≤ 0.001). The average SPPB score was 4.1 (3.3), 75% of residents were frail and 19% pre-frail. Bivariate analyses indicated no significant relationships between grip strength and SPPB score, but significant differences for grip strength, where males were significantly stronger (males 20.2 ± 8.3 kg; females 12.4 ± 5.4 kg; p ≤ 0.001). There was a significant positive relationship between SPPB total score and grip strength, gender (p ≤ 0.001), and marital status (p = 0.049) and a negative relationship between time from admission to assessment and SPPB total score (p ≤ 0.001). There were significant negative relationships between gender (p ≤ 0.001) and age (p ≤ 0.001), and time from admission to assessment (p ≤ 0.001) with grip strength. Conclusion Older adults living in residential aged care have a high level of physical frailty which may lead to increased risk of adverse outcomes. Time in the residential aged care setting and age appear to predict physical frailty. There is a need for a consistent battery of measures to continually monitor frailty and programs to address the high levels of frailty in residential aged care.
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Affiliation(s)
- Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jasmine Petersen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jo Boylan
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Tim Henwood
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Michael Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Stacey Torode
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Lucy K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Escribà-Salvans A, Jerez-Roig J, Molas-Tuneu M, Farrés-Godayol P, Moreno-Martin P, Goutan-Roura E, Güell-Masramon H, Amblàs-Novellas J, de Souza DLB, Skelton DA, Torres-Moreno M, Minobes-Molina E. Sarcopenia and associated factors according to the EWGSOP2 criteria in older people living in nursing homes: a cross-sectional study. BMC Geriatr 2022; 22:350. [PMID: 35448983 PMCID: PMC9022416 DOI: 10.1186/s12877-022-02827-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 01/11/2023] Open
Abstract
Background In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality. Aim Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain). Design A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia. Results Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040. Conclusions According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population.
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Affiliation(s)
- Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.
| | - Miriam Molas-Tuneu
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Ester Goutan-Roura
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Helena Güell-Masramon
- Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, VIC, 08500, Barcelona, Spain
| | - Dyego Leandro Bezerra de Souza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.,Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miriam Torres-Moreno
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
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Calf cirfumference as a predictor of skeletal muscle mass in postmenopausal women. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Interventions to Improve Physical Capability of Older Adults with Mild Disabilities: A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052651. [PMID: 35270341 PMCID: PMC8910335 DOI: 10.3390/ijerph19052651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Ageing is related to changes in physical health, including loss of mobility and muscle function. It can lead to impaired physical capability and reduced quality of life. The purpose of this study was to investigate whether a physical activity rehabilitation program (PARP) could improve range of joint motion (ROM), grip strength, and gait speed of older adults with mild disabilities. Forty older adults in a long-term care center in Taiwan joined as human participants and were split into control and experimental groups. The participants in the experimental group joined a PARP for eight weeks. The ROM of bodily joints, grip strength, and gait speed of all participants were measured both before and after the eight-week period. The results showed that all the ROMs, grip strength, and gait speed of the participants in the experimental group increased significantly after attending the program. The improvement of the ROMs for male and female participants in the experimental group ranged from 3.8% to 71% and from 7.8% to 75%, respectively. Male participants had greater improvement on gait speed (50%) than their female counterparts (22.9%). Female participants, on the other hand, had greater improvement on grip strength (25.4%) than their male counterparts (20.3%). The ROM, grip strength, and gait speed of the control group, on the other hand, did not change significantly during the same period. The results showed that the PARP adopted in this study was effective in increasing the ROM, grip strength, and gait speed of those who had joined the PARP. This study shows that an eight-week PARP without the use of gym machines was beneficial in reducing sarcopenia in elderly people with mild disabilities.
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Zhang H, Chen Z, Zhang J, Zhou X, Li S, Ren H. Effects of Developmental Bibliotherapy on Subjective Well-Being of Older Adults Living in Nursing Homes: A Quasi-Experimental Study. J Psychosoc Nurs Ment Health Serv 2022; 60:15-22. [PMID: 35191766 DOI: 10.3928/02793695-20220215-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study sought to create a developmental bibliotherapy material database (DBMD) and examine the effectiveness of developmental bibliotherapy on subjective well-being of older adults living in nursing homes. Based on the reading needs of older adults, we developed a DBMD, which included 327 materials with five themes: Health Care, Current Affairs and Politics, Historical Biographies, Geriatric Culture, and Psychological Adjustment. Fifty-four single materials were randomly selected from the DBMD to perform the intervention. This study used a quasi-experimental, single-group pre-/post-survey approach. Sixty-four older adults participated in the study for 6 weeks. Immediately before and after the intervention, older adults completed the Optimism-Pessimism Scale and Memorial University of Newfoundland Scale of Happiness. There were significant improvements in older adults' optimistic tendency and subjective well-being (p < 0.05). Reading materials in the DBMD promoted older adults' optimistic attitude toward life, reduced negative emotions, and improved subjective well-being. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Nutritional status and quality of life are associated with risk of sarcopenia in nursing home residents: A cross-sectional study. Nutr Res 2022; 101:14-22. [DOI: 10.1016/j.nutres.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 02/06/2023]
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Prokopidis K, Giannos P, Witard OC, Peckham D, Ispoglou T. Aberrant mitochondrial homeostasis at the crossroad of musculoskeletal ageing and non-small cell lung cancer. PLoS One 2022; 17:e0273766. [PMID: 36067173 PMCID: PMC9447904 DOI: 10.1371/journal.pone.0273766] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/12/2022] [Indexed: 11/19/2022] Open
Abstract
Cancer cachexia is accompanied by muscle atrophy, sharing multiple common catabolic pathways with sarcopenia, including mitochondrial dysfunction. This study investigated gene expression from skeletal muscle tissues of older healthy adults, who are at risk of age-related sarcopenia, to identify potential gene biomarkers whose dysregulated expression and protein interference were involved in non-small cell lung cancer (NSCLC). Screening of the literature resulted in 14 microarray datasets (GSE25941, GSE28392, GSE28422, GSE47881, GSE47969, GSE59880 in musculoskeletal ageing; GSE118370, GSE33532, GSE19804, GSE18842, GSE27262, GSE19188, GSE31210, GSE40791 in NSCLC). Differentially expressed genes (DEGs) were used to construct protein-protein interaction networks and retrieve clustering gene modules. Overlapping module DEGs were ranked based on 11 topological algorithms and were correlated with prognosis, tissue expression, and tumour purity in NSCLC. The analysis revealed that the dysregulated expression of the mammalian mitochondrial ribosomal proteins, Mitochondrial Ribosomal Protein S26 (MRPS26), Mitochondrial Ribosomal Protein S17 (MRPS17), Mitochondrial Ribosomal Protein L18 (MRPL18) and Mitochondrial Ribosomal Protein L51 (MRPL51) were linked to reduced survival and tumour purity in NSCLC while tissue expression of the same genes followed an opposite direction in healthy older adults. These results support a potential link between the mitochondrial ribosomal microenvironment in ageing muscle and NSCLC. Further studies comparing changes in sarcopenia and NSCLC associated cachexia are warranted.
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Affiliation(s)
- Konstantinos Prokopidis
- Society of Meta-Research and Biomedical Innovation, London, United Kingdom
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Panagiotis Giannos
- Society of Meta-Research and Biomedical Innovation, London, United Kingdom
- Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, United Kingdom
- * E-mail:
| | - Oliver C. Witard
- Faculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King’s College London, London, United Kingdom
| | - Daniel Peckham
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
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Interactive effect of sarcopenia and falls on vertebral osteoporotic fracture in patients with rheumatoid arthritis. Arch Osteoporos 2021; 16:145. [PMID: 34601644 DOI: 10.1007/s11657-021-01017-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/27/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Patients with rheumatoid arthritis (RA) had higher incidences of sarcopenia, falls, osteoporosis, and vertebral osteoporotic fractures (VOPF). Sarcopenia was associated with longer disease duration, higher disease activity, and more severe RA. The interactive effect of sarcopenia and falls was associated with a higher risk of VOPF in patients with RA. PURPOSE Whether sarcopenia and falls are a risk factor for vertebral fracture in RA patients has not been demonstrated. This study aimed to explore the incidence of vertebral osteoporotic fracture (VOPF) and its relationship with sarcopenia and falls in RA patients. METHODS A total of 474 RA patients and 156 controls were enrolled in this study. Anteroposterior and lateral X-ray examinations of the vertebral column (T4-L4) were used for the semiquantitative assessment of VOPF. Bone mineral density was measured by dual-energy X-ray absorptiometry. Skeletal muscle mass was measured by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA method). RESULTS RA patients had an increased risk of sarcopenia (62.4% vs 9.0%, x2 = 47.478, P < 0.001), falls (30.2% vs 3.2%), osteoporosis (OP) (33.5% vs 12.8%, x2 = 134.276, P < 0.001), and VOPF (20.3% vs 3.8%, x2 = 47.478, P < 0.001) than controls. Patients with sarcopenia were more likely to have VOPF than RA without sarcopenia (24.0% vs 14.0%, x2 = 6.802, P = 0.009). RA with sarcopenia and prior falls had the highest incidences of VOPF (36.7%). Older age (OR = 1.056, P < 0.001, 95% CI 1.030-1.083), falls (OR = 2.043, P = 0.003, 95% CI 1.238-3.371), OP (OR = 1.819, P = 0.034, 95% CI 1.046-3.163), and usage of glucocorticoids (GCs) (OR = 1.862, P = 0.022, 95% CI 1.093-3.172) were risk factors for VOPF in RA patients, while a higher skeletal muscle index (SMI) was a protective factor (OR = 0.754, P = 0.038, 95% CI 0.578-0.984) for VOPF in RA patients. CONCLUSIONS The interactive effect of sarcopenia and falls is associated with a higher risk of VOPF in patients with RA.
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González-Fernández M, Perez-Nogueras J, Serrano-Oliver A, Torres-Anoro E, Sanz-Arque A, Arbones-Mainar JM, Sanz-Paris A. Masseter Muscle Thickness Measured by Ultrasound as a Possible Link with Sarcopenia, Malnutrition and Dependence in Nursing Homes. Diagnostics (Basel) 2021; 11:1587. [PMID: 34573928 PMCID: PMC8469670 DOI: 10.3390/diagnostics11091587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength. It is frequently associated with malnutrition and dependence in nursing homes. Masticatory muscle strength could be the link between sarcopenia, malnutrition and dependence. We aimed to study the relation between sarcopenia, malnutrition and dependence with masseter muscle thickness measured by ultrasound. A cross-sectional study was realized, with 464 patients from 3 public nursing homes in Zaragoza (Spain). The diagnosis of sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People 2 criteria, malnutrition by the Mini Nutritional Assessment (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and functional capacity by the Barhel Index and the texture diet. Masseter muscle thickness (MMT) was measured by ultrasound. The median age was 84.7 years, and 70% of the participants were women. Sarcopenia was confirmed in 39.2% of patients, malnutrition in 26.5% (risk 47.8%), total dependence in 37.9% and diet texture was modified in 44.6%. By logistic regression, once the model was adjusted for age, sex, Barthel index and texture diet, our analyses indicated that each 1 mm decrease in MMT increased the risk of sarcopenia by ~57% (OR: 0.43), the risk of malnutrition by MNA by ~63% (OR: 0.37) and the risk of malnutrition by GLIM by ~34% (OR: 0.66). We found that MMT was reduced in sarcopenic, malnourished and dependent patients, and it could be the common point of a vicious cycle between sarcopenia and malnutrition. Further studies are needed to establish causality.
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Affiliation(s)
| | | | | | | | | | - Jose M. Arbones-Mainar
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50007 Zaragoza, Spain
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Alejandro Sanz-Paris
- Nutrition Department, University Hospital Miguel Servet, 50007 Zaragoza, Spain;
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
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Haigis D, Pomiersky R, Altmeier D, Frahsa A, Sudeck G, Thiel A, Eschweiler G, Nieß AM. Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents-A Pilot Study. Geriatrics (Basel) 2021; 6:geriatrics6030069. [PMID: 34287326 PMCID: PMC8293077 DOI: 10.3390/geriatrics6030069] [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: 06/19/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research.
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Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Correspondence:
| | - Rebekka Pomiersky
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Dorotheé Altmeier
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Annika Frahsa
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
| | - Gorden Sudeck
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Gerhard Eschweiler
- Centre for Geriatric Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
| | - Andreas Michael Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
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Response and Adherence of Nursing Home Residents to a Nutrition/Exercise Intervention. J Am Med Dir Assoc 2021; 22:1939-1945.e3. [PMID: 33961812 DOI: 10.1016/j.jamda.2021.04.001] [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] [Received: 12/22/2020] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Interindividual response variability to nutrition and exercise interventions is extensive in older adults. A group of nursing home (NH) residents participated in a combined intervention. The objective of this post-hoc analysis was to identify factors associated with intervention response measured by change in physical function and body composition. DESIGN Post-hoc analyses in the Older Person's Exercise and Nutrition study, a 2-arm randomized trial. The primary outcomes were 30-second Chair Stand Test and composite scores combining physical function and fat-free mass. A secondary outcome was intervention adherence. A 12-week intervention of sit-to-stand exercises and protein-rich nutritional supplements did not improve chair-stand capacity vs control on intention-to-treat basis. SETTING AND PARTICIPANTS Residents ≥75 years of age from dementia and somatic units in eight NHs in Sweden. METHODS Logistic regressions were performed to define factors associated with response (maintenance/improvement) or nonresponse (deterioration) in 30-second Chair Stand Test, and with intervention adherence. Linear regressions were performed to explore factors associated with response in composite scores. RESULTS Mean age of participants (n = 52 intervention, n = 49 control) was 85.8 years. Sarcopenia was occurring in 74%. Sarcopenia at baseline (P = .005) and high adherence to nutritional supplements (P = .002) increased the odds of response. Higher independence in daily activities increased the odds of adherence to sit-to-stand exercises (P = .027) and the combined intervention (P = .020). Allocation to the intervention group and higher self-perceived health were associated with higher composite scores. CONCLUSIONS AND IMPLICATIONS NH residents with baseline sarcopenia, better self-perceived health, and high adherence to nutritional supplements benefitted most from a combined nutrition and exercise intervention regarding chair-stand capacity and composite scores of function and fat-free mass. Adherence was related to higher grade of independence. Understanding factors associated with response and adherence to an intervention will help target susceptible residents in most need of support and to optimize the outcome.
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Van Jacobs A, Coltman A, Gomez-Perez SL, Bienia B, Sclamberg JS, Peterson SJ. Prevalence of low computed tomography-measured skeletal muscle index and handgrip strength in a general medical population. Nutr Clin Pract 2021; 37:102-109. [PMID: 33930219 DOI: 10.1002/ncp.10660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Sarcopenia is defined as the loss of muscle mass and function and has been associated with worsened outcomes, including disability and mortality. The aim of this study was to describe the prevalence of sarcopenia in patients who had an abdominal computed tomography (CT) scan completed within 7 days of hospital admission. METHODS A retrospective study was conducted. Adult patients admitted to either the general medical or surgical floor were included. Muscle function was assessed using handgrip strength (HGS, kg), completed within the first 48 hours of admission. Skeletal muscle index (SMI, kg/m2 ) at the third lumber region was calculated among patients who had an abdominal CT scan completed within 7 days of admission. Sarcopenia was identified by the combination of low SMI and HGS. The primary outcome was the percentage of patients diagnosed with sarcopenia. RESULTS A total of 1318 patients were admitted; 11% (n = 141) had an abdominal CT scan completed within 7 days of admission. Only race and prevalence of malnutrition were different between patients who did and did not have a CT completed. The overall prevalence of sarcopenia was 13% (n = 18/141). Additionally, 39% of the sample was at risk for sarcopenia, with either low SMI (n = 13/141) or low HGS (n = 42/141). CONCLUSIONS Overall prevalence of sarcopenia was low, but more than one-third of patients had either low SMI or low HGS. Minimal differences were observed between patients who did and did not have an abdominal CT scan completed upon admission.
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Affiliation(s)
- Amanda Van Jacobs
- Department of Food and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Sandra L Gomez-Perez
- Department of Clinical Nutrition, College of Health Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Benjamin Bienia
- Department of Radiology, Amita Health, Hinsdale, Illinois, USA
| | - Joy S Sclamberg
- Diagnostic Radiology Residency Program, Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA
| | - Sarah J Peterson
- Department of Clinical Nutrition, College of Health Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Alvero-Cruz JR, Fernandez Vazquez R, Martinez Blanco J, Rosety I, Diaz AJ, Rosety MA, Rosety-Rodriguez M, Ordonez FJ. Proposed cut-off points for anthropometric and bioelectrical measures based on overweight and obesity criteria in Spanish institutionalised elderly people. PLoS One 2021; 16:e0248028. [PMID: 33684155 PMCID: PMC7939364 DOI: 10.1371/journal.pone.0248028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/18/2021] [Indexed: 11/19/2022] Open
Abstract
The increasing prevalence of obesity among the institutionalised elderly population and its severe consequences on health requires an early and accurate diagnosis that can be easily achieved in any clinical setting. This study aimed to determine new cut-off values for anthropometric and bioelectrical impedance measures that are superior to body mass index criteria for overweight and obesity status in a sample of Spanish institutionalised elderly population. A total of 211 institutionalised older adults (132 women, aged 84.3±7.3 years; 79 men, aged 81.5±7.3 years) were enrolled in the current cross-sectional study. Anthropometric and bioelectrical impedance measures included the body mass index, waist circumference, gluteal circumference, waist-hip ratio, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio. In women, the waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat index presented strongly significant specificity and sensitivity (area under the curve [AUC], p<0.0001) and elevated discriminative values (receiver operating characteristic [ROC] curves: 0.827 to 0.867) for overweight and obesity status. In men, the waist-hip ratio, waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio were strongly significant AUC (p<0.0001), with moderate-to-high values (ROC curves: 0.757-0.871). In conclusion, our findings suggest that gluteal circumference, waist circumference, and sagittal-abdominal diameter in women and trunk fat, visceral-fat ratio, and waist circumference in men may represent more suitable cut-off values superior to body mass index criteria for overweight and obesity in the Spanish institutionalised elderly population.
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Affiliation(s)
- Jose Ramon Alvero-Cruz
- Department of Physiology, Histology, Pathological Anatomy and Sport Sciences, School of Medicine, University of Malaga, Málaga, Spain
| | - Rosalia Fernandez Vazquez
- Department of Physiology, Histology, Pathological Anatomy and Sport Sciences, School of Medicine, University of Malaga, Málaga, Spain
| | | | - Ignacio Rosety
- Department of Human Anatomy, School of Medicine, University of Cádiz, Cádiz, Spain
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Arnal-Gómez A, Cebrià i Iranzo MA, Tomas JM, Tortosa-Chuliá MA, Balasch-Bernat M, Sentandreu-Mañó T, Forcano S, Cezón-Serrano N. Using the Updated EWGSOP2 Definition in Diagnosing Sarcopenia in Spanish Older Adults: Clinical Approach. J Clin Med 2021; 10:1018. [PMID: 33801427 PMCID: PMC7958601 DOI: 10.3390/jcm10051018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 01/06/2023] Open
Abstract
Recently the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated diagnostic criteria for sarcopenia, which consist of one or more measures of muscle strength, muscle mass, and physical performance, plus an initial screening test called SARC-F. The main objective was to compare the number of cases of sarcopenia, using the different measurements and screening options. A cross-sectional study was conducted on Spanish older adults (n = 272, 72% women). Combining the different measures proposed by the steps described in the EWGSOP2 algorithm, 12 options were obtained (A-L). These options were studied in each of the three models: (1) using SARC-F as initial screening; (2) not using SARC-F; and (3) using SARC-CalF instead of SARC-F. A χ2 independence test was statistically significant (χ2(6) = 88.41, p < 0.001), and the association between the algorithm used and the classification of sarcopenia was moderate (Cramer's V = 0.226). We conclude that the different EWGSOP2 measurement options imply case-finding differences in the studied population. Moreover, when applying the SARC-F, the number of people classified as sarcopenic decreases. Finally, when SARC-CalF is used as screening, case finding of sarcopenic people decreases. Thus, clinical settings should consider these outcomes, since these steps can make preventive and therapeutic interventions on sarcopenia vary widely.
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Affiliation(s)
- Anna Arnal-Gómez
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (A.A.-G.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Research Unit in Clinical Biomechanics (UBIC), University of Valencia, 46010 Valencia, Spain
| | - Maria A. Cebrià i Iranzo
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (A.A.-G.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
| | - Jose M. Tomas
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain;
- Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, 46010 Valencia, Spain
| | - Maria A. Tortosa-Chuliá
- Department of Applied Economics, University of Valencia, 46022 Valencia, Spain;
- Psychological Development, Health and Society (PSDEHESO), University of Valencia, 46022 Valencia, Spain
| | - Mercè Balasch-Bernat
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (A.A.-G.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
| | - Trinidad Sentandreu-Mañó
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (A.A.-G.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, 46010 Valencia, Spain
| | - Silvia Forcano
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - Natalia Cezón-Serrano
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (A.A.-G.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
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Alodhayani AA, Alsaad SM, Almofarej N, Alrasheed N, Alotaibi B. Frailty, sarcopenia and health related outcomes among elderly patients in Saudi Arabia. Saudi J Biol Sci 2021; 28:1213-1217. [PMID: 33613049 PMCID: PMC7878688 DOI: 10.1016/j.sjbs.2020.11.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 12/25/2022] Open
Abstract
Objective To determine the prevalence of frailty and sarcopenia among elderly patients in Saudi Arabia and explore if there are significant association between frailty and sarcopenia. Methods A total of 498 patients from public tertiary hospital in Saudi Arabia participated in this descriptive cross-sectional study between March 2019 to June 2019. All participants answered a 5-part questionnaire, which includes demographic data, Edmonton Frail Scale, SARC-F and questions related to Activities of Daily living. Results The mean age of the participants was 69.98 ± 6.28. Of the 498 participants, 67.7% were aged 61–70 years and 42% had a BMI of greater than < 30 kg/m2. The prevalence of patients with mild frail, moderate frail and severely frail were 22, 12, and 4%, respectively. The analysis showed that majority of patients who had sarcopenia were females (84%). The analysis show that the level of frailty of patients were significantly different between age, marital status, educational level and patients’ needs of home care, activities of daily living, presence of comorbidity and sarcopenia (p = 0.001). In the logistic regression analysis, the pre-frailty group was significantly likely to have sarcopenia (OR 0.02 95% 0.01–0.23p = 0.001) than nonfrailty patients. Conclusion In conclusion, this research highlights the high prevalence of sarcopenia among elderly patients and the increasing percentage of frail patients in Saudi Arabia. In addition, significant difference and association were found with sarcopenia and frailty with many sociodemographic and clinical components of elderly patients in Saudi Arabia.
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Affiliation(s)
- Abdulaziz A. Alodhayani
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Corresponding author at: Family and Community Medicine Department, College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia.
| | - Saad M. Alsaad
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Badriah Alotaibi
- Department of Pharmaceutical Science, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Guillamón-Escudero C, Diago-Galmés A, Tenías-Burillo JM, Soriano JM, Fernández-Garrido JJ. Prevalence of Sarcopenia in Community-Dwelling Older Adults in Valencia, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239130. [PMID: 33297423 PMCID: PMC7730689 DOI: 10.3390/ijerph17239130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
This study is an observational and cross-sectional study on the prevalence of sarcopenic disease in 202 autonomous older adults; 18.8 and 81.2% were men and women, respectively, living in their own homes in Valencia, Spain. Sarcopenia was diagnosed using the criteria and cutting points for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), using the tests: SARC-F, grip strength, sit-to-stand, gait speed, appendicular skeletal muscle mass and short physical performance battery. According to the EWGSOP2 criteria, probable sarcopenia was present in 21.1% and 18.3% of men and women, respectively, and the sum of confirmed and severe sarcopenia was 7.9% and 7.3% in men and in women, respectively. A relationship was shown between the prevalence of the disease and the age of the participants, but no significant differences were found between the sum of confirmed and severe sarcopenia between the sexes, nor a relationship between the amount of muscle mass and the strength of grip. The SARC-F questionnaire diagnosed 40% of the sarcopenia cases present in the study. More thorough research is needed to continue using the EWGSOP2 criteria in different populations to establish a correct prevalence of sarcopenic disease in different populations of the world.
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Affiliation(s)
| | | | | | - Jose M. Soriano
- Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Valencia, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain
- Correspondence: ; Tel.: +34-963543056
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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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High Prevalence of Probable Sarcopenia in a Representative Sample From Colombia: Implications for Geriatrics in Latin America. J Am Med Dir Assoc 2020; 22:859-864.e1. [PMID: 33197411 DOI: 10.1016/j.jamda.2020.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recently defined the new concept of probable sarcopenia to help improve screening and prevent future sarcopenia. We investigated the prevalence of probable sarcopenia, defined as weak grip strength, in community-dwelling older Colombian adults, and examined the long-term associated conditions. DESIGN Cross-sectional study. SETTING Urban and rural Colombian older adults from the "Estudio Nacional de Salud, Bienestar y Envejecimiento (SABE) study". PARTICIPANTS 5237 Colombian older adults aged ≥60 years. MEASUREMENTS Probable sarcopenia was assessed following the cut-off points for weak grip strength recommended by EWGSOP2 guidelines. Odds ratios (ORs) of the relationship between long-term conditions and probable sarcopenia were determined using logistic regression. RESULTS The prevalence of probable sarcopenia defined as weak grip strength was 46.5% [95% confidence interval (CI), 45.1-47.8]. Physical inactivity "proxy" (OR 1.35, 95% CI 1.14-1.59); diabetes (OR 1.32, 95% CI 1.11-1.56); and arthritis, osteoarthritis, and rheumatism (OR 1.44, 95% CI 1.25-1.67) were independently associated with probable sarcopenia. CONCLUSIONS AND IMPLICATIONS We found that almost half of all the Colombian older adults in our sample had probable sarcopenia. Individuals with physical inactivity, diabetes, arthritis, or osteoarthritis and rheumatism had a higher prevalence of probable sarcopenia. Probable sarcopenia is clinically highly relevant, and several of the factors associated with this condition are potentially preventable, treatable, and reversible.
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Cheng TY, Lee PC, Chen YT, Chao Y, Hou MC, Huang YH. Pre-sarcopenia determines post-progression outcomes in advanced hepatocellular carcinoma after sorafenib failure. Sci Rep 2020; 10:18375. [PMID: 33110117 PMCID: PMC7591538 DOI: 10.1038/s41598-020-75198-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022] Open
Abstract
Many second-line therapies are recently approved for patients with advanced hepatocellular carcinoma (HCC), in whom protein malnutrition is prevalent that would affect treatment outcomes. In this study, we aimed to investigate the role of pre-sarcopenia and muscle restoration in patients with sorafenib-failed advanced HCC. From August 2012 to March 2017, 385 patients who developed radiology-proven HCC progression after sorafenib treatment were enrolled in the study. Pre-sarcopenia is defined as transverse psoas muscle thickness per body height < 16.8 mm/m, which was prevalent (64.7%) in our patients. Age > 60 years, female gender, and body mass index < 22 kg/m2 were independent predictors to the development of pre-sarcopenia. Patients with muscle depletion had significantly worse post-progression survival (PPS) compared with their counterparts (median PPS: 3.8 vs. 5.8 months, p = 0.003), particularly in those with intermediate liver reserves (Child–Pugh class B or Albumin-bilirubin grade 2). Besides, pre-sarcopenia independently predicted post-progression mortality in sorafenib-failed HCC (hazard ratio: 1.340, p = 0.012). In patients who developed pre-sarcopenia before sorafenib treatment, muscle restoration was associated with a longer PPS compared with their counterparts (6.3 vs. 3.6 months, p = 0.043). In conclusion, pre-sarcopenia independently determined the outcomes of sorafenib-failed HCC. Nutrition support to restore muscle mass would prolong survival for higher-risk patients.
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Affiliation(s)
- Tsung-Yi Cheng
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Chang Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yi-Tzen Chen
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yee Chao
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. .,Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. .,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
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Martínez-Arnau FM, Buigues C, Fonfría-Vivas R, Cauli O. Respiratory Muscle Strengths and Their Association with Lean Mass and Handgrip Strengths in Older Institutionalized Individuals. J Clin Med 2020; 9:E2727. [PMID: 32847002 PMCID: PMC7563242 DOI: 10.3390/jcm9092727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
The study of reduced respiratory muscle strengths in relation to the loss of muscular function associated with ageing is of great interest in the study of sarcopenia in older institutionalized individuals. The present study assesses the association between respiratory muscle parameters and skeletal mass content and strength, and analyzes associations with blood cell counts and biochemical parameters related to protein, lipid, glucose and ion profiles. A multicenter cross-sectional study was performed among patients institutionalized in nursing homes. The respiratory muscle function was evaluated by peak expiratory flow, maximal respiratory pressures and spirometry parameters, and skeletal mass function and lean mass content with handgrip strength, walking speed and bioimpedance, respectively. The prevalence of reduced respiratory muscle strength in the sample ranged from 37.9% to 80.7%. Peak expiratory flow significantly (p < 0.05) correlated to handgrip strength and gait speed, as well as maximal inspiratory pressure (p < 0.01). Maximal expiratory pressure significantly (p < 0.01) correlated to handgrip strength. No correlation was obtained with muscle mass in any of parameters related to reduced respiratory muscle strength. The most significant associations within the blood biochemical parameters were observed for some protein and lipid biomarkers e.g., glutamate-oxaloacetate transaminase (GOT), urea, triglycerides and cholesterol. Respiratory function muscle parameters, peak expiratory flow and maximal respiratory pressures were correlated with reduced strength and functional impairment but not with lean mass content. We identified for the first time a relationship between peak expiratory flow (PEF) values and GOT and urea concentrations in blood which deserves future investigations in order to manage these parameters as a possible biomarkers of reduced respiratory muscle strength.
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Affiliation(s)
- Francisco Miguel Martínez-Arnau
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
| | - Cristina Buigues
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Rosa Fonfría-Vivas
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
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Abbas H, Perna S, Shah A, Al-Mannai M, Gasparri C, Infantino V, Cereda E, Peroni G, Riva A, Petrangolini G, Rondanelli M. Risk factors for 5-year mortality in a cohort of elderly patients with sarcopenia. Exp Gerontol 2020; 136:110944. [PMID: 32289488 DOI: 10.1016/j.exger.2020.110944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The association between multiple risk factors and the mortality of sarcopenic patients has not been studied. This study's aim is to report the prevalence of sarcopenia among a sample of Italian hospitalized older adults, describe the physical function, body fat composition, cognitive, inflammatory and nutritional status of sarcopenic compared with non-sarcopenic subjects, and determine the risk factors associated with mortality in sarcopenic patients. METHOD A total of 462 patients were enrolled and followed up for a period of 5 years. Sarcopenia was diagnosed according to the EWGSOP2 criteria. Factors associated with sarcopenia were identified with linear regression analysis. Logistic regression was applied to explore the association between the risk factors and mortality in sarcopenic subjects. Survival analyses and predictors of mortality were identified using Kaplan-Meier and Cox regression. RESULTS The prevalence of sarcopenia was 33.5%. Linear regression showed that sarcopenia was associated with Barthel index (B -9.63, p0.004), BMI (B -3.19, p<0.001) and android fat (B 1.85, p0.004). Of these factors, only the number of co-morbidities (OR 1.394 C95% 1.023-1.862 p 0.025) and MMSE scores (OR 0.857 C95% 0.79-0.930 p <0.001) were associated with mortality in sarcopenia. Kaplan-Meier and the log-rank tests showed the negative prognostic effect of low BMI (p0.007), albumin (p<0.001) and Barthel index (p 0.018). The Cox regression showed that mortality hazard is reduced with BMI >24.9 (HR 0.287 C95% 0.095-0.866 p 0.027). CONCLUSION Sarcopenia is associated with low physical function and BMI but higher android fat. Low Barthel, BMI and albumin can significantly decrease the survival rate in sarcopenic patients. Whereas BMI >24.9 is associated with lower mortality hazard.
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Affiliation(s)
- Hanan Abbas
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Kingdom of Bahrain.
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Kingdom of Bahrain.
| | - Afzal Shah
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Kingdom of Bahrain
| | - Mariam Al-Mannai
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Kingdom of Bahrain.
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, Pavia 27100, Italy.
| | - Vittoria Infantino
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia 27100, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy.
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, Pavia 27100, Italy.
| | - Antonella Riva
- Research and Development Unit, Indena, Milan 20139, Italy.
| | | | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia 27100, Italy; IRCCS Mondino Foundation, Pavia 27100, Italy.
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Cebrià i Iranzo MA, Arnal-Gómez A, Tortosa-Chuliá MA, Balasch-Bernat M, Forcano S, Sentandreu-Mañó T, Tomas JM, Cezón-Serrano N. Functional and Clinical Characteristics for Predicting Sarcopenia in Institutionalised Older Adults: Identifying Tools for Clinical Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4483. [PMID: 32580427 PMCID: PMC7344603 DOI: 10.3390/ijerph17124483] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/13/2020] [Accepted: 06/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. METHODS A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson's Comorbidity Index (ACCI), number of medications, hospital stays and falls. RESULTS Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke's R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). CONCLUSION BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.
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Affiliation(s)
- Maria A. Cebrià i Iranzo
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (M.A.C.iI.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (M.A.C.iI.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Research Unit in Clinical Biomechanic (UBIC), University of Valencia, 46010 Valencia, Spain
| | - Maria A. Tortosa-Chuliá
- Department of Applied Economics, University of Valencia, 46022 Valencia, Spain;
- Psychological Development, Health and Society (PSDEHESO), University of Valencia, 46022 Valencia, Spain
| | - Mercè Balasch-Bernat
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (M.A.C.iI.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
| | - Silvia Forcano
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - Trinidad Sentandreu-Mañó
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (M.A.C.iI.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Advanced Research Methods Applied to Quality of Life promotion (ARMAQoL), University of Valencia, 46010 Valencia, Spain;
| | - Jose M. Tomas
- Advanced Research Methods Applied to Quality of Life promotion (ARMAQoL), University of Valencia, 46010 Valencia, Spain;
- Department of Methodology for the Behavioural Sciences, University of Valencia, 46010 Valencia, Spain
| | - Natalia Cezón-Serrano
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (M.A.C.iI.); (M.B.-B.); (T.S.-M.); (N.C.-S.)
- Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, 46010 Valencia, Spain
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Yap SF, Boo NY, Pramod DS, Thaw Z, Liew SF, Woo LF, Choo PY, Hatta NM. Risk Factors Associated with Sarcopenia Among Independently Mobile, Institutionalised Older People in the Klang Valley of Malaysia: A Cross-Sectional Study. Malays J Med Sci 2020; 27:120-128. [PMID: 32788848 PMCID: PMC7409580 DOI: 10.21315/mjms2020.27.2.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background Studies on sarcopenia among Malaysian older people (OP ≥ 60 years of age) living in the community but not in long-term care (LTC) homes have been reported previously. This study aimed to determine the prevalence of sarcopenia and its risk factors in OP in Malaysian LTC homes. Methods This cross-sectional study was conducted with 202 independently mobile OP (males 32%) in seven LTC homes in the Klang Valley of Malaysia. Trained personnel measured their anthropometrics, body composition, gait speed, hand grip strength and timed up-and-go (TUG) duration. Criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Asian Working Group for Sarcopenia were used to identify the presence of sarcopenia. The mini-nutritional assessment (MNA) was used to determine their nutritional status. Additionally, logistic regression analysis was performed to identify significant risk factors associated with pre-sarcopenia/sarcopenia. Results Pre-sarcopenia/sarcopenia was detected in 103 (51%) OP. The significant risk factors were body mass index (BMI, weight/height2; adjusted odds ratio [AOR] = 0.44, P < 0.001), percentage of body fat (PBF; AOR = 1.26, P < 0.001), age group (≥ 80 years; AOR = 3.63, P = 0.025) and ‘at risk of malnutrition’ status (AOR = 2.63, P = 0.049). Conclusion Sarcopenia is common among OP in LCT homes. The risk increases with decreasing BMI, increasing PBF, age ≥ 80 years and suboptimal nutrition status.
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Affiliation(s)
- Sook Fan Yap
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Nem Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Divakara Shenoy Pramod
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Zin Thaw
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Siew Fun Liew
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Li Fong Woo
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Peak Yean Choo
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Nadia Mohamad Hatta
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
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Factors associated with sarcopenia: A cross-sectional analysis using UK Biobank. Maturitas 2020; 133:60-67. [PMID: 32005425 DOI: 10.1016/j.maturitas.2020.01.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/03/2019] [Accepted: 01/06/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The critical sociodemographic, lifestyle and diseases factors influencing sarcopenia, defined by the current European Working Group on Sarcopenia 2 (EWGSOP2) classification and cut-off points, have not yet been fully elucidated. This study aimed, therefore, to determine sociodemographic, anthropometric, lifestyle and health-related factors associated with sarcopenia using the new EWGSOP2 definition. STUDY DESIGN 396,283 participants (52.8 % women, age 38-73 years) were included in this cross-sectional study. The potential factors associated with sarcopenia were allocated to four categories: sociodemographic (sex, age, education, income and professional qualification), anthropometric (nutritional status, abdominal obesity, body fat and birth weight), lifestyle (physical activity, smoking, sleeping, sitting time, TV viewing, alcohol, and dietary intakes) and health status (self-reported prevalent diseases). P-values were corrected for multiple testing using the Bonferroni method. RESULTS Age, women, lower education, higher deprivation, underweight, lower birth weight, and chronic diseases such as rheumatoid arthritis, chronic bronchitis and osteoporosis were associated with a higher likelihood of sarcopenia. Conversely, overweight, obesity, as well as a self-reported higher intake of energy, protein, vitamins (B12 and B9) and minerals (potassium, calcium and magnesium) were associated with lower odds of sarcopenia. CONCLUSION Women, people aged over 65 years, underweight people and those with rheumatoid arthritis were most likely to have sarcopenia. Considering the increase in the ageing population, sarcopenia is likely to become more prevalent. Identifying factors associated with sarcopenia could inform future strategies for early identification of individuals at high risk of sarcopenia and therefore the implementation of preventive strategies against the disease.
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Perez‐Sousa MA, Venegas‐Sanabria LC, Chavarro‐Carvajal DA, Cano‐Gutierrez CA, Izquierdo M, Correa‐Bautista JE, Ramírez‐Vélez R. Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living. J Cachexia Sarcopenia Muscle 2019; 10:1009-1015. [PMID: 31066999 PMCID: PMC6818451 DOI: 10.1002/jcsm.12444] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/05/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. METHODS A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to 'SABE Survey 2015'. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). RESULTS Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and non-sarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (β = -0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect (-0.009 to -0.004). CONCLUSIONS The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia.
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Affiliation(s)
| | | | | | | | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Navarrabiomed, CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIPamplonaSpain
| | - Jorge Enrique Correa‐Bautista
- Department of Health Sciences, Public University of Navarra, Navarrabiomed, CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIPamplonaSpain
| | - Robinson Ramírez‐Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed, CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIPamplonaSpain
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Barbalho ER, Gonzalez MC, Bielemann RM, da Rocha IMG, de Sousa IM, Bezerra RA, de Medeiros GOC, Fayh APT. Is skeletal muscle radiodensity able to indicate physical function impairment in older adults with gastrointestinal cancer? Exp Gerontol 2019; 125:110688. [DOI: 10.1016/j.exger.2019.110688] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/04/2019] [Accepted: 08/08/2019] [Indexed: 12/26/2022]
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Nasimi N, Dabbaghmanesh MH, Sohrabi Z. Nutritional status and body fat mass: Determinants of sarcopenia in community-dwelling older adults. Exp Gerontol 2019; 122:67-73. [PMID: 31022445 DOI: 10.1016/j.exger.2019.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/07/2019] [Accepted: 04/17/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sarcopenia is defined as the old age syndrome characterized by profound decline in muscle mass and function. This study aimed to investigate the prevalence of sarcopenia and its risk factors in older adults. METHODS Totally, 501 older people aged 65 years and older were recruited. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia (AWGS). For obtaining Skeletal Muscle mass Index (SMI), body composition was evaluated using Bioelectrical Impedance Analysis (BIA). Muscle strength and physical performance were measured by Handgrip Strength (HGS) and Gait Speed (GS), respectively. Nutritional status, physical activity level, and biochemical indicators were assessed, as well. RESULTS The prevalence of sarcopenia was 20.8%. Multiple logistic regression models of the predictors of decline in the components of sarcopenia showed that older age, low Body Mass Index (BMI), and serum albumin level were associated with a higher risk of low SMI. Low serum albumin level and older age were also predictive of low HGS. Besides, old age, high body fat mass, and low BMI were the risk factors of low GS. Conversely, increased Calf Circumference (CC) was protective against low SMI and GS. Finally, older age, male gender, low BMI, decreased mini-nutritional assessment score, low serum albumin level, and high body fat were associated with a higher risk of sarcopenia, whereas higher CC reduced its risk. CONCLUSION The prevalence of sarcopenia is high among elderly individuals. This study underlined that sarcopenia might develop in older adults with impaired nutritional status and high body fat mass. Further studies could evaluate the effects of appropriate nutritional interventions on sarcopenia management and prevention.
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Affiliation(s)
- Nasrin Nasimi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Shiraz Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Sohrabi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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