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Zou Y, Tang X, Yang S, Chen Z, Liu B, Zhou Z, Peng X, Tang C. New insights into the function of the NLRP3 inflammasome in sarcopenia: mechanism and therapeutic strategies. Metabolism 2024; 158:155972. [PMID: 38972476 DOI: 10.1016/j.metabol.2024.155972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
Sarcopenia is one of the most common skeletal muscle disorders and is characterized by infirmity and disability. While extensive research has focused on elucidating the mechanisms underlying the progression of sarcopenia, further comprehensive insights into its pathogenesis are necessary to identify new preventive and therapeutic approaches. The involvement of inflammasomes in sarcopenia is widely recognized, with particular emphasis on the NLRP3 (NLR family pyrin domain containing 3) inflammasome. In this review, we aim to elucidate the underlying mechanisms of the NLRP3 inflammasome and its relevance in sarcopenia of various etiologies. Furthermore, we highlight interventions targeting the NLRP3 inflammasome in the context of sarcopenia and discuss the current limitations of our knowledge in this area.
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Affiliation(s)
- Yunyi Zou
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Xiangbin Tang
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Siyuan Yang
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Zhanglin Chen
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Bin Liu
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Zuoqiong Zhou
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China
| | - Xiyang Peng
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China.
| | - Changfa Tang
- State Key Laboratory of Developmental Biology of Freshwater Fish, Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha, China.
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Fan M, Wang D, Wu X, Gao W. Exploring the causal relationship between female reproductive traits and frailty: a two-sample mendelian randomization study. Front Physiol 2024; 15:1349952. [PMID: 38606010 PMCID: PMC11008284 DOI: 10.3389/fphys.2024.1349952] [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: 12/19/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Background: The impact of female reproductive factors, including age at menarche (AAM), age at first birth (AFB), age at first sexual intercourse (AFS), age at natural menopause (ANM), and pregnancy abortion (PA), on the risk of developing frailty remains uncertain. Our objective is to examine the potential causal relationship between female reproductive traits and frailty through the utilization of two-sample univariable Mendelian Randomization (UVMR) and multivariable Mendelian Randomization (MVMR) analyses. Methods: Leveraging large-scale Genome-Wide Association Study (GWAS) data from individuals of European ancestry, we performed two-sample UVMR and MVMR analyses to examine the causal relationship between female reproductive traits and frailty. The primary analysis employed inverse-variance-weighted (IVW) estimation, and sensitivity analyses were conducted to assess the robustness of the findings. Results: The UVMR analysis revealed a significant causal relationship between female reproductive traits (AFS, AFB, AAM) and frailty [IVW: OR = 0.74, 95%CI(0.70-0.79), p = 0.000; OR = 0.93, 95%CI(0.92-0.95), p = 0.000; OR = 0.96, 95%CI(0.95-0.98), p = 0.000]. However, there was no significant effect of ANM and PA on frailty (p > 0.05). The sensitivity analysis results were robust, supporting the findings. Furthermore, this association remained significant even after adjusting for body mass index (BMI) and educational attainment (EA) in the MVMR analysis [IVW: OR = 0.94, 95%Cl (0.91-0.97), p = 0.000; OR = 0.77, 95%Cl (0.70-0.86), p = 0.000; OR = 0.95, 95%Cl (0.94-0.97), p = 0.000]. BMI and EA serve as mediators in this process. Conclusion: Our research has established a significant causal relationship between female reproductive traits (AFS, AFB, AAM) and frailty, with BMI and EA acting as mediating factors in this process. However, further research is warranted to validate our findings and elucidate the underlying biological mechanisms.
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Affiliation(s)
- Maoxia Fan
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Dandan Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Xiaoqi Wu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Wulin Gao
- Department of Geriatric Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Osadnik CR, Brighton LJ, Burtin C, Cesari M, Lahousse L, Man WDC, Marengoni A, Sajnic A, Singer JP, Ter Beek L, Tsiligianni I, Varga JT, Pavanello S, Maddocks M. European Respiratory Society statement on frailty in adults with chronic lung disease. Eur Respir J 2023; 62:2300442. [PMID: 37414420 DOI: 10.1183/13993003.00442-2023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/11/2023] [Indexed: 07/08/2023]
Abstract
Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine; however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a prerequisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work. This European Respiratory Society statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies) and identification of evidence gaps to inform future priority areas of research. Frailty is underrepresented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.
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Affiliation(s)
- Christian R Osadnik
- Monash University, Department of Physiotherapy, Frankston, Australia
- Monash Health, Monash Lung, Sleep, Allergy and Immunology, Frankston, Australia
| | - Lisa J Brighton
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Chris Burtin
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ghent, Belgium
| | - Will D C Man
- Heart Lung and Critical Care Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alessandra Marengoni
- Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Andreja Sajnic
- Department for Respiratory Diseases Jordanovac, University Hospital Center, Zagreb, Croatia
| | - Jonathan P Singer
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Lies Ter Beek
- Vrije Universiteit Amsterdam, University Medical Center Groningen, Amsterdam, The Netherlands
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Janos T Varga
- Semmelweis University, Department of Pulmonology, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Department of Pulmonary Rehabilitation, Budapest, Hungary
| | | | - Matthew Maddocks
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
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Jankowska EA, Ponikowski P. Acyl-ghrelin therapy for heart failure: already a novel inotrope or even more? Eur Heart J 2023; 44:2026-2028. [PMID: 37294903 DOI: 10.1093/eurheartj/ehad220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- Ewa A Jankowska
- Institute of Heart Diseases, Wroclaw Medical University and University Hospital in Wroclaw, Borowska 213, 50-556 Wroclaw, Poland
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University and University Hospital in Wroclaw, Borowska 213, 50-556 Wroclaw, Poland
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Cao H, Zhang J, Sun Z, Wu J, Hao C, Wang W. Frailty in kidney transplant candidates and recipients: pathogenesis and intervention strategies. Chin Med J (Engl) 2023; 136:1026-1036. [PMID: 37052144 PMCID: PMC10228484 DOI: 10.1097/cm9.0000000000002312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Indexed: 04/14/2023] Open
Abstract
ABSTRACT With the rapid aging of the global population posing a serious problem, frailty, a non-specific state that reflects physiological senescence rather than aging in time, has become more widely addressed by researchers in various medical fields. A high prevalence of frailty is found among kidney transplant (KT) candidates and recipients. Therefore, their frailty has become a research hotspot in the field of transplantation. However, current studies mainly focus on the cross-sectional survey of the incidence of frailty among KT candidates and recipients and the relationship between frailty and transplantation. Research on the pathogenesis and intervention is scattered, and relevant review literature is scarce. Exploring the pathogenesis of frailty in KT candidates and recipients and determining effective intervention measures may reduce waiting list mortality and improve the long-term quality of life of KT recipients. Therefore, this review explains the pathogenesis and intervention measures for frailty in KT candidates and recipients to provide a reference for the formulation of effective intervention strategies.
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Affiliation(s)
- Huawei Cao
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiandong Zhang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zejia Sun
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiyue Wu
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Changzhen Hao
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wei Wang
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
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Liu H, Li C, Jiao J, Wu X, Zhu M, Wen X, Jin J, Wang H, Lv D, Zhao S, Nicholas S, Maitland E, Zhu D. Development and validation of risk prediction model for identifying 30-day frailty in older inpatients with undernutrition: A multicenter cohort study. Front Nutr 2023; 9:1061299. [PMID: 36712546 PMCID: PMC9874615 DOI: 10.3389/fnut.2022.1061299] [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: 10/04/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
Objective To develop and externally validate a frailty prediction model integrating physical factors, psychological variables and routine laboratory test parameters to predict the 30-day frailty risk in older adults with undernutrition. Methods Based on an ongoing survey of geriatrics syndrome in elder adults across China (SGSE), this prognostic study identified the putative prognostic indicators for predicting the 30-day frailty risk of older adults with undernutrition. Using multivariable logistic regression analysis with backward elimination, the predictive model was subjected to internal (bootstrap) and external validation, and its calibration was evaluated by the calibration slope and its C statistic discriminative ability. The model derivation and model validation cohorts were collected between October 2018 and February 2019 from a prospective, large-scale cohort study of hospitalized older adults in tertiary hospitals in China. The modeling derivation cohort data (n = 2,194) were based on the SGSE data comprising southwest Sichuan Province, northern Beijing municipality, northwest Qinghai Province, northeast Heilongjiang Province, and eastern Zhejiang Province, with SGSE data from Hubei Province used to externally validate the model (validation cohort, n = 648). Results The incidence of frailty in the older undernutrition derivation cohort was 13.54% and 13.43% in the validation cohort. The final model developed to estimate the individual predicted risk of 30-day frailty was presented as a regression formula: predicted risk of 30-day frailty = [1/(1+e-riskscore )], where riskscore = -0.106 + 0.034 × age + 0.796 × sex -0.361 × vision dysfunction + 0.373 × hearing dysfunction + 0.408 × urination dysfunction - 0.012 × ADL + 0.064 × depression - 0.139 × nutritional status - 0.007 × hemoglobin - 0.034 × serum albumin - 0.012 × (male: ADL). Area under the curve (AUC) of 0.71 in the derivation cohort, and discrimination of the model were similar in both cohorts, with a C statistic of nearly 0.7, with excellent calibration of observed and predicted risks. Conclusion A new prediction model that quantifies the absolute risk of frailty of older patients suffering from undernutrition was developed and externally validated. Based on physical, psychological, and biological variables, the model provides an important assessment tool to provide different healthcare needs at different times for undernutrition frailty patients. Clinical trial registration Chinese Clinical Trial Registry [ChiCTR1800017682].
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Affiliation(s)
- Hongpeng Liu
- School of Nursing, Peking University, Beijing, China
| | - Cheng Li
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China,Center for Musculoskeletal Surgery (CMSC), Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitá-Universitätsmedizin Berlin, Berlin, Germany
| | - Jing Jiao
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Chinese Nursing Association, Beijing, China,*Correspondence: Xinjuan Wu ✉
| | - Minglei Zhu
- Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianxiu Wen
- Department of Nursing, Sichuan Provincial People's Hospital, Chengdu, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongmei Lv
- Department of Nursing, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shengxiu Zhao
- Department of Nursing, Qinghai Provincial People's Hospital, Xining, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Sydney, NSW, Australia,School of Economics and School of Management, Tianjin Normal University, Tianjin, China,Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China,Newcastle Business School, University of Newcastle, University Drive, Newcastle, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China,Dawei Zhu ✉
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Monteiro-Oliveira BB, Coelho-Oliveira AC, Paineiras-Domingos LL, Sonza A, Sá-Caputo DDCD, Bernardo-Filho M. Use of surface electromyography to evaluate effects of whole-body vibration exercises on neuromuscular activation and muscle strength in the elderly: a systematic review. Disabil Rehabil 2022; 44:7368-7377. [PMID: 34699285 DOI: 10.1080/09638288.2021.1994030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Reduction of muscle strength and lean mass, increase in the risk of falls, higher mortality, and morbidity are observed in geriatric syndromes. Physical activity is an effective intervention in reducing signs and symptoms of geriatric syndromes. Whole-body vibration exercise (WBVE) is an intervention with low cost and has been effective. MATERIALS AND METHODS The aim of this systematic review aimed to determine the effects of WBVE on neuromuscular activation and muscle strength in the elderly. Searches in PubMed, Embase, Science direct, and Scopus databases were conducted. Six studies, that analyzed the use of surface electromyography evaluating effects of WBVE on neuromuscular activation and muscle strength in the elderly, published in English, were included. RESULTS Six studies were included. One hundred forty-six individuals participated in the studies and 24 were males (16.43%), with an average age of 74.20 ± 7.66 years. Five publications were defined as "fair" methodological in the PEDro scale, the risk of bias was high and the risk of bias for non-randomized studies was moderate/high. In general, increased strength muscle was reported in the studies. CONCLUSION This systematic review suggests that WBVE might promote desirable neuromuscular responses in healthy elderly. However, it is necessary to perform further studies to reinforce the reported findings.IMPLICATIONS FOR REHABILITATIONThe reduction in lean mass and consequent reduction in muscle strength are present in healthy elderly people and the whole-body vibration exercise can reduce or alleviate these symptoms caused by the geriatric syndrome.Whole-body vibration exercise is a training modality that increases neuromuscular activation and muscle strength.Surface electromyography is a useful tool for the evaluation of the neuromuscular activation of the muscle fibers.
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Affiliation(s)
- Bruno Bessa Monteiro-Oliveira
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Ana Carolina Coelho-Oliveira
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Anelise Sonza
- Universidade do Estado de Santa Catarina, Florianopolis, Brazil
| | - Danúbia da Cunha de Sá-Caputo
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil.,Programa de Pós-graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Sex Difference in Cutoff and Prevalence of Sarcopenia among 300,090 Urban Korean Population: Association with Metabolic Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101361. [PMID: 36295523 PMCID: PMC9611231 DOI: 10.3390/medicina58101361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 12/18/2022]
Abstract
Background and Objectives: The study aimed to establish the threshold values and prevalence of sarcopenia and to investigate the association of sarcopenia with metabolic syndrome in an urban Korean population. Materials and Methods: The study included 300,090 adults who underwent anthropometric analyses by bioelectrical impedance analyzer. Sarcopenia was defined as: (1) class I, skeletal muscle mass index (SMI) within −1 to −2 standard deviations (SDs); (2) or class II, <−2 SD of SMI in a young population. Results: Low SMI threshold levels for class I and class II sarcopenia were 39.8 and 36.7% in men, and 35.5 and 32.3% in women. Among all age groups, the prevalence rates of sarcopenia were highest in the age group 80−89 years. Following adjustment for possible confounders including age, sex, height, metabolic and health behavioral factors, adjusted odds ratios (95% confidence intervals) for the risk of metabolic syndrome were 2.43 (2.33−2.54) for class I and 2.69 (2.49−2.91) for class II sarcopenia, compared with the normal reference. Sarcopenia was more strongly associated with metabolic syndrome in women than men (p for interaction < 0.01). The threshold values and prevalence of sarcopenia were demonstrated in a large Korean urban population. Conclusions: This study identified that sarcopenia was associated with increased risk of metabolic syndrome, showing itself to be significantly higher in women than men.
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Zhao Y, Ding Q, Lin T, Shu X, Xie D, Gao L, Yue J. Combined Vision and Hearing Impairment is Associated with Frailty in Older Adults: Results from the West China Health and Aging Trend Study. Clin Interv Aging 2022; 17:675-683. [PMID: 35528802 PMCID: PMC9075894 DOI: 10.2147/cia.s362191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
Objective Hearing and vision loss have been independently associated with frailty in older adults, but the relationship between concurrent hearing and visual impairment (dual sensory impairment) and frailty is not well understood. Therefore, we aimed to examine whether dual sensory impairment is associated with frailty in older adults. Methods This cross-sectional study was based on the data from the West China Health and Aging Trend (WCHAT) study of community-dwelling individuals aged 60 years and older. Frailty status was evaluated by the FRAIL scale and categorized as robust, prefrail and frail. Hearing and vision functions were based on self-report. We used multinomial regression models to explore the association between dual sensory impairment and frailty. Results Of 3985 participants, 1655 (41.5%) were male and the median age was 66 years (interquartile range: 61–68). Overall, 7.6% of participants reported hearing impairment only, 32.7% reported vision impairment only, and 28.6% reported dual sensory impairment. The prevalence of prefrailty and frailty was 60.7% and 6.1%, respectively. After adjustment for confounding variables, results from the multinomial regression analysis showed that dual sensory impairment was significantly associated with greater odds of becoming frail (OR = 2.17, 95% CI = 1.40–3.38) compared with no impairment. When stratified by gender, dual sensory impairment was significantly associated with frailty in women (OR = 2.42, 95% CI = 1.40–4.20) but not in men (OR = 1.30, 95% CI = 0.58–2.91). Conclusion Older adults with dual sensory impairment are more likely to be frail than those with no impairment, suggesting that interventions to improve sensory function may potentially help reduce the risk of frailty in older adults.
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Affiliation(s)
- Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Qunfang Ding
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
- Correspondence: Qunfang Ding, Department of Geriatrics and National Clinical Research Center for Geriatrics West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China, Tel +86 18980601353, Email
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Dongmei Xie
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Langli Gao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of China
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10
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Liu QQ, Xie WQ, Luo YX, Li YD, Huang WH, Wu YX, Li YS. High Intensity Interval Training: A Potential Method for Treating Sarcopenia. Clin Interv Aging 2022; 17:857-872. [PMID: 35656091 PMCID: PMC9152764 DOI: 10.2147/cia.s366245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenia, an age-related disease characterized by loss of muscle strength and muscle mass, has attracted the attention of medical experts due to its severe morbidity, low living quality, high expenditure of health care, and mortality. Traditionally, persistent aerobic exercise (PAE) is considered as a valid way to attenuate muscular atrophy. However, nowadays, high intensity interval training (HIIT) has emerged as a more effective and time-efficient method to replace traditional exercise modes. HIIT displays comprehensive effects on exercise capacity and skeletal muscle metabolism, and it provides a time-out for the recovery of cardiopulmonary and muscular functions without causing severe adverse effects. Studies demonstrated that compared with PAE, HIIT showed similar or even higher effects in improving muscle strength, enhancing physical performances and increasing muscle mass of elder people. Therefore, HIIT might become a promising way to cope with the age-related loss of muscle mass and muscle function. However, it is worth mentioning that no study of HIIT was conducted directly on sarcopenia patients, which is attributed to the suspicious of safety and validity. In this review, we will assess the effects of different training parameters on muscle and sarcopenia, summarize previous papers which compared the effects of HIIT and PAE in improving muscle quality and function, and evaluate the potential of HIIT to replace the status of PAE in treating old people with muscle atrophy and low modality; and point out drawbacks of temporary experiments. Our aim is to discuss the feasibility of HIIT to treat sarcopenia and provide a reference for clinical scientists who want to utilize HIIT as a new way to cope with sarcopenia.
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Affiliation(s)
- Qian-Qi Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wen-Qing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xuan Luo
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Yi-Dan Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wei-Hong Huang
- Mobile Health Ministry of Education - China Mobile Joint Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xiang Wu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, Hubei, 430056, People’s Republic of China
- Yu-Xiang Wu, Department of Health and Kinesiology, School of Physical Education, Jianghan University, No. 8, Sanjiaohu Road, Wuhan, Hubei, 430056, People’s Republic of China, Tel +86 27 8422 6921, Email
| | - Yu-Sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Correspondence: Yu-Sheng Li, Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Tel +86-13975889696, Email
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11
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Abdelhafiz AH, Sinclair AJ. Metabolic phenotypes explain the relationship between dysglycaemia and frailty in older people with type 2 diabetes. J Diabetes Complications 2022; 36:108144. [PMID: 35151546 DOI: 10.1016/j.jdiacomp.2022.108144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/17/2022] [Accepted: 01/29/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dysglycaemia (hyperglycaemia and hypoglycaemia) increase the risk of frailty in older people with diabetes, which appears contradictory. However, the characteristics of patients included in these studies are different and may reflect different metabolic phenotypes of frailty that may explain this apparent contradiction. AIMS To review the characteristics of frail patients included in clinical studies that reported an association between dysglycaemia and frailty in order to explore whether there is any metabolic differences in the profile of these patients. METHODS A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Key words around older people, type 2 diabetes mellitus, frailty, hyperglycaemia and low glycaemia were used in the literature search. RESULTS Only 8 studies met the inclusion criteria. Four studies investigated the risk of frailty associated with low glycaemia. Two studies showed that hypoglycaemia increased the risk of frailty by 44% (HR 1.60, 95% CI 1.14 to 2.42) and predicted greater level of dependency (p < 0.001), respectively. The other two studies reported that HbA1c inversely correlated with clinical frailty scale (r = -0.31, p < 0.01) and HbA1c < 6.0% was associated with increased risk of disability (3.45, 1.02 to 11.6), respectively. Compared with non-frail patients, those with frailty tended to have lower body weight or body mass index (BMI), have features of malnutrition such as low serum albumin or low total cholesterol and suffer from more comorbidities including dementia. Four studies explored the association of high glycaemia with frailty. Higher HbA1c predicted frailty (OR 1.43, 95% CI 1.045 to 1.97) and positively correlated with Edmonton frail score (r = 0.44, p < 0.001), respectively in two studies. The other two studies found that subjects with HbA1c ≥ 6.5% had the greatest prevalence of frailty (70.3%) and subjects with higher HbA1c at baseline to have a higher frailty level throughout later life, respectively. Compared with non-frail patients, those with frailty tended to have higher body weight, waist circumference and BMI. They also have less physical activity, higher cholesterol level and have more comorbidities. CONCLUSIONS Dysglycaemia increases the risk of frailty but the characteristics of patients in these studies suggest different metabolic phenotypes of frailty. Therefore, these metabolic differences in frailty should be taken into consideration in the management of older people with diabetes.
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Affiliation(s)
- A H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK
| | - A J Sinclair
- King's College, London, UK; Foundation for Diabetes Research in Older People (fDROP), Droitwich Spa WR9 0QH, UK.
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12
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Sun L, Chen T, Wang Z, Fan J, Cai S, Fan C, Zhong Y, Li Y. The gender-specific adverse association of polycyclic aromatic hydrocarbons on skeletal muscle mass and strength in the general adults and the possible mechanisms in experimental rats. CHEMOSPHERE 2022; 287:132066. [PMID: 34481170 DOI: 10.1016/j.chemosphere.2021.132066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/09/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
Whether polycyclic aromatic hydrocarbons (PAHs) exposure is associated with muscle mass and muscle strength has been scantly investigated. The cross-sectional associations of urinary PAH metabolites with appendicular skeletal muscle mass and hand grip strength in adults were first investigated in the National Health and Nutrition Examination Survey (NHANES). Laboratory study was further carried out to examine the effect of PAHs on skeletal muscle mass and strength. 2742 and 2462 US adults were finally analyzed for muscle mass and muscle strength, respectively. In male participants, urinary PAH metabolites were found to show an inverse relationship with muscle mass and grip strength. In female participants, no significant relationship was found between urinary PAH metabolites with muscle mass or grip strength. In male Sprague-Dawley (SD) rats, administration of B [a]P induced muscle atrophy when compared with the control. However, muscle mass and strength were not significantly altered in female rats. The variations in muscle morphology parameters were accompanied by significant decrease in plasma testosterone levels in the B [a]P-treated male rats. Testosterone co-treatment significantly mitigated B [a]P mediated damages in skeletal muscle in male rats. The results of the present study indicate that there may be a gender-specific causal relationship between the PAHs and muscle atrophy.
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Affiliation(s)
- Lingling Sun
- Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tao Chen
- Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhan Wang
- Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiayao Fan
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Shaofang Cai
- Department of Science and Education, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Chunhong Fan
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Yaohong Zhong
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Yingjun Li
- School of Public Health, Hangzhou Medical College, Hangzhou, China.
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13
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Carini G, Musazzi L, Bolzetta F, Cester A, Fiorentini C, Ieraci A, Maggi S, Popoli M, Veronese N, Barbon A. The Potential Role of miRNAs in Cognitive Frailty. Front Aging Neurosci 2021; 13:763110. [PMID: 34867290 PMCID: PMC8632944 DOI: 10.3389/fnagi.2021.763110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/19/2021] [Indexed: 12/30/2022] Open
Abstract
Frailty is an aging related condition, which has been defined as a state of enhanced vulnerability to stressors, leading to a limited capacity to meet homeostatic demands. Cognitive impairment is also frequent in older people, often accompanying frailty. Age is the main independent risk factor for both frailty and cognitive impairment, and compelling evidence suggests that similar age-associated mechanisms could underlie both clinical conditions. Accordingly, it has been suggested that frailty and cognitive impairment share common pathways, and some authors proposed "cognitive frailty" as a single complex phenotype. Nevertheless, so far, no clear common underlying pathways have been discovered for both conditions. microRNAs (miRNAs) have emerged as key fine-tuning regulators in most physiological processes, as well as pathological conditions. Importantly, miRNAs have been proposed as both peripheral biomarkers and potential molecular factors involved in physiological and pathological aging. In this review, we discuss the evidence linking changes of selected miRNAs expression with frailty and cognitive impairment. Overall, miR-92a-5p and miR-532-5p, as well as other miRNAs implicated in pathological aging, should be investigated as potential biomarkers (and putative molecular effectors) of cognitive frailty.
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Affiliation(s)
- Giulia Carini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Musazzi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesco Bolzetta
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima," Venice, Italy
| | - Alberto Cester
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima," Venice, Italy
| | - Chiara Fiorentini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Alessandro Ieraci
- Department of Pharmaceutical Sciences, University of Milan, Milan, Italy
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy
| | - Maurizio Popoli
- Department of Pharmaceutical Sciences, University of Milan, Milan, Italy
| | - Nicola Veronese
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima," Venice, Italy.,Geriatrics Section, Department of Medicine, University of Palermo, Palermo, Italy
| | - Alessandro Barbon
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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14
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Chen JH, Shih HS, Tu J, Chiou JM, Chang SH, Hsu WL, Lai LC, Chen TF, Chen YC. A Longitudinal Study on the Association of Interrelated Factors Among Frailty Dimensions, Cognitive Domains, Cognitive Frailty, and All-Cause Mortality. J Alzheimers Dis 2021; 84:1795-1809. [PMID: 34719497 DOI: 10.3233/jad-215111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cognitive frailty integrating impaired cognitive domains and frailty dimensions has not been explored. OBJECTIVE This study aimed to explore 1) associations among frailty dimensions and cognitive domains over time and 2) the extended definitions of cognitive frailty for predicting all-cause mortality. METHODS This four-year cohort study recruited 521 older adults at baseline (2011-2013). We utilized 1) generalized linear mixed models exploring associations of frailty dimensions (physical dimension: modified from Fried et al.; psychosocial dimension: integrating self-rated health, mood, and social relationship and support; global frailty: combining physical and psychosocial frailty) with cognition (global and domain-specific) over time and 2) time-dependent Cox proportional hazard models assessing associations between extended definitions of cognitive frailty (cognitive domains-frailty dimensions) and all-cause mortality. RESULTS At baseline, the prevalence was 3.0%for physical frailty and 37.6%for psychosocial frailty. Greater physical frailty was associated with poor global cognition (adjusted odds ratio = 1.43-3.29, β: -1.07), logical memory (β: -0.14 to -0.10), and executive function (β: -0.51 to -0.12). Greater psychosocial frailty was associated with poor global cognition (β: -0.44) and attention (β: -0.15 to -0.13). Three newly proposed definitions of cognitive frailty, "mild cognitive impairment (MCI)-psychosocial frailty," "MCI-global frailty," and "impaired verbal fluency-global frailty," outperformed traditional cognitive frailty for predicting all-cause mortality (adjusted hazard ratio = 3.49, 6.83, 3.29 versus 4.87; AIC = 224.3, 221.8, 226.1 versus 228.1). CONCLUSION Notably, extended definitions of cognitive frailty proposed by this study better predict all-cause mortality in older adults than the traditional definition of cognitive frailty, highlighting the importance of psychosocial frailty to reduce mortality in older adults.
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Affiliation(s)
- Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hua-San Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jennifer Tu
- Duke University School of Medicine, Durham, NC, USA
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan
| | - Shu-Hui Chang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Chuan Lai
- Graduate Institute of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
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15
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Mandelli A, Tacconi E, Levinger I, Duque G, Hayes A. The role of estrogens in osteosarcopenia: from biology to potential dual therapeutic effects. Climacteric 2021; 25:81-87. [PMID: 34423690 DOI: 10.1080/13697137.2021.1965118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Osteoporosis and sarcopenia are two conditions associated with aging and characterized by a simultaneous decline in bone and muscle mass, respectively. These conditions share common risk factors (genetic, endocrine, nutritional and lifestyle factors) and biological pathways that often co-exist in a syndrome known as osteosarcopenia. Among the endocrine causes, estrogens play a critical role, especially in women. Estrogens have been demonstrated to exert a positive effect on bone and muscle development and maintenance. For this reason, menopause is characterized by a loss in bone mineral density and skeletal muscle quality and quantity. To date, studies indicate a positive effect of hormonal therapy on the prevention and management of osteoporosis, to the point that estrogen is prescribed as a first-line treatment for osteoporosis by the major international authorities. While results on sarcopenia are still disputable, such that estrogens are not recommended to prevent muscle loss in postmenopausal women, increased response to anabolic stimuli with estrogen therapy suggests similar beneficial effects on muscle as seen with bone, particularly when combined with resistance exercise.
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Affiliation(s)
- A Mandelli
- Institute for Health and Sport, Victoria University, St Albans, VIC, Australia
| | - E Tacconi
- Explorer Training S.r.l. Massa and Cozzile, Tuscany, Italy
| | - I Levinger
- Institute for Health and Sport, Victoria University, St Albans, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia.,Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, Australia
| | - G Duque
- Institute for Health and Sport, Victoria University, St Albans, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia.,Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, Australia
| | - A Hayes
- Institute for Health and Sport, Victoria University, St Albans, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia.,Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, Australia
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16
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Pratt J, De Vito G, Narici M, Boreham C. Neuromuscular Junction Aging: A Role for Biomarkers and Exercise. J Gerontol A Biol Sci Med Sci 2021; 76:576-585. [PMID: 32832976 DOI: 10.1093/gerona/glaa207] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
Age-related skeletal muscle degradation known as "sarcopenia" exerts considerable strain on public health systems globally. While the pathogenesis of such atrophy is undoubtedly multifactorial, disruption at the neuromuscular junction (NMJ) has recently gained traction as a key explanatory factor. The NMJ, an essential communicatory link between nerve and muscle, undergoes profound changes with advancing age. Ascertaining whether such changes potentiate the onset of sarcopenia would be paramount in facilitating a timely implementation of targeted therapeutic strategies. Hence, there is a growing level of importance to further substantiate the effects of age on NMJs, in parallel with developing measures to attenuate such changes. As such, this review aimed to establish the current standpoint on age-related NMJ deterioration and consequences for skeletal muscle, while illuminating a role for biomarkers and exercise in ameliorating these alterations. Recent insights into the importance of key biomarkers for NMJ stability are provided, while the stimulative benefits of exercise in preserving NMJ function are demonstrated. Further elucidation of the diagnostic and prognostic relevance of biomarkers, coupled with the therapeutic benefits of regular exercise may be crucial in combating age-related NMJ and skeletal muscle degradation.
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Affiliation(s)
- Jedd Pratt
- Institute for Sport and Health, University College Dublin, Ireland.,Genuity Science, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, CIR-Myo Myology Centre, Neuromuscular Physiology Laboratory, University of Padua, Italy
| | - Marco Narici
- Department of Biomedical Sciences, CIR-Myo Myology Centre, Neuromuscular Physiology Laboratory, University of Padua, Italy
| | - Colin Boreham
- Institute for Sport and Health, University College Dublin, Ireland
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17
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Coelho-Júnior HJ, Uchida MC, Picca A, Bernabei R, Landi F, Calvani R, Cesari M, Marzetti E. Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers. Aging Clin Exp Res 2021; 33:2069-2086. [PMID: 33587271 DOI: 10.1007/s40520-021-01802-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil.
- Rehabilitation Unit, Lar Mãe Mariana Nursing Home, Poá, Brazil.
| | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil
| | - Anna Picca
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | | | - Riccardo Calvani
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20122, Milan, Italy
- Geriatric Unit, IRCCS Istutiti Clinici Scientifici Maugeri, 20138, Milan, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy.
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18
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Coelho-Júnior HJ, Uchida MC. Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. Front Med (Lausanne) 2021; 8:702436. [PMID: 34381802 PMCID: PMC8350041 DOI: 10.3389/fmed.2021.702436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people. Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity. Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate. Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT. Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
| | - Marco Carlos Uchida
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
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19
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Sarcopenia and fall-related injury among older adults in five low- and middle-income countries. Exp Gerontol 2021; 147:111262. [PMID: 33516908 DOI: 10.1016/j.exger.2021.111262] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained through self-reported information. Multivariable logistic regression analysis and meta-analysis were conducted. The sample consisted of 13,101 individuals aged ≥65 years (mean (SD) age 72.6 (11.3) years; 45% males). The prevalence of fall-related injury was higher among those with sarcopenia than in those without this condition (e.g., Mexico 9.8% vs. 2.7%). Adjusted analyses showed that sarcopenia was associated with a 1.85 (95%CI = 1.24-2.77) times higher odds for fall-related injury, with a low level of between-country heterogeneity. Future studies of longitudinal design may shed light on whether sarcopenia in LMICs may be considered as a risk factor for falls.
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20
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Geraci A, Calvani R, Ferri E, Marzetti E, Arosio B, Cesari M. Sarcopenia and Menopause: The Role of Estradiol. Front Endocrinol (Lausanne) 2021; 12:682012. [PMID: 34093446 PMCID: PMC8170301 DOI: 10.3389/fendo.2021.682012] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/05/2021] [Indexed: 12/22/2022] Open
Abstract
During aging and menopausal transition in women, a progressive muscle degeneration (i.e. decrease in quality and muscle function) occurs. This muscle dysfunction, caused by decreased proliferation of muscle satellite cells, increased levels of inflammatory markers, and altered levels of sex hormones, exposes women to a raised incidence of sarcopenia. In this regard, hormonal balance and, in particular, estradiol, seems to be essential in skeletal muscle function. The role of the estradiol on satellite cells and the release of inflammatory cytokines in menopausal women are reviewed. In particular, estradiol has a beneficial effect on the skeletal muscle by stimulating satellite cell proliferation. Skeletal muscle can respond to estrogenic hormonal control due to the presence of specific receptors for estradiol at the level of muscle fibers. Additionally, estradiol can limit inflammatory stress damage on skeletal muscle. In this review, we primarily focused on the role of estradiol in sarcopenia and on the possibility of using Estradiol Replacement Therapy, which combined with nutritional and physical activity programs, can counteract this condition representing a valid tool to treat sarcopenia in women.
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Affiliation(s)
- Annalisa Geraci
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Annalisa Geraci,
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Evelyn Ferri
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
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21
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Moraes MBD, Avgerinou C, Fukushima FB, Vidal EIO. Nutritional interventions for the management of frailty in older adults: systematic review and meta-analysis of randomized clinical trials. Nutr Rev 2020; 79:889-913. [PMID: 33330911 DOI: 10.1093/nutrit/nuaa101] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CONTEXT Although nutrition is considered an important intervention for the management of frailty, the actual effectiveness of interventions addressing nutrition in frail older people remains unclear. OBJECTIVE The aim for this systematic review was to appraise the evidence regarding the effectiveness of nutritional interventions for the management of frailty in older adults. DATA EXTRACTION We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Web of Science, and Latin American and Caribbean Health Sciences Literature databases were searched from January 2001 to November 2019. Two independent reviewers extracted relevant data. From 2370 initial records, 19 publications presenting data from 17 studies (1564 individuals; follow-up: 7-96 weeks) were included. DATA ANALYSIS None of the Bayesian random-effects meta-analyses comparing nutritional supplements with placebo regarding mortality, body mass index, weight, frailty status, muscle strength, gait speed, body composition, and cognitive function showed statistically significant differences. The same applies to a single meta-analysis comparing nutritional education with general health advice regarding muscle strength. CONCLUSION Our results suggest, mostly with low to very low degrees of certainty, that nutritional supplements or nutritional education delivered in isolation may not be effective for the management of frailty in older people. REVIEW REGISTRATION NUMBER CRD42018111510 (PROSPERO).
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Affiliation(s)
- Mariana B de Moraes
- Public Health Department, São Paulo State University, Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Fernanda B Fukushima
- Anesthesiology Department, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Edison I O Vidal
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil
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Rozenberg D, Orsso CE, Chohan K, Orchanian‐Cheff A, Nourouzpour S, Nicholson JM, Elangeswaran B, Vagaon A, Fidler L, Singer LG, Mathur S. Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review. Transpl Int 2020; 33:1610-1625. [DOI: 10.1111/tri.13749] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/24/2020] [Accepted: 09/13/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Dmitry Rozenberg
- Department of Medicine University of Toronto Toronto ON Canada
- Lung Transplant Program Respirology Toronto General Hospital Research InstituteUniversity Health Network Toronto ON Canada
| | - Camila E. Orsso
- Department of Agricultural, Food and Nutritional Science University of Alberta Edmonton AB Canada
| | - Karan Chohan
- Department of Medicine University of Toronto Toronto ON Canada
| | - Ani Orchanian‐Cheff
- Library and Information Services University Health Network Toronto ON Canada
| | - Sahar Nourouzpour
- Lung Transplant Program Respirology Toronto General Hospital Research InstituteUniversity Health Network Toronto ON Canada
| | | | - Brenawen Elangeswaran
- Lung Transplant Program Respirology Toronto General Hospital Research InstituteUniversity Health Network Toronto ON Canada
| | - Andrei Vagaon
- Department of Medicine University of Toronto Toronto ON Canada
| | - Lee Fidler
- Department of Medicine University of Toronto Toronto ON Canada
- Respirology Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Lianne G. Singer
- Department of Medicine University of Toronto Toronto ON Canada
- Lung Transplant Program Respirology Toronto General Hospital Research InstituteUniversity Health Network Toronto ON Canada
| | - Sunita Mathur
- Department of Physical Therapy University of Toronto Toronto ON Canada
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Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12082286. [PMID: 32751730 PMCID: PMC7469050 DOI: 10.3390/nu12082286] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
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Abstract
Frailty is a clinical state of vulnerability to stressors resulting from cumulative alterations in multiple physiological and molecular systems. Frailty assessment in patients with chronic disease is useful for identifying those who are at increased risk for poor clinical and patient reported outcomes. Due to biobehavioral changes purported to cause both frailty and certain chronic lung diseases, patients with lung disease appear susceptible to frailty and prone to developing it decades earlier than community dwelling healthy populations. Herein, we review the literature and potential pathobiological mechanisms underpinning associations between frailty in lung disease and age, sex, comorbidity and symptom burden, severity of lung disease, inflammatory biomarkers, various clinical parameters, body composition measures, and physical activity levels. We also propose a multipronged program of future research focused on improving the accuracy and precision of frailty measurement in lung disease, identifying blood-based biomarkers and measures of body composition for frailty, determining whether subphenotypes of frailty with distinct pathobiology exist, and developing personalized interventions that target the specific underlying mechanisms causing frailty.
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25
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Cho YJ, Lim YH, Yun JM, Yoon HJ, Park M. Sex- and age-specific effects of energy intake and physical activity on sarcopenia. Sci Rep 2020; 10:9822. [PMID: 32555196 PMCID: PMC7300112 DOI: 10.1038/s41598-020-66249-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/19/2020] [Indexed: 01/06/2023] Open
Abstract
Sarcopenia is a common health issue that is not limited to only elderly patients. However, many studies have reported factors to prevent sarcopenia only in susceptible groups. This study evaluates the relationship of the total energy intake to basal metabolic rate ratio (EI/BMR) and physical activity (PA) with sarcopenia. A second aim was to analyze the interaction between EI/BMR and PA by sex and age. We analyzed 16,313 subjects aged ≥ 19 years who had dual‒energy X-ray absorptiometry data. Sarcopenia was defined as appendicular lean mass/weight (%) that was 1 standard deviation below the sex-specific mean value for a young reference group. Multivariate logistic regression analysis was used to examine the interaction between EI/BMR and PA. In this study, as EI/BMR increased, the risk of sarcopenia decreased, particularly in the older groups. Both high PA and high EI/BMR were independently related to the reduced risk of sarcopenia and showed additive effects on reducing the risk in young male and older groups. However, high PA was associated with an increased risk of sarcopenia in the young female group with low energy intake. Our findings suggest that an adequate balance between energy intake and PA is related to a low risk of sarcopenia, especially in young females.
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Affiliation(s)
- Yu Jin Cho
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Hyung-Jin Yoon
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea.,Bio-MAX Institute, Seoul National University, Seoul, Korea
| | - Minseon Park
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea.
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Jeon S, Kim J. Effects of Augmented-Reality-Based Exercise on Muscle Parameters, Physical Performance, and Exercise Self-Efficacy for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093260. [PMID: 32392833 PMCID: PMC7246760 DOI: 10.3390/ijerph17093260] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 12/17/2022]
Abstract
This study was intended to determine the applicability of an augmented-reality-based muscle reduction prevention exercise program for elderly Korean women by observing changes in exercise self-efficacy and verifying the effectiveness of the program in the elderly after the application of the program. A total of 27 participants, who were elderly women aged 65+ and had not participated in any exercise programs until this study, were recruited for this study. They were divided into an experimental group (13 people) and a control group (14 people), and then the augmented-reality-based muscle reduction prevention exercise program was applied. This was a 30-min program, which included regular, aerobic, and flexibility exercises, and it was applied 5 times a week for 12 weeks. As a result of observing changes, it was found that the appendicular skeletal muscle mass (ASM) (F = 11.222, p < 0.002) and the skeletal muscle index (SMI) (kg/m2) (F = 10.874, p < 0.003) muscle parameters increased more in the experimental group compared to the control group, and there was a significant increase in gait speed (m/s) (F = 7.221, p < 0.005). For physical performance, as a result of conducting the Senior Fitness Test (SFT), a significant change was observed in the chair stand test (F = 5.110, p < 0.033), 2-min step test (2MST) (F = 6.621, p < 0.020), and the timed up-and-go test (TUG) (F = 5.110, p < 0.032) and a significant increase was also observed for exercise self-efficacy (F = 20.464, p < 0.001). Finally, the augmented-reality-based exercise program in this study was found to be effective in inducing physical activity in the elderly. Therefore, the augmented-reality-based muscle reduction prevention exercise program is considered to be effective in increasing the sustainability of exercise, thus preventing muscle reduction in the elderly.
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Affiliation(s)
- Sangwan Jeon
- Exercise Rehabilitation Convergence Institute, Gachon University191 Hombakmoero, Yeonsu-gu, Incheon 406-799, Korea;
| | - Jiyoun Kim
- Department of Exercise Rehabilitation & Welfare, Gachon University 191 Hombakmoero, Yeonsu-gu, Incheon 406799, Korea
- Correspondence:
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Ma L, Chan P. Understanding the Physiological Links Between Physical Frailty and Cognitive Decline. Aging Dis 2020; 11:405-418. [PMID: 32257550 PMCID: PMC7069469 DOI: 10.14336/ad.2019.0521] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/21/2019] [Indexed: 12/14/2022] Open
Abstract
Declines in both physical and cognitive function are associated with increasing age. Understanding the physiological link between physical frailty and cognitive decline may allow us to develop interventions that prevent and treat both conditions. Although there is significant epidemiological evidence linking physical frailty to cognitive decline, a complete understanding of the underpinning biological basis of the two disorders remains fragmented. This narrative review discusses insights into the potential roles of chronic inflammation, impaired hypothalamic-pituitary axis stress response, imbalanced energy metabolism, mitochondrial dysfunction, oxidative stress, and neuroendocrine dysfunction linking physical frailty with cognitive decline. We highlight the importance of easier identification of strategic approaches delaying the progression and onset of physical frailty and cognitive decline as well as preventing disability in the older population.
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Affiliation(s)
- Lina Ma
- 1Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,2China National Clinical Research Center for Geriatric Medicine, Beijing, China
| | - Piu Chan
- 1Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,2China National Clinical Research Center for Geriatric Medicine, Beijing, China.,3Department of Neurology and Neurobiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,4Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
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28
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Effect of Whole-Body Vibration Training on the Physical Capability, Activities of Daily Living, and Sleep Quality of Older People with Sarcopenia. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aim: To investigate the effect of whole-body vibration on older people with sarcopenia, and their physical capability, activities of daily living, and sleep quality. Methods: This study is quasi-experimental and adopts single-group pretest–posttest design. The study included participants aged older than 65 years who lived in nursing homes and care centers in Taipei, Taiwan. The whole-body vibration training was performed for 3 months, and during each training session, a participant received ten cycles of 60-sec vibration with 30-sec breaks between the cycles. The physical capability, activities of daily living, and sleep quality of the participants were examined to understand the pretest and posttest results of whole-body vibration training. Concerning the statistical methods adopted, nonparametric method-based tests were employed. Results: In addition to sleep quality (z = 7.367, p > 0.05), significant differences were observed between before and after whole-body vibration training intervention for one-foot balance (z = −2.447, p < 0.05), shoulder and arm flexibility (z = −3.159, p < 0.05), walking speed (z = −2.692, p < 0.05), right-hand grip (z = −3.388, p < 0.05), left-hand grip (z = −3.264, p < 0.05), five sit–stand repetitions (z = −2.936, p < 0.05), skeletal muscle mass index (z = −3.621, p < 0.05), and activities of daily living (z = 1.163, p < 0.05). Conclusions: According to this study, with the 12-week whole-body vibration training in older people with sarcopenia, their physical capability and activities of daily living have improved, though sleeping quality is not statistically significant.
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Abdelhafiz AH, Davies PC, Sinclair AJ. Triad of impairment in older people with diabetes-reciprocal relations and clinical implications. Diabetes Res Clin Pract 2020; 161:108065. [PMID: 32044347 DOI: 10.1016/j.diabres.2020.108065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 12/25/2022]
Abstract
Frailty is emerging as a new category complication of diabetes in older people. Clinically, frailty is still not well defined and mostly viewed as a decline in solely the physical domain. However, frailty is a multidimensional syndrome and the newly introduced concept of "triad of impairment" (physical, cognitive and emotional) may be a more representative of the broad nature of frailty. The components of the triad of impairment (TOI) commonly coexist and demonstrate a reciprocal relation. Diabetes in old age appears to increase the risk of the triad of impairment, which may eventually progress to disability. Therefore, older people with diabetes should be regularly assessed for the presence of these three key components. Adequate nutrition and regular resistance exercise training have been shown to have a positive impact on the long-term outcome in this population. However, the role of good glycaemic control and the use of current hypoglycaemic medications in reducing the incidence of this triad are less clear. Future research is needed to develop novel hypoglycaemic medications that not only focus on glycaemic control and cardiovascular safety but also on reducing the risk of the triad of impairment.
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Affiliation(s)
- A H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK.
| | - P C Davies
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK
| | - A J Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa WR9 0QH, UK; Kings College, London SE1 9NH, UK
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30
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Alves VMC, Soares VN, Oliveira DVD, Fernandes PT. Sociodemographic and psychological variables, physical activity and quality of life in elderly at Unati Campinas, São Paulo. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Although previous studies have characterized the sociodemographic profile and physical activity level of older people at the Universities of the Third Age (Unati - Universidade Aberta da Terceira Idade), there are research gaps regarding the relationship of these variables with the psychological aspects and the quality of life. Objective: To assess the relationship between sociodemographic and psychological variables, physical activity level and quality of life (QoL) in older people at Unati in Campinas, São Paulo, Brazil. Method: This is a cross-sectional study that recruited 116 older participants of both gender, aged between 60 and 89 years. They were submitted to the following tests: the Rosenberg Self-Esteem Scale (RSES), the Wagnild & Young’s Resilience Scale (RS), the General Self-Efficacy Scale (GSE), the WHOQOL BREF, the Mini-Mental State Examination (MMSE), the Self-Reporting Questionnaire (SRQ20) and the International Physical Activity Questionnaire (IPAQ). The data were analyzed using the Kolmogorov-Smirnov, chi-squared, Fisher’s exact, t- and Mann-Whitney U tests, as well as the generalized linear models. Results: Self-esteem was associated with age, income, schooling level, membership time, and the psychological domain of the WHOQOL-BREF (p < 0.05). Resilience was associated with the schooling level and the psychological domain of the WHOQOL-BREF (p < 0.05), and the self-efficacy with the psychological domain of the WHOQOL-BREF. Common mental disorders were related to the physical and psychological domains of the WHOQOL-BREF, as well as the self-efficacy and being male. The physical activity level showed no correlation with the psychological aspects and the sociodemographic variables studied (p > 0.05). Conclusion: The sociodemographic variables influence emotional aspects, particularly older people’s self-esteem and resilience at Unati. Additionally, the psychological domain of the WHOQOL-BREF was a predictor of all the emotional variables in this sample.
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The “Metabolic biomarkers of frailty in older people with type 2 diabetes mellitus” (MetaboFrail) study: Rationale, design and methods. Exp Gerontol 2020; 129:110782. [DOI: 10.1016/j.exger.2019.110782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/14/2019] [Indexed: 12/19/2022]
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Arc-Chagnaud C, Millan F, Salvador-Pascual A, Correas A, Olaso-Gonzalez G, De la Rosa A, Carretero A, Gomez-Cabrera M, Viña J. Reversal of age-associated frailty by controlled physical exercise: The pre-clinical and clinical evidences. SPORTS MEDICINE AND HEALTH SCIENCE 2019; 1:33-39. [PMID: 35782461 PMCID: PMC9219339 DOI: 10.1016/j.smhs.2019.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Demographic aging is one of the most serious challenges facing our society. Although we live longer, we do not live better because it is considered that approximately 16–20% of our life is spent in late-life morbidity. Older people have the greatest risk of developing frailty increasing the risk of presenting various adverse health events such as low quality of life, disability, hospitalization and even death. Frail men and women over 65 years old have lower muscle quality and muscle mass and higher percentage of body fat than non-frail people of the same age. In this review we will address the main physiological changes in the muscular and nervous system associated to aging. More specifically we will review the changes in muscle mass, quality, and strength relating them with the decrease in capillarization and muscular oxidative capacity as well as with the alterations in protein synthesis in the muscle with aging. The last section of the manuscript will be devoted to the animal models of frailty and the indexes developed to measure frailty in these models. We will finally address the importance of exercise training as an intervention to delay or even reverse frailty.
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Affiliation(s)
- C. Arc-Chagnaud
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
- INRA, UMR866 Dynamique Musculaire et Métabolisme, Université de Montpellier, F-34060, Montpellier, France
| | - F. Millan
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. Salvador-Pascual
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A.G. Correas
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - G. Olaso-Gonzalez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. De la Rosa
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. Carretero
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - M.C. Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
- Corresponding author. Av. Blasco Ibañez 15, 46010, Valencia, Spain.
| | - J. Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
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Semmarath W, Seesen M, Yodkeeree S, Sapbamrer R, Ayood P, Malasao R, Siviroj P, Limtrakul Dejkriengkraikul P. The Association between Frailty Indicators and Blood-Based Biomarkers in Early-Old Community Dwellers of Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183457. [PMID: 31533354 PMCID: PMC6765843 DOI: 10.3390/ijerph16183457] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/29/2022]
Abstract
Thailand has officially reached the status of an "aged society" and become the developing country with the 2nd largest proportion of senior citizens in Southeast Asia. A cross-sectional study of 526 early-old community dwellers was conducted for the Fried frailty phenotype assessment, This included five indicators: Weakness, slowness, physical activity, exhaustion, and weight loss. C-reactive protein (CRP), interleukin-6 (IL-6), insulin-like growth factor-1, and CD4+:CD8+ Ratio which serve as blood-based biomarkers of frailty. The prevalence of frailty and pre-frail in this population was found to be 15% and 69.6% respectively and was higher among women than men. Frail (n = 58) and non-frail (n = 60) participants were evaluated for the associations between the frail indicators and the blood-based biomarkers. Serum levels of IL-6 and CRP from frail group were significantly elevated when compared with the non-frail counterparts (p = 0.044 and 0.033, respectively), and were significantly associated with the frailty status with an Odd RatioIL-6 [OR] of 1.554-fold (95% confidence interval [CI], 1.229-1.966) and an ORCRP of 1.011-fold (95 CI, 1.006-1.016). Decreased hand-grip strength was the only frailty indicator that was significantly associated with both inflammatory biomarkers, (ORIL-6 of 1.470-fold and ORCRP of 1.008-fold). Our study is the first to assess the frailty status among the early-old population in Thailand. These findings will encourage general practitioners to combine frailty indicators and serum biomarkers as early detection tools for at-risk older adults to achieve the goal of healthy aging.
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Affiliation(s)
- Warathit Semmarath
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Mathuramat Seesen
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Supachai Yodkeeree
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pisittawoot Ayood
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rungnapa Malasao
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pornngarm Limtrakul Dejkriengkraikul
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand.
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Coelho-Junior HJ, Picca A, Calvani R, Uchida MC, Marzetti E. If my muscle could talk: Myokines as a biomarker of frailty. Exp Gerontol 2019; 127:110715. [PMID: 31473199 DOI: 10.1016/j.exger.2019.110715] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/12/2019] [Accepted: 08/26/2019] [Indexed: 01/03/2023]
Abstract
Frailty is a potentially reversible state of increased vulnerability to negative health-related outcomes that occurs as a result of multisystem biological impairment and environmental aspects. Given the relevance of this condition in both clinics and research, biomarkers of frailty have been actively sought after. Although several candidate biomarkers of frailty have been identified, none of them has yet been incorporated in the assessment or monitoring of the condition. Over the last years, increasing research interest has been focused on myokines, a set of cytokines, small proteins and proteoglycan peptides that are synthetized, expressed and released by skeletal myocytes in response to muscular contractions. Myokines may act in autocrine, paracrine, and endocrine manner and regulate several processes associated with physical frailty, including muscle wasting, dynapenia, and slowness. This review discusses the rationale to support the use of myokines as biomarkers of frailty in older adults.
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Affiliation(s)
- Hélio J Coelho-Junior
- Università Cattolica del Sacro Cuore, Rome, Italy; Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, SP, Brazil.
| | - Anna Picca
- Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Riccardo Calvani
- Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Marco C Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, SP, Brazil
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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The Role of Water Homeostasis in Muscle Function and Frailty: A Review. Nutrients 2019; 11:nu11081857. [PMID: 31405072 PMCID: PMC6723611 DOI: 10.3390/nu11081857] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/07/2023] Open
Abstract
Water, the main component of the body, is distributed in the extracellular and intracellular compartments. Water exchange between these compartments is mainly governed by osmotic pressure. Extracellular water osmolarity must remain within very narrow limits to be compatible with life. Older adults lose the thirst sensation and the ability to concentrate urine, and this favours increased extracellular osmolarity (hyperosmotic stress). This situation, in turn, leads to cell dehydration, which has severe consequences for the intracellular protein structure and function and, ultimately, results in cell damage. Moreover, the fact that water determines cell volume may act as a metabolic signal, with cell swelling acting as an anabolic signal and cell shrinkage acting as a catabolic signal. Ageing also leads to a progressive loss in muscle mass and strength. Muscle strength is the main determinant of functional capacity, and, in elderly people, depends more on muscle quality than on muscle quantity (or muscle mass). Intracellular water content in lean mass has been related to muscle strength, functional capacity, and frailty risk, and has been proposed as an indicator of muscle quality and cell hydration. This review aims to assess the role of hyperosmotic stress and cell dehydration on muscle function and frailty.
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Ikeda K, Horie-Inoue K, Inoue S. Functions of estrogen and estrogen receptor signaling on skeletal muscle. J Steroid Biochem Mol Biol 2019; 191:105375. [PMID: 31067490 DOI: 10.1016/j.jsbmb.2019.105375] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/03/2019] [Indexed: 12/23/2022]
Abstract
Activity of estrogen, a sex steroid hormone, is not only limited to the reproductive organs but also involves other organs and tissues, including skeletal muscle. In postmenopausal women, estrogen decline causes endocrine and metabolic dysfunction, leading to a predisposition to osteoporosis, metabolic syndrome, and decreased muscle mass and strength. The decline in skeletal muscle mass often associates with sarcopenia, a popular condition observed in fragile elder people. In addition, varying estrogen levels associated with the menstrual phases may modulate exercise performance in women. Estrogen is thus considered to play a crucial role in skeletal muscle homeostasis and exercise capacity, although its precise mechanisms remain to be elucidated. In this article, we review the role of estrogen in the skeletal muscle, outlining the proposed molecular mechanisms. We especially focus on the current understanding of estrogen actions on mitochondria metabolism in skeletal muscle.
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Affiliation(s)
- Kazuhiro Ikeda
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Kuniko Horie-Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Satoshi Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan; Department of Systems Aging Science and Medicine, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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Panza F, Lozupone M, Solfrizzi V, Sardone R, Dibello V, Di Lena L, D'Urso F, Stallone R, Petruzzi M, Giannelli G, Quaranta N, Bellomo A, Greco A, Daniele A, Seripa D, Logroscino G. Different Cognitive Frailty Models and Health- and Cognitive-related Outcomes in Older Age: From Epidemiology to Prevention. J Alzheimers Dis 2019; 62:993-1012. [PMID: 29562543 PMCID: PMC5870024 DOI: 10.3233/jad-170963] [Citation(s) in RCA: 193] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Frailty, a critical intermediate status of the aging process that is at increased risk for negative health-related events, includes physical, cognitive, and psychosocial domains or phenotypes. Cognitive frailty is a condition recently defined by operationalized criteria describing coexisting physical frailty and mild cognitive impairment (MCI), with two proposed subtypes: potentially reversible cognitive frailty (physical frailty/MCI) and reversible cognitive frailty (physical frailty/pre-MCI subjective cognitive decline). In the present article, we reviewed the framework for the definition, different models, and the current epidemiology of cognitive frailty, also describing neurobiological mechanisms, and exploring the possible prevention of the cognitive frailty progression. Several studies suggested a relevant heterogeneity with prevalence estimates ranging 1.0–22.0% (10.7–22.0% in clinical-based settings and 1.0–4.4% in population-based settings). Cross-sectional and longitudinal population-based studies showed that different cognitive frailty models may be associated with increased risk of functional disability, worsened quality of life, hospitalization, mortality, incidence of dementia, vascular dementia, and neurocognitive disorders. The operationalization of clinical constructs based on cognitive impairment related to physical causes (physical frailty, motor function decline, or other physical factors) appears to be interesting for dementia secondary prevention given the increased risk for progression to dementia of these clinical entities. Multidomain interventions have the potential to be effective in preventing cognitive frailty. In the near future, we need to establish more reliable clinical and research criteria, using different operational definitions for frailty and cognitive impairment, and useful clinical, biological, and imaging markers to implement intervention programs targeted to improve frailty, so preventing also late-life cognitive disorders.
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Affiliation(s)
- Francesco Panza
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Vittorio Dibello
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Luca Di Lena
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Francesca D'Urso
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Roberta Stallone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | | | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Antonio Greco
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Seripa
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Giancarlo Logroscino
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
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Shimokata H, Shimada H, Satake S, Endo N, Shibasaki K, Ogawa S, Arai H. Chapter 2 Epidemiology of sarcopenia. Geriatr Gerontol Int 2019; 18 Suppl 1:13-22. [PMID: 29745460 DOI: 10.1111/ggi.13320] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | | | - Shosuke Satake
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoto Endo
- Department of Orthopedics, Niigata University, Nigata, Japan
| | - Koji Shibasaki
- Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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Sun XL, Hao QK, Tang RJ, Xiao C, Ge ML, Dong BR. Frailty and Rejuvenation with Stem Cells: Therapeutic Opportunities and Clinical Challenges. Rejuvenation Res 2019; 22:484-497. [PMID: 30693831 PMCID: PMC6919243 DOI: 10.1089/rej.2017.2048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Frailty, one appealing target for improving successful aging of the elderly population, is a common clinical syndrome based on the accumulation of multisystemic function declines and the increase in susceptibility to stressors during biological aging. The age-dependent senescence, the frailty-related stem cell depletion, chronic inflammation, imbalance of immune homeostasis, and the reduction of multipotent stem cells collectively suggest the rational hypothesis that it is possible to (partially) cure frailty with stem cells. This systematic review has included all of the human trials of stem cell therapy for frailty from the main electronic databases and printed materials and screened the closely related reviews themed on the mechanisms of aging, frailty, and stem cells, to provide more insights in stem cell strategies for frailty, one promising method to recover health from a frail status. To date, a total of four trials about this subject have been registered on clinicaltrials.gov. The use of mesenchymal stem cells (MSCs), doses of 100 million cells, single peripheral intravenous infusion, follow-up periods of 6–12 months, and a focus primarily on safety and secondarily on efficacy are common characteristics of these studies. We conclude that intravenous infusion of allogenic MSCs is safe, well tolerated, and preliminarily effective clinically. More preclinical experiments and clinical trials are warranted to precisely elucidate the mechanism, safety, and efficacy of frailty stem cell therapy.
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Affiliation(s)
- Xue-Lian Sun
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Chengdu, China
| | - Qiu-Kui Hao
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ren-Jie Tang
- Department of Urinary Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, China.,Department of Urology, Chengdu Sixth People's Hospital, Chengdu, China
| | - Chun Xiao
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Research Institute of Chi Ding Sheng Tong, Chengdu, China
| | - Mei-Ling Ge
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Chengdu, China
| | - Bi-Rong Dong
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Chengdu, China
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40
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Franco I, Fernandez-Gonzalo R, Vrtačnik P, Lundberg TR, Eriksson M, Gustafsson T. Healthy skeletal muscle aging: The role of satellite cells, somatic mutations and exercise. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2019; 346:157-200. [DOI: 10.1016/bs.ircmb.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dent E, Morley JE, Cruz-Jentoft AJ, Woodhouse L, Rodríguez-Mañas L, Fried LP, Woo J, Aprahamian I, Sanford A, Lundy J, Landi F, Beilby J, Martin FC, Bauer JM, Ferrucci L, Merchant RA, Dong B, Arai H, Hoogendijk EO, Won CW, Abbatecola A, Cederholm T, Strandberg T, Gutiérrez Robledo LM, Flicker L, Bhasin S, Aubertin-Leheudre M, Bischoff-Ferrari HA, Guralnik JM, Muscedere J, Pahor M, Ruiz J, Negm AM, Reginster JY, Waters DL, Vellas B. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. J Nutr Health Aging 2019; 23:771-787. [PMID: 31641726 PMCID: PMC6800406 DOI: 10.1007/s12603-019-1273-z] [Citation(s) in RCA: 430] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. METHODS These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
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Affiliation(s)
- E Dent
- E. Dent, Torrens University Australia, Adelaide, Australia,
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Serra-Prat M, Lorenzo I, Palomera E, Ramírez S, Yébenes JC. Total Body Water and Intracellular Water Relationships with Muscle Strength, Frailty and Functional Performance in an Elderly Population. J Nutr Health Aging 2019; 23:96-101. [PMID: 30569076 DOI: 10.1007/s12603-018-1129-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND As a person ages, total body water (TBW), intracellular water (ICW), muscle mass and muscle strength tend to decline. The decline in ICW may reflect losses in the number of muscle cells but may also be responsible for less hydrated muscle cells. AIM To assess whether TBW and ICW are associated with muscle strength, functional performance and frailty in an aged population, independently of muscle mass. METHODOLOGY Design: An observational cross-sectional study of community-dwelling individuals aged 75 years and older. TBW, ICW, fat mass, lean mass and muscle mass were assessed by bioelectrical impedance analysis, frailty status was measured according to Fried criteria, handgrip strength was measured using the hand-held JAMAR dynamometer, and functional performance was measured according to the Barthel index and gait speed. RESULTS A total of 324 subjects were recruited (mean age 80.1 years, 47.5% women). TBW and ICW were closely correlated with muscle mass in both sexes. ICW was also associated with Barthel score, gait speed and frailty in both sexes and with handgrip in men. Considerable variability in ICW was observed for the same muscle mass. Multivariate analysis showed a positive effect of ICW on handgrip, functional performance and gait speed and a protective effect of ICW on frailty, independently of age, sex, body mass index and number of comorbidities. CONCLUSIONS In elderly individuals with similar muscle mass, those with higher ICW had a better functional performance and a lower frailty risk, suggesting a protective effect of cell hydration, independently of muscle mass.
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Affiliation(s)
- M Serra-Prat
- Mateu Serra Prat, Research Unit, Hospital of Mataró, Carretera de Cirera s/n, 08304 Mataró, Barcelona, Spain, Tel. 34 93 741 77 30, Fax. 34 93 757 33 21, e-mail:
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43
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You JY, Kim YJ, Shin WY, Kim NY, Cho SH, Kim JH. Heritability of muscle mass in Korean parent-offspring pairs in the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V). Maturitas 2018; 114:67-72. [PMID: 29907249 DOI: 10.1016/j.maturitas.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/26/2018] [Accepted: 06/03/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Decreased muscle mass is known to be associated with several serious medical conditions. We analyzed the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V, 2010-2011) to estimate the heritability of muscle mass in Korean parent-offspring pairs. STUDY DESIGN Cross-sectional. MAIN OUTCOME MEASURES A total of 1233 parents (average age 57.67 ± 8.50 years) and 917 offspring (average age 29.10 ± 7.57 years) from 743 families were included in the analysis. Muscle mass was estimated based on three different indices: appendicular skeletal muscle mass (ASM) measured with a dual-energy X-ray absorptiometry (DXA), weight-adjusted ASM (SMI), and height-adjusted ASM (RASM). The heritability was estimated by employing the maximum-likelihood variance components implemented in Sequential Oligogenic Linkage Analysis Routines (SOLAR). The best-fitting model was determined out of four polygenic models. Pearson's partial correlation coefficient was also calculated using the muscle mass indices to further study the association between father or mother and son or daughter pairs. RESULTS The heritability estimates of the muscle mass indices ranged from 55% to 80% (all p < 0.01). The correlation coefficient of father and offspring ranged from 0.11 to 0.40, while that of mother and offspring ranged from 0.23 to 0.43 (all p < 0.01). CONCLUSIONS The heritability estimates of muscle mass in Koreans are large and significant, suggesting that parental muscle mass is an important predictor of the offspring's muscle mass. The result implies that there may be a genetic factor partly determining muscle mass.
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Affiliation(s)
- Ju-Young You
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yun-Jee Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Woo-Young Shin
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Na-Yeon Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung-Ha Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
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Refining Low Physical Activity Measurement Improves Frailty Assessment in Advanced Lung Disease and Survivors of Critical Illness. Ann Am Thorac Soc 2018; 14:1270-1279. [PMID: 28398076 DOI: 10.1513/annalsats.201612-1008oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
RATIONALE The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and in critical illness survivors. Because respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES To test and validate substituting the Duke Activity Status Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Physical Activity (MLTA) questionnaire, a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype (FFP) instrument. METHODS In separate multicenter prospective cohort studies of adults with advanced lung disease who were candidates for lung transplant and older survivors of acute respiratory failure, we assessed the FFP using either the MLTA or the DASI. For both the DASI and MLTA, we evaluated content validity by testing floor effects and construct validity through comparisons with conceptually related factors. We tested the predictive validity of substituting the DASI for the MLTA in the FFP assessment using Cox models to estimate associations between the FFP and delisting/death before transplant in those with advanced lung disease and 6-month mortality in older intensive care unit (ICU) survivors. RESULTS Among 618 adults with advanced lung disease and 130 older ICU survivors, the MLTA had a substantially greater floor effect than the DASI (42% vs. 1%, and 49% vs. 12%, respectively). The DASI correlated more strongly with strength and function measures than did the MLTA in both cohorts. In models adjusting for age, sex, comorbidities, and illness severity, substitution of the DASI for the MLTA led to stronger associations of the FFP with delisting/death in lung transplant candidates (FFP-MLTA hazard ratio [HR], 1.42; 95% confidence interval [CI], 0.55-3.65; FFP-DASI HR, 2.99; 95% CI, 1.03-8.65) and with mortality in older ICU survivors (FFP-MLTA HR, 2.68; 95% CI, 0.62-11.6; FFP-DASI HR, 5.71; 95% CI, 1.34-24.3). CONCLUSIONS The DASI improves the construct and predictive validity of frailty assessment in adults with advanced lung disease or recent critical illness. This simple questionnaire should replace the more complex MLTA in assessing the frailty phenotype in these populations.
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Yamaga M, Takemoto M, Shoji M, Sakamoto K, Yamamoto M, Ishikawa T, Koshizaka M, Maezawa Y, Kobayashi K, Yokote K. Werner syndrome: a model for sarcopenia due to accelerated aging. Aging (Albany NY) 2018; 9:1738-1744. [PMID: 28738022 PMCID: PMC5559172 DOI: 10.18632/aging.101265] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/19/2017] [Indexed: 12/25/2022]
Abstract
Werner syndrome (WS) is a rare inheritable progeroid syndrome caused by a mutation in the WRN gene. Although WS has been described as a characteristic appearance of very slender extremities with a stocky trunk, few studies have investigated the loss of muscle mass, fat mass distribution (body composition), and mobility according to age and sex. Therefore, the aim of this study was to precisely describe the body composition in WS. Nine Japanese patients with WS (four males and five females; mean age 48±8.8 years) were recruited. Body composition was examined by dual-energy X-ray absorptiometry and computed tomography (CT). The hand grip strength and mobility were evaluated using the two-step test, stand-up test and 25-question geriatric locomotive function scale (GLFS). The mean skeletal muscle index (SMI) was 4.0±0.6 kg/m2. SMI of all patients met the criteria of sarcopenia, even though some patients were aged < 40 years. All patients also showed deceased mobility. In conclusion, these results indicate that all patients with WS, even those aged < 40 years, had already lost muscle mass to the level of sarcopenia. Continued research on sarcopenia in WS might facilitate the discovery of novel mechanisms and development of new treatment strategies for sarcopenia.
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Affiliation(s)
- Masaya Yamaga
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Minoru Takemoto
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,School of Medicine, International University of Health and Welfare, Department of Diabetes, Metabolism and Endocrinology, Chiba, 286-8686, Japan
| | - Mayumi Shoji
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Kenichi Sakamoto
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Eastern Chiba Medical Center, Chiba, 283-8686, Japan
| | - Masashi Yamamoto
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Takahiro Ishikawa
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Masaya Koshizaka
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Yoshiro Maezawa
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
| | - Kazuki Kobayashi
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Asahi General Hospital, 1326 I, Chiba, 289-2511, Japan
| | - Koutaro Yokote
- Department of Clinical Cell Biology and Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, Japan.,Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, 260-8670, Japan
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Chang SF, Lin PC, Yang RS, Yang RJ. The preliminary effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life among older people with sarcopenia. BMC Geriatr 2018; 18:17. [PMID: 29343219 PMCID: PMC5773163 DOI: 10.1186/s12877-018-0712-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/09/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Studies have shown that sarcopenia easily leads to difficulty moving, disability, and poor quality of life. However, researches on the use of whole-body vibration for older adults with sarcopenia living in institutions have been lacking. Therefore, the main objective of the present study was to investigate the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of older adults with sarcopenia living in institutions. METHODS This study adopted a quasi-experimental, single-group, pretest-posttest design. The whole-body vibration intervention was performed over a 3-month period, in which the older adults trained 3 times per week; each training lasted 60 s with a break of 30 s for 10 repetitions. The older adults' skeletal muscle mass index, physical fitness and quality of life before and after the intervention of the whole-body vibration was collected. Concerning the statistical methods adopted, nonparametric method-based tests were employed. RESULTS According to the results of analysis, after the intervention of the 12-week whole-body vibration, the skeletal muscle mass index (z = - 3.621, p = 0.000), physical fitness on standing on one foot (z = - 2.447, p = 0.014), shoulder-arm flexibility (z = - 3.159, p = 0.002), 8-ft up and go test (z = - 2.692, p = 0.009), hand grip strength (z = - 3.388, p = 0.009), and five repeated sit-to-stand tests (z = - 2.936, p = 0.003), all improved significantly. Furthermore, concerning the quality of life of the older adults in the pretest and posttest, the improvements were statistically significant (z = - 2.533, p = 0.011). CONCLUSIONS The study results showed the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of sarcopenic older people living in institutions and could serve as a crucial reference to health care professionals.
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Affiliation(s)
- Shu-Fang Chang
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, Pei-Tou, Taipei, 112 Taiwan, Republic of China
| | - Pei-Chen Lin
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, Pei-Tou, Taipei, 112 Taiwan, Republic of China
| | - Rong-Sen Yang
- Department of Orthopaedics, National Taiwan University & Hospital, No.7, Chung-Shan S. Rd, Taipei, Taiwan, Republic of China
| | - Rea-Jeng Yang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Ming Te Rd., Peitou, Taipei City, 112 Taiwan, Republic of China
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Dong L, Qiao X, Tian X, Liu N, Jin Y, Si H, Wang C. Cross-Cultural Adaptation and Validation of the FRAIL Scale in Chinese Community-Dwelling Older Adults. J Am Med Dir Assoc 2018; 19:12-17. [DOI: 10.1016/j.jamda.2017.06.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 01/17/2023]
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Dent E, Morley JE, Cruz-Jentoft AJ, Arai H, Kritchevsky SB, Guralnik J, Bauer JM, Pahor M, Clark BC, Cesari M, Ruiz J, Sieber CC, Aubertin-Leheudre M, Waters DL, Visvanathan R, Landi F, Villareal DT, Fielding R, Won CW, Theou O, Martin FC, Dong B, Woo J, Flicker L, Ferrucci L, Merchant RA, Cao L, Cederholm T, Ribeiro SML, Rodríguez-Mañas L, Anker SD, Lundy J, Gutiérrez Robledo LM, Bautmans I, Aprahamian I, Schols JMGA, Izquierdo M, Vellas B. International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr Health Aging 2018; 22:1148-1161. [PMID: 30498820 DOI: 10.1007/s12603-018-1139-9] [Citation(s) in RCA: 468] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR). METHODS To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefit-harm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process. RECOMMENDATIONS We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.
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Affiliation(s)
- E Dent
- Dr. Elsa Dent, , Torrens University Australia, Wakefield Street, Adelaide, SA, Australia
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Reyes-Padilla E, Valenzuela-Melendres M, Camou JP, Sebranek JG, Alemán-Mateo H, Dávila-Ramírez JL, Cumplido-Barbeitia G, González-Ríos H. Quality evaluation of low fat bologna-type meat product with a nutritional profile designed for the elderly. Meat Sci 2017; 135:115-122. [PMID: 28968554 DOI: 10.1016/j.meatsci.2017.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/02/2017] [Accepted: 09/18/2017] [Indexed: 12/25/2022]
Abstract
The objective of this work was to evaluate the quality of a bologna-type meat product designed for the elderly. Treatments were: control, without addition of cranberries (C), prunes (P), pecan nuts (N) or flaxseed (F); NP, with 5% N+5% P; FC, with 5% F+5% C; NC, with 5% N+5% C; FP, with 5% F+5% P. These formulations resulted in a product with high protein, low SFA and high antioxidant activity. Treatments with pecan nuts had higher MUFA while those with flaxseed had higher polyunsaturated fatty acids (PUFA). Treatments with pecan nuts and flaxseed had higher PUFA/SFA ratios, but only those with flaxseed had very low n6/n3 ratios when compared to the control. Although treatments showed acceptable scores (>5.4), they were lower than the control. A combination of these non-traditional ingredients could be used to develop a meat product for older adults to provide a better nutritional profile with acceptable sensory properties.
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Affiliation(s)
- Elizabeth Reyes-Padilla
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
| | - Martín Valenzuela-Melendres
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico.
| | - Juan Pedro Camou
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
| | - Joseph G Sebranek
- Iowa State University, Department of Animal Science, 194 Meat Laboratory, Ames, IA 50011, USA
| | - Heliodoro Alemán-Mateo
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Nutrición, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
| | - José Luis Dávila-Ramírez
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
| | - German Cumplido-Barbeitia
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
| | - Humberto González-Ríos
- Centro de Investigación en Alimentación y Desarrollo, A.C., Coordinación de Tecnología de Alimentos de Origen Animal, Carretera a la Victoria Km. 0.6, Hermosillo, Sonora CP 83304, Mexico
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Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications 2017; 31:1465-1473. [PMID: 28669464 DOI: 10.1016/j.jdiacomp.2017.05.003] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 12/14/2022]
Abstract
Diabetes increases the risk of physical dysfunction and disability. Diabetes-related complications and coexisting morbidities partially explain the deterioration in physical function. The decline in muscle mass, strength and function associated with diabetes leads to sarcopenia, frailty and eventually disability. Frailty acts as a mediator in the pathogenesis of disability in older people with diabetes and its measurement in routine daily practice is recommended. Frailty is a dynamic process which progresses from a robust condition to a pre-frail stage then frailty and eventually disability. Therefore, a multimodal intervention which includes adequate nutrition, exercise training, good glycaemic control and the use of appropriate hypoglycemic medications may help delay or prevent the progression to disability.
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Affiliation(s)
- Alan J Sinclair
- University of Aston and Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK.
| | - Ahmed H Abdelhafiz
- Department of Elderly Medicine, Rotherham General Hospital, Moorgate Road, Rotherham, UK
| | - Leocadio Rodríguez-Mañas
- Hospital Universitario de Getafe, Department of Geriatrics and School of Health Sciences, Universidad Europea de Madrid, Spain
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