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Yang M, Liu Y, Zuo Y, Tang H. Sarcopenia for predicting falls and hospitalization in community-dwelling older adults: EWGSOP versus EWGSOP2. Sci Rep 2019; 9:17636. [PMID: 31776354 PMCID: PMC6881315 DOI: 10.1038/s41598-019-53522-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/31/2019] [Indexed: 02/05/2023] Open
Abstract
The European Working Group on Sarcopenia in Older People (EWGSOP) recently published an updated version (EWGSOP2). We aimed to compare the predictive values of EWGSOP-defined and EWGSOP2-defined sarcopenia for the incidence of falls and hospitalization in older adults. We defined sarcopenia according to the EWGSOP and the EWGSOP2. We further modified the cut-off points of the EWGSOP and EWGSOP2 according to the lowest quintile values of the gender-specific distribution of our study population, named "modified EWGSOP" and "modified EWGSOP2", respectively. We included 384 participants. During the follow-up, 98 participants (26.5%) and 51 participants (13.8%) had at least one fall or hospitalization, respectively. EWGSOP2-defined sarcopenia (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.22-1.84) and modified EWGSOP2-defined sarcopenia (HR 2.09, 95% CI 1.23-3.55) were significantly associated with an increased incidence of falls, respectively. EWGSOP-defined sarcopenia and modified EWGSOP-defined sarcopenia also have a trend to be associated with the incidence of falls, but the results were not statistically significant. Only modified EWGSOP2-defined sarcopenia (HR 2.07, 95% CI 1.01-4.27) was significantly related to an increased incidence of hospitalization. In conclusion, EWGSOP2-defined sarcopenia performed more sensitive than EWGSOP-defined sarcopenia for predicting the incidence of falls or hospitalization, especially when using the modified cutoffs.
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Affiliation(s)
- Ming Yang
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
- Precision Medicine Research Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
| | - Ying Liu
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
| | - Yun Zuo
- Health Management Center, Shangjin Nanfu Hospital, Chengdu, Sichuan, China
| | - Huairong Tang
- Health Management Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
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Woo J, Yu R, Leung J. A 3-Item SARC-F. J Am Med Dir Assoc 2018; 19:223-228. [DOI: 10.1016/j.jamda.2017.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 12/12/2022]
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A sarcopenia screening test predicts mortality in hospitalized older adults. Sci Rep 2018; 8:2923. [PMID: 29440681 PMCID: PMC5811535 DOI: 10.1038/s41598-018-21237-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/31/2018] [Indexed: 02/05/2023] Open
Abstract
The aim of this study is to investigate the validation of a sarcopenia screening test (Ishii’s formula) for predicting long-term mortality among older adult inpatients. A prospective, observational study was conducted in acute geriatric wards at three hospitals in western China. Sarcopenia was estimated using Ishii’s formula. Survival status was assessed at 12, 24, and 36 months after the baseline investigation. Cox proportional-hazard models were applied to calculate the hazard ratio for mortality associated with sarcopenia. Three hundred and eighty participants (100 women) with a mean age of 80.2 ± 7.1 years were included. According to Ishii’s formula, 264 participants (69.5%) were sarcopenic. The prevalence of sarcopenia was similar in men and women (71.1% vs. 65.0%, respectively, P = 0.258). Sixty-seven participants (17.6%) died during the 3-year follow-up period. The all-cause mortality was significantly higher in the sarcopenia group than in the non-sarcopenia group (20.1% vs. 12.1%, respectively, P < 0.05). Multivariate Cox proportional hazards analysis identified sarcopenia as a significant predictor of 3-year all-cause mortality (adjusted hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.02–4.15). In conclusion, sarcopenia, estimated by Ishii’s formula, can predict 3-year all-cause mortality in a study population of hospitalized older adults.
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Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients. Sci Rep 2017; 7:3171. [PMID: 28600505 PMCID: PMC5466644 DOI: 10.1038/s41598-017-03388-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/28/2017] [Indexed: 02/05/2023] Open
Abstract
A new term, malnutrition-sarcopenia syndrome (MSS), was recently coined to describe the clinical presentation of both malnutrition and sarcopenia. The aim of this study was to investigate the association between MSS and long-term mortality in older inpatients. We conducted a prospective study in acute geriatric wards of two local hospitals in China. Muscle mass and malnutrition were estimated by anthropometric measures and the Mini Nutritional Assessment (MNA). Of the 453 participants, 14 (3.1%) had sarcopenia with normal nutrition, 139 (30.7%) had malnutrition risk without sarcopenia, 48 (10.6%) had malnutrition risk with sarcopenia, 25 (5.5%) had malnutrition without sarcopenia, and 22 (4.9%) had MSS at baseline. Compared with non-sarcopenic subjects with normal nutrition, subjects with MSS and subjects with malnutrition risk and sarcopenia were more than four times more likely to die (hazard ratio [HR], 4.78; 95% confidence interval [CI], 2.09-10.97; and HR, 4.25; 95% CI, 2.22-8.12, respectively); non-sarcopenic subjects with malnutrition risk were more than two times more likely to die (HR, 2.41; 95% CI, 1.32-4.39). In conclusion, MSS may serve as a prognostic factor in the management of hospitalized older patients.
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Morley JE. Rapid Geriatric Assessment: Secondary Prevention to Stop Age-Associated Disability. Clin Geriatr Med 2017; 33:431-440. [PMID: 28689573 DOI: 10.1016/j.cger.2017.03.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Rapid Geriatric Assessment (RGA) measures frailty, sarcopenia, anorexia, cognition, and advanced directives. The RGA is a screen for primary care physicians to be able to detect geriatric syndromes. Early intervention when geriatric syndromes are recognized can decrease disability, hospitalization, and mortality.
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Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA; Division of Endocrinology, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA.
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Hu X, Jiang J, Wang H, Zhang L, Dong B, Yang M. Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study. Medicine (Baltimore) 2017; 96:e6268. [PMID: 28272238 PMCID: PMC5348186 DOI: 10.1097/md.0000000000006268] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.
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Affiliation(s)
- Xiaoyi Hu
- The Center of Gerontology and Geriatrics
| | | | - Haozhong Wang
- The Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Zhang
- The Center of Gerontology and Geriatrics
| | | | - Ming Yang
- The Center of Gerontology and Geriatrics
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Morley JE. The Future of Long-Term Care. J Am Med Dir Assoc 2017; 18:1-7. [DOI: 10.1016/j.jamda.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
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Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016; 7:512-514. [PMID: 27891296 PMCID: PMC5114626 DOI: 10.1002/jcsm.12147] [Citation(s) in RCA: 507] [Impact Index Per Article: 63.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/09/2016] [Indexed: 12/22/2022] Open
Abstract
The new ICD-10-CM (M62.84) code for sarcopenia represents a major step forward in recognizing sarcopenia as a disease. This should lead to an increase in availability of diagnostic tools and the enthusiasm for pharmacological companies to develop drugs for sarcopenia.
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Affiliation(s)
- Stefan D. Anker
- Innovative Clinical Trials, Department of Cardiology and PneumologyUniversity of Göttingen Medical Centre, Georg‐August‐UniversityGöttingenGermany
| | - John E. Morley
- Divisions of Geriatric Medicine and EndocrinologySaint Louis University School of MedicineSt. LouisMOUSA
| | - Stephan von Haehling
- Innovative Clinical Trials, Department of Cardiology and PneumologyUniversity of Göttingen Medical Centre, Georg‐August‐UniversityGöttingenGermany
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Morley JE. Frailty and sarcopenia in elderly. Wien Klin Wochenschr 2016; 128:439-445. [PMID: 27670855 DOI: 10.1007/s00508-016-1087-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/23/2016] [Indexed: 12/18/2022]
Abstract
Frailty is a pre-disability syndrome where an older person can be identified as being at risk when exposed to stressors associated with high risk for disability or needing to be hospitalized. Two major frailty definitions exist. The physical phenotype of frailty and the multiple deficit model. A simple frailty screening tool-FRAIL-has been validated. Treatment of frailty involves resistance exercise, optimization of nutrition, and treatment of fatigue (sleep apnea, depression), treatable causes of weight loss and adjustment of polypharmacy. Sarcopenia (decline in function with low muscle mass) is a major cause of frailty. A simple sarcopenia screening tool-SARC-F-has been validated. The multiple causes of sarcopenia are reviewed. Optimal treatment is resistance exercise, leucine-enriched essential amino acids and vitamin D replacement.
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Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, 63104, St. Louis, MO, USA.
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Morley JE. Aging Successfully: The Key to Aging in Place. J Am Med Dir Assoc 2015; 16:1005-7. [DOI: 10.1016/j.jamda.2015.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 12/16/2022]
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Morley JE, Cao L. Rapid screening for sarcopenia. J Cachexia Sarcopenia Muscle 2015; 6:312-4. [PMID: 26676168 PMCID: PMC4670738 DOI: 10.1002/jcsm.12079] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 02/05/2023] Open
Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine St. Louis, MO, USA
| | - Li Cao
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University Sichuan, China
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15
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Morley JE. Nutritional Supplementation and Sarcopenia: The Evidence Grows. J Am Med Dir Assoc 2015; 16:717-9. [DOI: 10.1016/j.jamda.2015.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 12/25/2022]
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Abstract
‘Ageing well’ has been declared a global health priority by the World Health Organisation and the role of sarcopenia and frailty in late-life health is receiving increasing attention. Frailty is the decline in an individual's homeostatic function, strength and physiologic reserves leading to increased vulnerability, while sarcopenia describes the loss of muscle mass and function with age. The conceptual definitions of these conditions have been widely agreed but there is a lack of consensus on how to measure them. We review the different operational definitions described in the literature and the evidence that, whatever definition used, the prevalence and clinical impact of these conditions is high. We also consider the commonality of low physical function to both conditions, a feature which could provide a pragmatic way forward in terms of identifying those at risk. Objective measures of physical function such as usual walking speed are simple and feasible measures, extensively validated against health outcomes. Additionally, clinical applications of sarcopenia and frailty are reviewed with particular consideration to their potential role in the management of older people undergoing surgery. Frailty appears to outperform traditional anaesthetic and surgical risk scores in terms of its association with post-operative complications, length of hospital stay, institutionalisation and mortality. However, even within this sub-specialty area there is wide variation in the approaches used to measure frailty and there is an urgent need for studies to utilise established, validated and reproducible methods to identify sarcopenia and frailty in their study participants, in order to expedite scientific development.
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