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Struijk EA, Fung TT, Bischoff‐Ferrari HA, Willett WC, Lopez‐Garcia E. Total magnesium intake and risk of frailty in older women. J Cachexia Sarcopenia Muscle 2024; 15:1275-1282. [PMID: 38845194 PMCID: PMC11294045 DOI: 10.1002/jcsm.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND An adequate magnesium intake might lower the risk of frailty through its role in muscle function. METHODS We analysed data from 81 524 women aged ≥60 years participating in the Nurses' Health Study. Total magnesium intake was obtained from repeated food frequency questionnaires administered between 1984 and 2010 and self-reported information on supplementation. Frailty was defined as having at least three of the following five FRAIL scale criteria: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses and weight loss ≥ 5%. The occurrence of frailty was assessed every 4 years from 1992 to 2018. Cox proportional hazards models adjusted for lifestyle factors, medication use and dietary factors were used to assess the association between magnesium intake and frailty. RESULTS During a median follow-up of 16 years, we identified 15 477 incident cases of frailty. Women with a higher intake of total energy-adjusted magnesium had a decreased risk of frailty after adjustment for lifestyle factors, medication use and dietary factors. The relative risk (95% confidence interval) for Quintile 5 (Q5) versus Quintile 1 (Q1) was 0.88 (0.82, 0.94) (P-trend < 0.001). When only energy-adjusted magnesium from the diet was considered, the inverse association was stronger (Q5 vs. Q1: 0.68 [0.56, 0.82]; P-trend < 0.001). Those reaching the recommended daily allowance (RDA) of magnesium through diet had a 14% (9%, 19%) lower risk of frailty compared with those not meeting the RDA. CONCLUSIONS Increased intake of foods rich in magnesium was associated with a decreased risk of frailty.
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Affiliation(s)
- Ellen A. Struijk
- Department of Preventive Medicine and Public Health, School of MedicineUniversidad Autónoma de Madrid‐IdiPazMadridSpain
- CIBERESP (CIBER of Epidemiology and Public Health)MadridSpain
| | - Teresa T. Fung
- Department of NutritionSimmons UniversityBostonMAUSA
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Heike A. Bischoff‐Ferrari
- Department of Geriatrics and Aging ResearchUniversity Hospital Zürich and University of ZürichZürichSwitzerland
- Centre on Aging and MobilityUniversity Hospital Zürich and Waid City HospitalZürichSwitzerland
| | - Walter C. Willett
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMAUSA
- Channing Division of Network Medicine, Department of MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMAUSA
| | - Esther Lopez‐Garcia
- Department of Preventive Medicine and Public Health, School of MedicineUniversidad Autónoma de Madrid‐IdiPazMadridSpain
- CIBERESP (CIBER of Epidemiology and Public Health)MadridSpain
- IMDEA/Food Institute, CEI UAM + CSICMadridSpain
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2
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Celik HI, Koc F, Siyasal K, Ay B, Ilter NB, Celik OM. Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults. Eur Rev Aging Phys Act 2024; 21:18. [PMID: 38982337 PMCID: PMC11232342 DOI: 10.1186/s11556-024-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/04/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Malnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults. METHODS This cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed. RESULTS The mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085). CONCLUSIONS The SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.
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Affiliation(s)
- Halil Ibrahim Celik
- Bilge Çocuk Special Education and Rehabilitation Center, Beysukent, Çankaya, Ankara, s06800, Turkey.
| | - Ferda Koc
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Kübra Siyasal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Büsra Ay
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Nazlı Bengu Ilter
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Ozge Mengi Celik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
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Rojas-Rivera AF, Alves de Oliveira Lucchesi P, Andrade Anziani M, Lillo P, Ferretti-Rebustini REDL. Psychometric Properties of the FRAIL Scale for Frailty Screening: A Scoping Review. J Am Med Dir Assoc 2024; 25:105133. [PMID: 38981581 DOI: 10.1016/j.jamda.2024.105133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES The aim of this study was to identify and map the available psychometric evidence of the FRAIL scale to screen frailty among older adults. DESIGN Scoping review of published articles on 9 databases (PubMed, Scopus, Web of Science, CINAHL, Cochrane, Embase, PsycINFO, VHL Regional Portal, and Epistemonikos) and 8 gray literature sources. SETTING AND PARTICIPANTS Studies in adults or older adults, in both inpatient and outpatient settings (without context restrictions). METHODS Cross-cultural adaptations, validity and reliability evidence studies, whose main objective was to develop and/or validate and/or culturally adapt the FRAIL Scale to assess frailty in adults or older adults, published since 2007 were included in this scoping review. The databases were searched between February and March 2023.The JBI methodology for scoping reviews was used to guide the process. The protocol of this study was registered on the Open Science Framework platform. RESULTS Of the 1031 records found during the search, 40 articles that met the established criteria for analysis were included. Nearly 1 in 10 countries worldwide (11.9%) have psychometric evidence regarding this scale. Ten studies were identified with the goal of cross-cultural adaptation and/or validation in a different cultural context for the first time. Twenty-one of 40 studies used Morley 2012 operationalization of FRAIL Scale criteria. Thirty-nine studies provided evidence of associations with other variables. The rest of the evidence for content, internal structure, response processes, and reliability was only evaluated in cross-cultural adaptation studies, with limitations. CONCLUSIONS AND IMPLICATIONS In conclusion, there is some evidence of validity for FRAIL Scale; nevertheless, studies are needed to adapt the scale to new cultures, using rigorous Cross-Cultural Adaptation processes, and to provide new evidence of validity and reliability, to strengthen and consolidate the body of knowledge for its application to various patient groups and context.
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Affiliation(s)
- Alejandra F Rojas-Rivera
- Universidad de los Andes, Santiago, Chile, Facultad de Enfermería y Obstetricia, Escuela de Enfermería; Escola de Enfermagem da Universidade São Paulo, Brasil.
| | | | | | - Patricia Lillo
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Centro de Gerociencia, Salud Mental y Metabolismo, GERO, Santiago, Chile; Clínica Universidad de los Andes, Santiago, Chile, Centro de Neurociencias
| | - Renata Eloah de Lucena Ferretti-Rebustini
- Escola de Enfermagem da Universidade São Paulo, Brasil; Laboratório de Fisiopatologia no Envelhecimento da Faculdade de Medicina da Universidade de São Paulo, Brasil
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Meerkerk CDA, Bruijnen CP, van den Bos F, Emmelot-Vonk MH, de Bree R. The geriatric assessment and sarcopenia to assess frailty in older patients with cancer. J Geriatr Oncol 2024; 15:101776. [PMID: 38677936 DOI: 10.1016/j.jgo.2024.101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/23/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Christiaan D A Meerkerk
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Cheryl P Bruijnen
- Department of Medical Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Frederiek van den Bos
- Department of Geriatrics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Marielle H Emmelot-Vonk
- Department of Geriatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
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Li X, Wang R, Hou Z, Sun Q. Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 122:105390. [PMID: 38460267 DOI: 10.1016/j.archger.2024.105390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors. METHODS Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis. RESULTS Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia. CONCLUSIONS Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.
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Affiliation(s)
- Xiaoyan Li
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhuoer Hou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiuhua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
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Fung TT, Rossato SL, Chen Z, Khandpur N, Rodriguez-Artalejo F, Willett WC, Struijk EA, Lopez-Garcia E. Ultraprocessed foods, unprocessed or minimally processed foods, and risk of frailty in a cohort of United States females. Am J Clin Nutr 2024; 120:232-239. [PMID: 38750726 DOI: 10.1016/j.ajcnut.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Ultraprocessed foods (UPFs) and poor diet quality have been associated with frailty but existing studies had relatively short follow-up time. It is also unclear whether the association of UPF was primarily due to its correlation with poorer diet quality. OBJECTIVES We examined the association between unprocessed or minimally processed foods (UMFs) and UPF and risk of frailty and explored whether the association with UPF was mainly driven by poor diet quality. METHODS In total, 63,743 nonfrail females aged 60+ y from the Nurses' Health Study (cohort study) were followed up for ≥26 y. Diet was assessed every 4 y by food frequency questionnaires. UPF and UMF intakes were calculated using the Nova classification. Diet quality was estimated using the Alternate Healthy Eating Index (AHEI) 2010. The association of UMF and UPF with risk of frailty was examined using multivariable adjusted Cox proportional hazard model. RESULTS During the follow-up period, we recorded 15,187 incident cases of frailty. The hazard ratio (HR) of frailty for the highest compared with the lowest quintile of UMFs (servings per day) was 0.86 (95% CI: 0.83, 0.95; P-trend < 0.001). However, this was no longer statistically significant after adjustment for AHEI-2010. UPFs (servings per day) was directly associated with risk of frailty, even after adjustment for AHEI-2010 (1.31; 95% CI: 1.23, 1.39; P-trend < 0.001). Among those at the highest category of the AHEI-2010, UPFs remained directly associated with frailty (HR comparing top with bottom quintile: 1.40; 95% CI:1.24, 1.57; P-trend < 0.001). For UPF components, we found a higher frailty risk with each serving per day of artificial and sugar-sweetened beverages; fat, spreads, and condiments; yogurt and dairy-based desserts; and other UPFs. However, processed whole grains were not associated with frailty. CONCLUSIONS Higher intake of UPF is associated with a higher risk of frailty in older females. This is not explained by a lower diet quality contributed by UPFs.
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Affiliation(s)
- Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Sinara L Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Laboratory of Research and Extension in Epidemiolgy (Lapex-Epi), Institute of Geography Universidade Federal de Uberlândia. Uberlândia, Brazil
| | - Zhangling Chen
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Division of Human Nutrition and Health, Wageningen University, Netherlands; Faculty of Public Health, University of Sao Paulo, Brazil
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Instituto Madrileño De Estudios Avanzado-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid+Centro Superior de Investigaciones Científicas, Madrid, Spain
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Shafiee G, Aryan AS, Maleki Birjandi S, Zargar Balajam N, Sharifi F, Ostovar A, Fahimfar N, Nabipour I, Larijani B, Heshmat R. Overlap between Osteosarcopenia and Frailty and their Association with Poor Health Conditions: The Bushehr Elderly Health Program. Ann Geriatr Med Res 2024; 28:219-227. [PMID: 38584427 PMCID: PMC11217651 DOI: 10.4235/agmr.23.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/17/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. METHODS This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. RESULTS This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20-3.15), poor ADL (adjOR=2.85; 95% CI, 1.81-4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85-9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. CONCLUSION Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.
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Affiliation(s)
- Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sam Aryan
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Maleki Birjandi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Zargar Balajam
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Vo NT, Tu YK, Lin KC, Chiu HY, Huang HC. Diagnostic Accuracy of the FRAIL Scale, Groningen Frailty Indicator, Tilburg Frailty Indicator, and PRISMA-7 for Frailty Screening Among Older Adults in Community Settings: A Systematic Review and Network Meta-Analysis. THE GERONTOLOGIST 2024; 64:gnae008. [PMID: 38332716 DOI: 10.1093/geront/gnae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES This study aimed to investigate the diagnostic accuracy of four questionnaire-based tools (i.e., the FRAIL scale, Groningen Frailty Indicator [GFI], Tilburg Frailty Indicator [TFI], and PRISMA-7) for screening frailty in older adults. RESEARCH DESIGN AND METHODS The 4 databases comprising the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, and ProQuest were searched from inception to June 20, 2023. Study quality comprising risks of bias and applicability was assessed via a QUADAS-2 questionnaire. A bivariate network meta-analysis model and Youden's index were performed to identify the optimal tool and cutoff points. RESULTS In total, 20 studies comprising 13 for FRAIL, 7 for GFI, 6 for TFI, and 5 for PRISMA-7 were included. Regarding study quality appraisal, all studies had high risks of bias for study quality assessment domains. Values of the pooled sensitivity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.58, 0.74, 0.66, and 0.73, respectively. Values of the pooled specificity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.92, 0.77, 0.84, and 0.86, respectively. The Youden's index was obtained for the FRAIL scale with a cutoff of 2 points (Youden's index = 0.65), indicating that the FRAIL scale with a cutoff of 2 points was the optimal tool for frailty screening in older adults. DISCUSSION AND IMPLICATIONS The FRAIL scale comprising 5 self-assessed items is a suitable tool for interview older adults for early frailty detection in community settings; it has the advantages of being short, simple, and easy to respond to.
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Affiliation(s)
- Nhi Thi Vo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
- Faculty of Nursing, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan, China
- Department of Dentistry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan, China
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, Community Medicine Research Center, Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, China
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
- Department of Nursing, Taipei Medical University Hospital, Taipei City, Taiwan, China
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, China
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Ng YX, Cheng LJ, Quek YY, Yu R, Wu XV. The measurement properties and feasibility of FRAIL scale in older adults: A systematic review and meta-analysis. Ageing Res Rev 2024; 95:102243. [PMID: 38395198 DOI: 10.1016/j.arr.2024.102243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Abstract
Frailty is a prevalent condition amongst older adults, significantly affecting their quality of life. The FRAIL tool has been purposefully designed for clinical application by assisting healthcare professionals in identifying and managing frailty-related issues in older adults, making it a preferred choice for assessing frailty across diverse older populations. This review aimed to synthesize the measurement properties and feasibility of FRAIL. Guided by COSMIN guidelines, seven databases were searched from inception to 31 Mar 2023. The measurement properties were extracted for quality appraisal of the populations in the studied samples. Where possible, random-effects meta-analysis and meta-regression were used for quantitative synthesis. Eighteen articles containing 273 tests were drawn from 14 different populations. We found that populations testing for criterion validity had high-quality ratings, while construct validity ratings varied based on health status and geographical region. Test-retest reliability had sufficient quality ratings, while scale agreement had sufficient ratings in only four out of 14 populations tested. Responsiveness ratings were insufficient in seven out of eight populations, with inconsistent ratings in one population. Our analysis of missing data across three articles showed a 16.3% rate, indicating good feasibility of the FRAIL. FRAIL is a feasible tool for assessing frailty of older adults in community settings, with good criterion validity and test-retest reliability. However, more research is needed on construct validity and responsiveness.
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Affiliation(s)
- Yu Xuan Ng
- Alexandra Hospital, National University Health System, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yu Yi Quek
- Alexandra Hospital, National University Health System, Singapore
| | - Ruby Yu
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, Singapore.
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10
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Kondoh H, Kameda M. Metabolites in aging and aging-relevant diseases: Frailty, sarcopenia and cognitive decline. Geriatr Gerontol Int 2024; 24 Suppl 1:44-48. [PMID: 37837183 DOI: 10.1111/ggi.14684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/15/2023]
Abstract
Aging shows biologically complex features with high individual variability, which reflects the exposure to several stimuli and the adaptation to them. Among them, metabolic changes are well observed as consequences or possible causes of aging. Calorie restriction extends organismal life span in experimental models. Several metabolites; for example, resveratrol or nicotinamide mononucleotide, are reported to mimic calorie restriction effects in vivo. Metabolomic research would be useful to evaluate metabolites as biomarkers in aging-relevant events and to identify metabolic regulation of aging. We recently developed the metabolomic approach for whole blood analysis, which functions as strong tool for this purpose. We review the update findings in aging-relevant metabolites detected by this method. Geriatr Gerontol Int 2024; 24: 44-48.
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Affiliation(s)
- Hiroshi Kondoh
- Geriatric Unit, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Kameda
- Geriatric Unit, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Struijk EA, Fung TT, Rodriguez-Artalejo F, Bischoff-Ferrari HA, Willett WC, Lopez-Garcia E. Specific dairy foods and risk of frailty in older women: a prospective cohort study. BMC Med 2024; 22:89. [PMID: 38424524 PMCID: PMC10905813 DOI: 10.1186/s12916-024-03280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dairy contains a complex mixture of lipids, proteins, and micronutrients. Whether habitual dairy consumption is associated with health benefits is not well established. Since dairy is high in nutrients that are potentially protective against frailty, the association between dairy products and the risk of frailty is of interest. METHODS We analyzed data from 85,280 women aged ≥ 60 years participating in the Nurses' Health Study. Consumption of milk, yogurt, and cheese was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥ 5 chronic illnesses, and a weight loss of ≥ 5%. The occurrence of frailty was assessed every four years from 1992 to 2018. Cox proportional hazard models were used to examine the association between the intake of dairy foods and frailty. RESULTS During follow-up we identified 15,912 incident cases of frailty. Consumption of milk or yogurt was not associated with the risk of frailty after adjustment for lifestyle factors, medication use, and overall diet quality. Cheese consumption was positively associated with risk of frailty [relative risk (95% confidence interval) for one serving/day increment in consumption: 1.10 (1.05, 1.16)]. Replacing one serving/day of milk, yogurt, or cheese with one serving/day of whole grains, nuts, or legumes was associated with a significant lower risk of frailty, while replacing milk, yogurt, or cheese with red meat or eggs was associated with an increased risk. When milk was replaced with a sugar-sweetened or artificially sweetened beverage, a greater risk of frailty was observed, while replacing milk with orange juice was associated with a lower risk of frailty. CONCLUSIONS The results suggest that the association between milk, yogurt, and cheese and frailty partly depends on the replacement product. Habitual consumption of milk or yogurt was not associated with risk of frailty, whereas cheese consumption may be associated with an increased risk.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Centre On Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute. CEI UAM+CSIC, Madrid, Spain
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Virto N, Río X, Angulo-Garay G, García Molina R, Avendaño Céspedes A, Cortés Zamora EB, Gómez Jiménez E, Alcantud Córcoles R, Rodriguez Mañas L, Costa-Grille A, Matheu A, Marcos-Pérez D, Lazcano U, Vergara I, Arjona L, Saeteros M, Lopez-de-Ipiña D, Coca A, Abizanda Soler P, Sanabria SJ. Development of Continuous Assessment of Muscle Quality and Frailty in Older Patients Using Multiparametric Combinations of Ultrasound and Blood Biomarkers: Protocol for the ECOFRAIL Study. JMIR Res Protoc 2024; 13:e50325. [PMID: 38393761 PMCID: PMC10924264 DOI: 10.2196/50325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/11/2023] [Accepted: 01/02/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Frailty resulting from the loss of muscle quality can potentially be delayed through early detection and physical exercise interventions. There is a demand for cost-effective tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessments. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional, and microstructural muscle properties, while biological assays derived from blood samples are associated with functional information. OBJECTIVE This study aims to assess multiparametric combinations of ultrasound and blood-based biomarkers to offer a cross-sectional evaluation of the patient frailty phenotype and to track changes in muscle quality associated with supervised exercise programs. METHODS This prospective observational multicenter study will include patients aged 70 years and older who are capable of providing informed consent. We aim to recruit 100 patients from hospital environments and 100 from primary care facilities. Each patient will undergo at least two examinations (baseline and follow-up), totaling a minimum of 400 examinations. In hospital environments, 50 patients will be measured before/after a 16-week individualized and supervised exercise program, while another 50 patients will be followed up after the same period without intervention. Primary care patients will undergo a 1-year follow-up evaluation. The primary objective is to compare cross-sectional evaluations of physical performance, functional capacity, body composition, and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based assays. We will analyze ultrasound raw data obtained with a point-of-care device, along with a set of biomarkers previously associated with frailty, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Additionally, we will examine the sensitivity of these biomarkers to detect short-term muscle quality changes and functional improvement after a supervised exercise intervention compared with usual care. RESULTS At the time of manuscript submission, the enrollment of volunteers is ongoing. Recruitment started on March 1, 2022, and ends on June 30, 2024. CONCLUSIONS The outlined study protocol will integrate portable technologies, using quantitative muscle ultrasound and blood biomarkers, to facilitate an objective cross-sectional assessment of muscle quality in both hospital and primary care settings. The primary objective is to generate data that can be used to explore associations between biomarker combinations and the cross-sectional clinical assessment of frailty and sarcopenia. Additionally, the study aims to investigate musculoskeletal changes following multicomponent physical exercise programs. TRIAL REGISTRATION ClinicalTrials.gov NCT05294757; https://clinicaltrials.gov/ct2/show/NCT05294757. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50325.
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Affiliation(s)
- Naiara Virto
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Xabier Río
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Garazi Angulo-Garay
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Rafael García Molina
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Avendaño Céspedes
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Elisa Belen Cortés Zamora
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Gómez Jiménez
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Ruben Alcantud Córcoles
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
| | - Leocadio Rodriguez Mañas
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
- Geriatrics Department, University Hospital of Getafe, Getafe, Spain
| | | | - Ander Matheu
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
- Biodonostia, Health Research Institute, Donostia, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Diego Marcos-Pérez
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Uxue Lazcano
- Biodonostia, Health Research Institute, Donostia, Spain
| | - Itziar Vergara
- Biodonostia, Health Research Institute, Donostia, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Osakidetza, Health Care Department, Research Unit APOSIs, Gipuzkoa, Spain
- Research Network in Chronicity, Primary Care and Health Promotion (RICAPPS), Barakaldo, Spain
| | - Laura Arjona
- Deusto Institute of Technology, University of Deusto, Bilbao, Spain
| | - Morelva Saeteros
- Deusto Institute of Technology, University of Deusto, Bilbao, Spain
| | | | - Aitor Coca
- Department of Physical Activity and Sports Sciences, Faculty of Health Sciences, Euneiz University, Vitoria-Gasteiz, Spain
| | - Pedro Abizanda Soler
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Center for Biomedical Research Network on Fragility and Healthy Aging (CIBERfes), Instituto de Salud Carlos III, Madrid, Spain
- Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Sergio J Sanabria
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Deusto Institute of Technology, University of Deusto, Bilbao, Spain
- Department of Radiology, Stanford University, Palo Alto, CA, United States
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Chun SY, Cho YS, Kim HB. Association between reduced muscle mass and poor prognosis of biliary sepsis. Sci Rep 2024; 14:1857. [PMID: 38253616 PMCID: PMC10803318 DOI: 10.1038/s41598-024-52502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/19/2024] [Indexed: 01/24/2024] Open
Abstract
Sepsis is a life-threatening disease, contributing to significant morbidity and mortality. This study aimed to investigate the association between low muscle mass and the prognosis of patients with biliary sepsis, focusing on outcomes such as length of hospital stay (LOS), intensive care unit (ICU) admission, and in-hospital mortality. This retrospective, single-center, observational study included adult patients with biliary sepsis who visited the emergency department between January 2016 and December 2021. Low muscle mass was assessed using the psoas muscle index (PMI). Using computed tomography imaging, the area of both sides of the psoas muscle at the L3 level was measured, and the PMI, corrected by the patient's height was calculated. The primary outcome was in-hospital mortality, and the secondary outcomes were intensive care unit (ICU) admission, LOS, and 14-day mortality. A total of 745 patients were included in this study. Low muscle mass was defined as a PMI < 421 mm2/m2 for males and < 268 mm2/m2 for females with the lower quartile of PMI according to sex. The cohort was classified into sarcopenic (n = 189) and non-sarcopenic (n = 556) groups. There was a significant association between low muscle mass and in-hospital mortality (odds ratio, 3.81; 95% confidence interval, 1.08-13.47; p < 0.001), while there was no significant association between low muscle mass and ICU admission. In addition, the median LOS in the sarcopenic group (10 [7-14] days) was significantly longer than the median (8 [6-11] days) in the non-sarcopenic group. Low muscle mass was significantly associated with clinical outcomes, particularly in-hospital mortality and LOS, in patients with biliary sepsis.
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Affiliation(s)
- Soh Yeon Chun
- Department of Emergency Medicine, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea
| | - Young Soon Cho
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Bucheon-si, Gyeonggi-do, Republic of Korea
| | - Han Bit Kim
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Bucheon-si, Gyeonggi-do, Republic of Korea.
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14
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Guo K, Wang X, Lu X, Yang Y, Lu W, Wang S, Tang X, Wu Y, Xu Y, Chen Q, Liu S. Effects of sarcopenia and frailty on postoperative recovery in elderly patients: A prospective cohort study. J Cachexia Sarcopenia Muscle 2023; 14:2642-2652. [PMID: 37724506 PMCID: PMC10751444 DOI: 10.1002/jcsm.13337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Sarcopenia and frailty are both age-related declines in functional reserve that are linked to adverse health outcomes. It is critical to know about the outcomes of a combination of these conditions. The study aimed to investigate the effects of sarcopenia and frailty on postoperative recovery in elderly patients and to explore risk factors. METHODS This prospective cohort study was conducted among 608 patients aged ≥60 years, American Society of Anesthesiologists I-III, who were scheduled to undergo thoracic (non-cardiac) and abdominal surgery from 1 March 2022 to 31 October 2022 at the Affiliated Hospital of Xuzhou Medical University. Frailty was measured by the 28-item frailty index, and sarcopenia was assessed sarcopenia was assessed by skeletal muscle index in computed tomographic scan, handgrip strength and 6-m walk. Participants were classified as follows: Group A: both sarcopenia and frailty; Group B: sarcopenia only; Group C: frailty only; and Group D: neither frailty nor sarcopenia. The primary outcome was 90-day morbidity. Multivariable logistic regression model was used to estimate the association between sarcopenia, frailty and 90-day morbidity. RESULTS The median (interquartile range) age of participants was 68 (64-72) years, and 62.7% were men. The prevalence rates of sarcopenia and frailty were 32.8% and 47.6%, respectively. The 90-day morbidity in Group A was 58.5%, in Group B was 46.2%, in Group C was 42.0% and in Group D was 28.8%, and the difference was significant (P < 0.001). In the multivariable analysis, both sarcopenia and frailty [odds ratio (OR), 2.21; 95% confidence interval (CI), 1.26-3.89], sarcopenia only (OR, 1.84; 95% CI, 1.01-3.36), frailty only (OR, 1.77; 95% CI, 1.03-3.03), women (OR, 0.67; 95% CI, 0.45-0.99), body mass index (OR, 0.94; 95% CI, 0.88-0.99), pre-operative albumin (OR, 0.96; 95% CI, 0.91-1.00) and operative stress score (OSS) [OSS 3 (OR, 2.09; 95% CI, 1.21-3.67); OSS 4-5 (OR, 3.81; 95% CI, 2.31-6.42)] were independently associated with 90-day morbidity. In the multivariable analysis with inverse probability weighting adjusted cohort, sarcopenia and frailty were also significantly associated with 90-day morbidity. CONCLUSIONS Sarcopenia and frailty were associated with higher risks of postoperative 90-day morbidity in elderly patients alone and in combination. Sex, body mass index, pre-operative albumin and operative stress were also independent factors for postoperative morbidity within 90 days.
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Affiliation(s)
- Kedi Guo
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Xinghe Wang
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
- Department of AnesthesiologyXuzhou Central HospitalXuzhouChina
| | - Xian Lu
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Yuping Yang
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Wensi Lu
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Shuting Wang
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Xihui Tang
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Yan Wu
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Yuqing Xu
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Qingsong Chen
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
| | - Su Liu
- Department of AnesthesiologyThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
- Jiangsu Province Key Laboratory of AnesthesiologyXuzhou Medical UniversityXuzhouChina
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Sousa IM, Silva FM, das Virgens IPA, Costa EC, Fayh APT. Independent and joint association of sarcopenia and frailty with mortality in older patients with gastrointestinal cancer: a cohort study with prospective data collection. Support Care Cancer 2023; 31:728. [PMID: 38015271 DOI: 10.1007/s00520-023-08173-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE Sarcopenia and frailty are associated with mortality in older patients with gastrointestinal cancer. However, it is unclear if there is an additional risk when both are present. This study aimed to investigate the independent and overlapping of sarcopenia and frailty with mortality in this population. METHODS A prospective cohort study including older patients (≥ 60 years old) with gastrointestinal cancer. Sarcopenia was defined by the EWGSP2 criteria: (i) low muscle strength (handgrip test), (ii) low muscle mass (skeletal muscle index), and/or low muscle quality (skeletal muscle radiodensity) by computed tomography. Frailty was defined according to Fried phenotype (at least three of the five components): (i) low muscle strength (handgrip test), (ii) unintentional weight loss, (iii) self-reported exhaustion, (iv) low physical activity, and (v) low gait speed. Cox proportional hazards model was used to assess overall survival rates and risk of mortality. RESULTS We evaluated 179 patients with gastrointestinal cancer [68.0 (61.0-75.0) years old; 45% women]. The prevalence of sarcopenia, frailty, and sarcopenia-frailty was 32.9% (n = 59), 59.2% (n = 106), and 24.6% (n = 44), respectively. The incidence of mortality was 27.9% (n = 50) over a 23-month (IQR, 10, 28) period. There was an association of sarcopenia (HR = 1.78, 95% CI 1.03-3.06) with mortality, but no association was found of frailty and the outcome. Sarcopenia-frailty was associated with the highest risk of mortality (HR = 2.23, 95% CI 1.27-3.92). CONCLUSION Sarcopenic-frail older patients with gastrointestinal cancer have a higher risk of mortality than those with sarcopenia or frailty alone, which reinforces the importance of assessing both conditions in oncology clinical care.
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Affiliation(s)
- Iasmin Matias Sousa
- Graduate Program in Nutrition, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Flávia Moraes Silva
- Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
- Department of Nutrition, Nutrition Science Graduate Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
| | - Isabel Pinto Amorim das Virgens
- Graduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Graduate Program in Nutrition, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
- Graduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
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Chi CY, Wang J, Lee SY, Chao CT, Hung KY, Chien KL. The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study. Aging Dis 2023; 14:1917-1926. [PMID: 37196125 PMCID: PMC10529743 DOI: 10.14336/ad.2023.0225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/25/2023] [Indexed: 05/19/2023] Open
Abstract
Patients with diabetes mellitus (DM) have a higher risk of incident and aggravating frailty over time. Frailty-initiating risk factors have been identified, but modulators of frail severity over time remain poorly defined. We aimed to explore the influences of glucose-lowering drug (GLD) strategy on DM patients' risk of increasing frail severity. We retrospectively identified type 2 DM patients between 2008 and 2016, dividing them into "no GLD", oral GLD (oGLD) monotherapy, oGLD combination, and those receiving insulin without or with oGLD at baseline. Increasing frail severity, defined as ≥1 FRAIL component increase, was the outcome of interest. Cox proportional hazard regression was utilized to analyze the risk of increasing frail severity associated with GLD strategy, accounting for demographic, physical data, comorbidities, medication, and laboratory panel. After screening 82,208 patients with DM, 49,519 (no GLD, 42.7%; monotherapy, 24.0%; combination, 28.5%; and insulin user, 4.8%) were enrolled for analysis. After 4 years, 12,295 (24.8%) had increasing frail severity. After multivariate adjustment, oGLD combination group exhibited a significantly lower risk of increasing frail severity (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.86 - 0.94), while the risk of insulin users increased (HR 1.11, 95% CI 1.02 - 1.21) than no GLD group. Users receiving more oGLD exhibited a trend of less risk reduction relative to others. In conclusion, we discovered that the strategy of oral glucose lowering drugs combination might reduce the risk of frail severity increase. Accordingly, medication reconciliation in frail diabetic older adults should take into account their GLD regimens.
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Affiliation(s)
- Chun-Yi Chi
- Nephrology division, Department of Internal Medicine, National Taiwan University Hospital Yunlin branch, Yunlin County, Taiwan.
| | - Jui Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan.
| | - Szu-Ying Lee
- Nephrology division, Department of Internal Medicine, National Taiwan University Hospital Yunlin branch, Yunlin County, Taiwan.
| | - Chia-Ter Chao
- Nephrology division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Nephrology division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
- Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Yu Hung
- Nephrology division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Nephrology division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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da Costa Pereira JP, Diniz ADS, de Lemos MCC, Pinho Ramiro CPS, Cabral PC. Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study. Geriatr Gerontol Int 2023; 23:736-743. [PMID: 37691481 DOI: 10.1111/ggi.14660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023]
Abstract
AIM There are few studies comparing the effects of geriatric syndromes and abnormalities in nutritional status and body composition on outcomes among older individuals who have been previously hospitalized. Our study aimed to evaluate the frequency and diagnosis of geriatric syndromes, low muscle quality, and nutritional status in hospitalized older individuals, and to examine their impact on both short- and long-term outcomes. METHODS This was a prospective study involving older adults (≥60 years). We assessed nutritional status, muscle quality, sarcopenia, and frailty. The outcomes were functional dependence, length of hospital stay, transfer to the Intensive Care Unit, number of readmissions, and mortality. Multivariate analysis was conducted to identify independent risk factors. RESULTS Even after adjustment for age and sex, increased risk of death was associated with possible undernourishment, sarcopenia, low muscle quality, and frailty (P < 0.05), but not the length of hospital stay (P > 0.05). Our multivariate analysis showed that frailty was independently associated with mortality and functional dependence. Low muscle quality was independently associated with functional dependence. CONCLUSIONS Geriatric syndromes, abnormalities in body composition, and the overall nutritional status of older patients are important risk factors for adverse outcomes, including functional dependence and mortality. These findings emphasize the need for interventions to improve muscle quality, prevent and treat malnutrition and sarcopenia, and address frailty in hospitalized patients. Geriatr Gerontol Int 2023; 23: 736-743.
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18
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Hu X, Ma Y, Jiang X, Tang W, Xia Y, Song P. Neurosurgical perioperative management of frail elderly patients. Biosci Trends 2023; 17:271-282. [PMID: 37635083 DOI: 10.5582/bst.2023.01208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
With the rapid increase in global aging, the prevalence of frailty is increasing and frailty has emerged as an emerging public health burden. Frail elderly patients suffer from reduced homeostatic reserve capacity, which is associated with a disproportionate decline in physical status after exposure to stress and an increased risk of adverse events. Frailty is closely associated with changes in the volume of the white and gray matter of the brain. Sarcopenia has been suggested to be an important component of frailty, and reductions in muscle strength and muscle mass lead to reductions in physical function and independence, which are critical factors contributing to poor prognosis. Approximately 10-32% of patients undergoing neurological surgery are frail, and the risk of frailty increases with age, which is significantly associated with the occurrence of adverse postoperative events (major complications, total duration of hospitalization, and need for discharge to a nursing facility). The postoperative mortality rate in severely frail patients is 9-11 times higher than that in non-frail individuals. Therefore, due attention must be paid to neurosurgical frailty and muscle assessment in elderly patients. Specialized interventions in the perioperative period of neurosurgery in frail elderly patients may improve their postoperative prognosis.
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Affiliation(s)
- Xiqi Hu
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine Haikou, China
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yanan Ma
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Gastroenterology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xuemei Jiang
- Department of Gastroenterology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Wei Tang
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ying Xia
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine Haikou, China
| | - Peipei Song
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Chen A, Ren L, Min S, Li P, Wei K, Cao J, Tao Y, Lv F. Analysis of the relationship between body habitus and frailty of community adults in Chongqing: a cross-sectional survey study. Front Public Health 2023; 11:1189173. [PMID: 37744499 PMCID: PMC10516556 DOI: 10.3389/fpubh.2023.1189173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Currently, a multitude of studies are underway to investigate the factors affecting the degree of frailty, with a significant focus on the critical role of body mass index (BMI). This study aims to conduct a cross-sectional survey to investigate the multifaceted relationship between multiple body habitus and the factors that influence the degree of frailty. Methods A questionnaire survey was conducted among 840 adult residents in Chongqing communities. A total of 723 participants were included in the data analysis, with an effective response rate of 92.0%. Fried's frailty scale was used to classify individuals into fit, pre-frail, or frail. Non-parametric tests and chi-square tests were employed to evaluate the inter-group differences in frailty levels under different influencing factors. Multivariate logistic regression analysis was performed to select the independent variables associated with frailty statistics. According to the results of the parallel line test, ordered or disordered multivariate logistic regression was used to evaluate the impact of a single independent variable on frailty for different variables. Results Adult community residents in Chongqing accounted for 29.18 and 5.67% in pre-frailty and frailty, respectively. In multivariate logistic regression analysis, high BMI, and high waist-hip ratio (WHR) were identified as major risk factors for frailty. Furthermore, the process of aging, coupled with moderate to heavy alcohol consumption, active weight loss behavior in the past year, and the presence of comorbidities, emerged as significant contributors to frailty. Conversely, factors such as a positive inclination toward taste, consistent meal timing, habitual breakfast consumption, sound nutritional intake, and the cultivation of healthy dietary practices were recognized as pivotal elements that act as protective factors against frailty. Conclusion The integration of both BMI and WHR provides a more comprehensive perspective, effectively capturing the intertwined influence of obesity and sarcopenia on the extent of frailty. To mitigate the risk of community-wide frailty, a multipronged approach is essential, involving the promotion of favorable dietary practices and achieving nutritional equilibrium, diligent management of coexisting medical conditions, moderation in alcohol consumption, and the enhancement of physical functionality.
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Affiliation(s)
- Aini Chen
- School of Medical, Chongqing Medical University, Chongqing, China
| | - Li Ren
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Li
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ke Wei
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Tao
- Department of Phase I Clinical Trial Ward, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Lv
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Gagesch M, Wieczorek M, Abderhalden LA, Lang W, Freystaetter G, Armbrecht G, Kressig RW, Vellas B, Rizzoli R, Blauth M, Orav EJ, Egli A, Bischoff-Ferrari HA. Grip strength cut-points from the Swiss DO-HEALTH population. Eur Rev Aging Phys Act 2023; 20:13. [PMID: 37543639 PMCID: PMC10403936 DOI: 10.1186/s11556-023-00323-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND While grip strength (GS) is commonly assessed using a Dynamometer, the Martin Vigorimeter was proposed as an alternative method especially in older adults. However, its reference values for Swiss older adults are missing. We therefore aimed to derive sex- and age-specific GS cut-points for the dominant and non-dominant hand (DH; NDH) using the Martin Vigorimeter. Additionally, we aimed to identify clinically relevant weakness and assess convergent validity with key markers of physical function and sarcopenia in generally healthy Swiss older adults. METHODS This cross-sectional analysis includes baseline data from Swiss participants enrolled in DO-HEALTH, a 3-year randomized controlled trial in community-dwelling adults age 70 + . For both DH and NDH, 4 different definitions of weakness to derive GS cut-points by sex and age category (≤ 75 vs. > 75 years) were used: i) GS below the median of the 1st quintile, ii) GS below the upper limit of the 1st quintile, iii) GS below 2-standard deviation (SD) of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers (i.e. individuals without major chronic diseases, disabilities, cognitive impairment or mental health issues) and iv) GS below 2.5-SD of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers. To assess the proposed cut-points' convergent validity, we assessed their association with gait speed, time to complete the 5 Times Sit-To-Stand (5TSTS) test, and present sarcopenia. RESULTS In total, 976 participants had available GS at the DH (mean age 75.2, 62% women). According to the 4 weakness definitions, GS cut-points at the DH ranged from 29-42 and 25-39 kPa in younger and older women respectively, and from 51-69 and 31-50 kPa in younger and older men respectively. Overall, weakness prevalence ranged from 2.0% to 19.3%. Definitions of weakness using the median and the upper limit of the 1st GS quintile were most consistently associated with markers of physical performance. Weak participants were more likely to have lower gait speed, longer time to complete the 5TSTS, and sarcopenia, compared to participants without weakness. CONCLUSIONS In generally healthy Swiss older adults, weakness defined by the median or the upper limit of the 1st GS quintile may serve as reference to identify clinically relevant weakness. Additional research is needed in less healthy populations in order to derive representative population-based cut-points. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01745263.
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Affiliation(s)
- Michael Gagesch
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland.
| | - Maud Wieczorek
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Lauren A Abderhalden
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Wei Lang
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Gregor Freystaetter
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Gabriele Armbrecht
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Bruno Vellas
- UMR INSERM 1027, Gérontopôle, Toulouse University Hospital, University of Toulouse, Toulouse, France
- IHU HealthAge, University Hospital Toulouse, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - E John Orav
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Andreas Egli
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
- IHU HealthAge, University Hospital Toulouse, Toulouse, France
- University Clinic for Acute Geriatric Care, City Hospital Waid and Triemli, Zurich, Switzerland
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Melvin RL, Ruple A, Pearson EB, Olby NJ, Fitzpatrick AL, Creevy KE. A review of frailty instruments in human medicine and proposal of a frailty instrument for dogs. Front Vet Sci 2023; 10:1139308. [PMID: 37441560 PMCID: PMC10333704 DOI: 10.3389/fvets.2023.1139308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Over the last few decades, frailty has become a pillar of research and clinical assessment in human gerontology. This complex syndrome, characterized by loss of physiologic reserves leading to decreased resilience to stressors, is of critical importance because it predicts higher risks of poor health outcomes, including mortality. Thus, identifying frailty among the elderly human population has become a key focus of gerontology. This narrative review presents current scientific literature on frailty in both humans and animals. The authors discuss the need for an accessible frailty instrument for companion dogs suitable for general use in veterinary medicine and the advances that would be facilitated by this instrument. A phenotypic frailty instrument for companion dogs, utilizing components that are easily collected by owners, or in the general practice setting, is proposed. The authors elaborate on the domains (physical condition, physical activity, mobility, strength, cognitive task performance, and social behavior), factors that will be included, and the data from the Dog Aging Project that inform each domain.
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Affiliation(s)
- Rachel L. Melvin
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Elizabeth B. Pearson
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
| | - Natasha J. Olby
- Department of Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States
| | | | - Kate E. Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University School of Veterinary Medicine & Biomedical Sciences, College Station, TX, United States
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Frigotto MF, Rodrigues R, Rabello R, Pietta-Dias C. COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity. SPORT SCIENCES FOR HEALTH 2023; 19:527-535. [PMID: 36855399 PMCID: PMC9951134 DOI: 10.1007/s11332-022-01040-w] [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: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 03/02/2023]
Abstract
Objective To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes. Materials and methods Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again. Results Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66). Conclusion Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.
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Affiliation(s)
- Michele Fernandes Frigotto
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
| | - Rodrigo Rodrigues
- Institute of Education, Federal University of Rio Grande, Rio Grande, RS Brazil
| | - Rodrigo Rabello
- Department of Biomedical Sciences for Health, University of Milan, Milan, MI Italy
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
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Wang XM, Zhong WF, Li ZH, Chen PL, Zhang YJ, Ren JJ, Liu D, Shen QQ, Yang P, Song WQ, Liang F, Nan Y, Xiang JX, Wu YR, Lv YB, Gao X, Kraus VB, Shi XM, Mao C. Dietary diversity and frailty among older Chinese people: evidence from the Chinese Longitudinal Healthy Longevity Study. Am J Clin Nutr 2023; 117:383-391. [PMID: 36811562 DOI: 10.1016/j.ajcnut.2022.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/26/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dietary diversity is widely advocated as a means to promote health, but little is known regarding whether the beneficial effects still apply in older adults. OBJECTIVE To examine the association between the dietary diversity score (DDS) and frailty among older Chinese adults. METHODS A total of 13,721 adults aged ≥65 y without frailty at baseline were enrolled. The DDS at baseline was constructed based on 9 items of a food frequency questionnaire. We used 39 self-reported health items to construct a frailty index (FI), with FI ≥ 0.25 indicating frailty. Cox models with restricted cubic splines were used to evaluate the dose-response relationships of DDS (continuous) with frailty. In addition, Cox proportional hazard models were used to examine the association between DDS (categorized as scores ≤4, 5-6, 7, and ≥8) and frailty. RESULTS During the mean follow-up of 5.94 y, 5250 participants met the criteria for frailty. Each 1-unit increase in DDS corresponded to a 5% lower risk of frailty (hazard ratio [HR]; 0.95; 95% CI: 0.94, 0.97]. Compared with participants with DDS ≤4 points, those with a DDS of 5-6, 7, and ≥8 points exhibited a lower frailty risk, with HRs of 0.79 (95% CI: 0.71, 0.87), 0.75 (95% CI: 0.68, 0.83), and 0.74 (95% CI: 0.67, 0.81), respectively (P-trend < 0.001). Protein-rich food items, such as meat; eggs; and beans, were associated with protective effects against frailty. In addition, a significant association was observed between higher consumption of 2 high-frequency foods, tea and fruits, and lower risk of frailty. CONCLUSIONS A higher DDS was associated with a lower risk of frailty among older Chinese adults. This study highlights the importance of a diverse diet as a potential modifiable behavioral factor for preventing frailty in older Chinese adults.
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Affiliation(s)
- Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu-Jie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao-Jiao Ren
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiao-Qiao Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fen Liang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Nan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia-Xuan Xiang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yin-Ru Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, Philadelphia, PA, USA; and
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
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Fung TT, Lee IM, Struijk E, Artalejo FR, Willett WC, Lopez-Garcia E. Physical Activity and Risk of Frailty in U.S. Women 60 Yr and Older. Med Sci Sports Exerc 2023; 55:273-280. [PMID: 36170551 PMCID: PMC9840669 DOI: 10.1249/mss.0000000000003046] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE Several studies have shown a lower risk of developing frailty with long-term higher levels of physical activity. However, most these studies lacked repeated measurement over the follow-up period. Therefore, we examined the association between different types of physical activity and in frailty development using repeated measurements. METHODS A total of 69,642 nonfrail women 60 yr and older from the Nurses' Health Study were followed from 1992 to 2016. Leisure time physical activity was assessed biennially. Frailty was defined as having 3+ of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and ≥5% weight loss. Cox models adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence interval (CI) for the association between total, moderate-intensity physical activity, vigorous-intensity physical activity, walking, and incident frailty. RESULTS During 24 yr of follow-up, we documented 16,479 incident frailty cases. Comparing top to bottom quintiles of MET-hours per week of physical activity, the HR was 0.48 (95% CI = 0.45-0.50) for total physical activity, 0.51 (0.48-0.54) for moderate, and 0.75 (0.71-0.79) for vigorous activity ( Ptrend <0.001 for all activities). For each hour per week increase, HR was 0.56 (0.53-0.58), 0.51 (0.48-0.54), and 0.63 (0.58-0.68) for total, moderate, and vigorous activity, respectively. Walking was the most common activity, and each hour per day increase in walking was associated with an HR of 0.41 (0.38-0.44) for frailty incidence; this was evident even among those older than 70 yr and those with preexisting frailty characteristics. CONCLUSIONS Both moderate and vigorous physical activities were associated with a lower risk of frailty. In particular, walking, a broadly accessible activity, was also associated with lower risk.
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Jankowska-Polańska B, Kałuska M, Mazurek T, Badura A, Lisiewicz-Jakubaszko J, Tomasiewicz B, Tański W. THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF GERIATRICS - HEALTH CHALLENGES AND JUSTIFICATION OF THE PROJECT IMPLEMENTATION. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:665-673. [PMID: 38207070 DOI: 10.36740/merkur202306114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Aim: To present the essentials of the pilot project for testing a telemedicine model in the field of geriatrics, along with a snapshot of the health challenges. PATIENTS AND METHODS Materials and Methods: This review paper use the synthetic method summarizing the main objectives of the telemedicine project in the field of geriatrics. The described project involving telemedical care of patients with geriatric complexes in the area of frailty syndrome, sarcopenia and malnutrition, according to the proposed model addresses the aforementioned problems. The project provides a holistic model of home and outpatient care, which will allow concerting on 3 groups of the above-mentioned geriatric syndromes. The project will have a pilot character and is aimed at clinical verification through the introduction (implementation) of the new method and accompanying organizational and technological solutions (platform, equipment) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. CONCLUSION Conclusions: The implementation of telemedicine solutions creates an opportunity for geriatric patients and their families by improving access to specialized medical care. This project will support patients, but also caregivers, who (through training and telemedicine) will be better able to provide care services with the ability to reconcile them with their own work.
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Affiliation(s)
| | - Magdalena Kałuska
- DEPARTMENT OF FUNDS ACQUISITION, 4TH MILITARY CLINICAL HOSPITAL, WROCLAW, POLAND
| | - Tomasz Mazurek
- CLINICAL RESEARCH SUPPORT CENTRE, 4TH MILITARY CLINICAL HOSPITAL, WROCLAW, POLAND
| | - Andrzej Badura
- DEPARTMENT OF CLINICAL ENDOCRINOLOGY, 4TH MILITARY CLINICAL HOSPITAL, WROCLAW, POLAND
| | | | - Beata Tomasiewicz
- DEPARTMENT OF INTERNAL MEDICINE, 4TH MILITARY CLINICAL HOSPITAL, WROCLAW, POLAND
| | - Wojciech Tański
- DEPARTMENT OF INTERNAL MEDICINE, 4TH MILITARY CLINICAL HOSPITAL, WROCLAW, POLAND
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Wang F, Zhen HN, Wang HP, Yu K. Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition. Front Nutr 2023; 10:1143213. [PMID: 37139454 PMCID: PMC10149728 DOI: 10.3389/fnut.2023.1143213] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Background Sarcopenia, frailty, and malnutrition are associated with undesirable clinical outcomes in cancer patients. Sarcopenia-related measurements may be promising fast biomarkers for frailty. Our objectives were to assess the prevalence of nutritional risk, malnutrition, frailty, and sarcopenia in lung cancer inpatients, and describe the relationship of them. Methods Stage III and IV lung cancer inpatients were recruited before chemotherapy. The skeletal muscle index (SMI) was assessed by multi-frequency bioelectric impedance analysis (m-BIA). Sarcopenia, frailty, nutritional risk, and malnutrition were diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), Fried Frailty Phenotype (FFP), nutritional risk screening-2002 (NRS-2002), and Global Leadership Initiative on Malnutrition criteria (GLIM), and correlation analysis was performed between them with Pearson's r correlation coefficients. A univariate and multivariate logistic regression analysis was conducted for all patients, gender and age-stratified subgroups to obtain odds ratios (ORs) and 95% confidence intervals (95%CIs). Results The cohort included 97 men (77%) and 29 women (23%), with mean age of 64.8 ± 8.7 years. Among the 126 patients, 32 (25.4%) and 41 (32.5%) had sarcopenia and frailty, and the prevalence of nutritional risk and malnutrition was 31.0% (n = 39) and 25.4% (n = 32). Adjusted for age and gender, SMI was correlated with FFP (r = -0.204, p = 0.027), and did not remain significantly when stratified by gender. Stratification according to age revealed in ≥65-years-old population, SMI and FFP were significantly correlated (r = -0.297, p = 0.016), which is not seen in <65-years-old group (r = 0.048, p = 0.748). The multivariate regression analysis showed FFP, BMI, and ECOG were the independent variables associated with sarcopenia (OR 1.536, 95%CI 1.062-2.452, p = 0.042; OR 0.625, 95%CI 0.479-0.815, p = 0.001; OR 7.286, 95%CI 1.779-29.838, p = 0.004). Conclusion Comprehensively assessed sarcopenia is independently associated with frailty based on FFP questionnaire, BMI, and ECOG. Therefore, sarcopenia assessment including m-BIA based SMI, and muscle strength and function could be used to indicate frailty to help select the targeting patients for care. Moreover, in addition to muscle mass, muscle quality should not be ignored in clinical practice.
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Affiliation(s)
- Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-nan Zhen
- Department of Radiotherapy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Han-ping Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Kang Yu,
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Zhou Z, Huang Y, Wang J, Su H, Tang H, Wang Y. A novel digital biomarker of sarcopenia in frail elderly: New combination of gait parameters under dual-task walking. Front Aging Neurosci 2023; 15:1087318. [PMID: 36891555 PMCID: PMC9986265 DOI: 10.3389/fnagi.2023.1087318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Background Frailty caused by deterioration in multiple physiological systems has led to a significant increase in adverse events such as falls, disability, and death in frail older people. Similar to frailty, sarcopenia, defined as loss of skeletal muscle mass and strength, is tightly related to mobility disorders, falls, and fractures. With population aging, co-occurrences of frailty and sarcopenia are increasingly common in the elderly, which are more deleterious for the health and independence of older adults. But the high similarity and overlap between the frailty and sarcopenia increase the difficulty of early recognition of frailty with sarcopenia. The purpose of this study is to use detailed gait assessment to determine the more convenient and sensitive digital biomarker of sarcopenia in the frail population. Methods Ninety-five frail elderly people (age = 86 ± 7 years old, BMI, and body mass index = 23.21 ± 3.40 kg/m2) were screened out by the evaluation of Fried criteria. Then, 41 participants (46%) were identified with sarcopenia, and 51 participants (54%) were identified without sarcopenia. Using a validated wearable platform, participants' gait performance was evaluated under single-task and dual-task (DT). Participants walked back and forth on the 7-m-long trail for 2 min at a habitual speed. Gait parameters of interest include cadence, gait cycle duration, step duration, gait speed, variability of gait speed, stride length, turn duration, and steps in turn. Results Our results showed that compared with the frail elderly without sarcopenia, the gait performance of the sarcopenic group in single-task and dual-task walking was worse. Overall, the parameters with high performance were the gait speed (DT) (OR 0.914; 95% CI 0.868-0.962) and turn duration (DT) (OR 7.907; 95% CI 2.401-26.039) under dual-task conditions, and the AUC in distinguishing between frail older adults with and without sarcopenia was 0.688 and 0.736, respectively. Turn duration in dual-task testing had larger observed effect than gait speed to identify sarcopenia in the frail population, this result remained significant even after controlling for potential confounds. When gait speed (DT) and turn duration (DT) were combined in the model, AUC increased from 0.688 to 0.763. Conclusion This study shows that gait speed and turn duration under dual-task are good predictors of sarcopenia in frail elderly, and turn duration (DT) has a better predictive ability. The gait speed (DT) combined with turn duration (DT) is a potential gait digital Biomarker of sarcopenia in the frail elderly. Dual-task gait assessment and detailed gait indexes provide important value for identification of sarcopenia in frail elderly people.
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Affiliation(s)
- Zheping Zhou
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yulun Huang
- Department of Neurosurgery, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Jing Wang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huan Su
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haiying Tang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yueju Wang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Sotos-Prieto M, Struijk EA, Fung TT, Rodríguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between the quality of plant-based diets and risk of frailty. J Cachexia Sarcopenia Muscle 2022; 13:2854-2862. [PMID: 36177985 PMCID: PMC9745455 DOI: 10.1002/jcsm.13077] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Our aim was to assess the association between plant-based diet quality and risk of frailty. METHODS Prospective cohort consisted with 82 234 women aged ≥60 years from the Nurses' Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to June 23, 2021. Dietary data were collected every 4 years using a validated semi-quantitative food frequency questionnaire. The plant-based diet quality was assessed with two indices (range 18-90 points): (a) healthful plant-based diet index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils and tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets/desserts) and animal foods received reverse scores; and (b) unhealthful plant-based diet index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Frailty incidence was assessed every 4 years, being defined as having three or more of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and their 95% confidence interval (CI). RESULTS We identified 12 910 incident cases of frailty over 1 176 401 person-year follow-up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (hazard ratio [HR] for the highest vs. lowest quintile: 0.77, 95% confidence interval: 0.72-0.81; P trend <0.001). In addition, a 10-unit increment in the hPDI was associated with a relative 15% lower risk of frailty. Conversely, a direct association was found between the uPDI and risk of frailty (HR highest vs. lowest quintile: 1.24 [1.17, 1.32], P trend <0.001). These associations were consistent for each frailty criterion, among participants with no frailty criteria at baseline, after excluding participants with diabetes, cancer and cardiovascular disease at baseline, for alternative versions of the plant-based diet indices (PDIs), in subgroup analysis by categories of potential confounders, and in latency analysis. CONCLUSIONS A healthful plant-based diet was associated with lower risk of frailty whereas an unhealthful plant-based diet was associated with higher risk.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Gupta M, Lehl SS, Lamba AS. Ultrasonography for Assessment of Sarcopenia: A Primer. J Midlife Health 2022; 13:269-277. [PMID: 37324795 PMCID: PMC10266568 DOI: 10.4103/jmh.jmh_234_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/05/2023] [Accepted: 02/13/2023] [Indexed: 06/17/2023] Open
Abstract
The human skeletal muscle has a pivotal role in preserving health by maintaining mobility, balance, and metabolic homeostasis. Significant muscle loss as a part of aging and accelerated by disease leads to sarcopenia which becomes an important predictor of quality of life in older persons. Therefore, clinical screening for sarcopenia and validation by precise qualitative and quantitative measurement of skeletal muscle mass (MM) and function is at the center-stage of translational research. Many imaging modalities are available, each having their strengths and limitations, either in interpretation, technical processes, time constraints, or expense. B-mode ultrasonography (US) is a relatively novel approach to evaluating muscle. It can measure several parameters such as MM and architecture simultaneously including muscle thickness, cross-sectional area, echogenicity, pennate angle, and fascicle length. It can also evaluate dynamic parameters like muscle contraction force and muscle microcirculation. US has not gained global attention due to a lack of consensus on standardization and diagnostic threshold values to diagnose sarcopenia. However, it is an inexpensive and widely available technique with clinical applicability. The ultrasound-derived parameters correlate well with strength and functional capacity and provide potential prognostic information. Our aim is to present an update on the evidence-based role of this promising technique in sarcopenia, its advantages over the existing modalities, and its limitations in actual practice with the hope that it may emerge as the "stethoscope" for community diagnosis of sarcopenia.
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Affiliation(s)
- Monica Gupta
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Sarabmeet Singh Lehl
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Amtoj Singh Lamba
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
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Fernandes AL, Pereira RMR. Frailty in the context of COVID-19 pandemic: A life-threatening condition. Front Med (Lausanne) 2022; 9:965562. [PMID: 36091682 PMCID: PMC9451136 DOI: 10.3389/fmed.2022.965562] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
The pandemic outbreak of coronavirus disease 2019 (COVID-19) has caused emerging challenges for healthcare systems regarding the assistance to the older adult population which, added to the increased life expectancy, may be exposing frail older adults to an increased risk of unfavorable health outcomes. Frailty has a pathogenesis of multifactorial etiology and is defined as a condition characterized by progressive decline in physiological function, weakness, decreased strength, and reduced resilience to stressors, leading to vulnerability and an increased risk of fractures, falls, institutionalization, and death. In the context of COVID-19, frail older adults accounted for approximately 51% of hospitalized patients with confirmed cases and elevated risk of mortality in-hospital. In addition, frailty may be associated with recent “excess mortality” reported by the World Health Organization (WHO) in terms of the full death toll associated directly (due to the disease) or indirectly (due to the pandemic's impact on health systems and society) to COVID-19. Therefore, this mini review aimed to provide a summarized discussion from meta-analyses data regarding the impact of frailty in community-dwelling older adults hospitalized with COVID-19 on short-term mortality risk.
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Shin HE, Won CW, Kim M. Metabolomic profiles to explore biomarkers of severe sarcopenia in older men: A pilot study. Exp Gerontol 2022; 167:111924. [PMID: 35963453 DOI: 10.1016/j.exger.2022.111924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 08/07/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND The pathophysiology of sarcopenia is complex and multifactorial; however, it has not yet been fully elucidated. Identifying metabolomic profiles may help clarify the mechanisms underlying sarcopenia. OBJECTIVE This pilot study explored potential noninvasive biomarkers of severe sarcopenia through metabolomic analysis in community-dwelling older men. METHODS Twenty older men (mean age: 81.9 ± 2.8 years) were selected from the Korean Frailty and Aging Cohort Study. Participants with severe sarcopenia (n = 10) were compared with non-sarcopenic, age- and body mass index-matched controls (n = 10). Severe sarcopenia was defined as low muscle mass, low muscle strength, and low physical performance using the Asian Working Group for Sarcopenia 2019 criteria. Non-targeted metabolomic profiling of plasma metabolites was performed using capillary electrophoresis time-of-flight mass spectrometry and absolute quantification was performed in target metabolites. RESULTS Among 191 plasma metabolic peaks, the concentrations of 10 metabolites significantly differed between severe sarcopenia group and non-sarcopenic controls. The plasma concentrations of L-alanine, homocitrulline, N-acetylserine, gluconic acid, N-acetylalanine, proline, and sulfotyrosine were higher, while those of 4-methyl-2-oxovaleric acid, 3-methyl-2-oxovaleric acid, and tryptophan were lower in participants with severe sarcopenia than in non-sarcopenic controls (all, p < 0.05). Among the 53 metabolites quantified as target metabolites, L-alanine (area under the receiver operating characteristic curve [AUC] = 0.760; p = 0.049), gluconic acid (AUC = 0.800; p = 0.023), proline (AUC = 0.785; p = 0.031), and tryptophan (AUC = 0.800; p = 0.023) determined the presence of severe sarcopenia. CONCLUSIONS Plasma metabolomic analysis demonstrated that L-alanine, gluconic acid, proline, and tryptophan may be potential biomarkers of severe sarcopenia. The identified metabolites can provide new insights into the underlying pathophysiology of severe sarcopenia and serve as the basis for preventive interventions.
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Affiliation(s)
- Hyung Eun Shin
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, South Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, South Korea.
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, South Korea.
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Santos AO, Fernandes MH, Pedreira RBS, Brito TA, Coqueiro RDS, Carneiro JAO. [Maximum expiratory pressure is a good predictor of the incidence of the frailty syndrome in elderly men]. CIENCIA & SAUDE COLETIVA 2022; 27:3249-3260. [PMID: 35894335 DOI: 10.1590/1413-81232022278.02562022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
This article aims to investigate the association between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with the incidence of frailty syndrome (FS), in addition to testing the predictive ability of MIP and MEP to discriminate FS in elderly adults, according to sex. It is a longitudinal study with a five-year follow-up period (2014-2019), carried out with 104 elderly adults registered in the Family Health Strategy of a municipality in Bahia. The incidence of frailty syndrome was diagnosed according to criteria proposed by Fried et al., using data from 2019, after a five-year follow-up. The MIP and MEP were evaluated according to the recommendations of the Brazilian Society of Pulmonology and Phthisiology data in 2014 (baseline data). The total incidence of frailty syndrome was 16.3% (95%CI: 9.2-23.6), with 13.6% (95%CI: 4.56-22.55) in women and 20% (95%CI: 7.85-32.15) in men. The mean values of MIP and MEP were, respectively, 60,8±21,2 cmH2O and 76,7±23,1 cmH2O in women, and 79,5±27,0 cmH2O and 114,7±29,8 cmH2O in men. The frailty syndrome was associated with MEP in elderly adult men (adjusted RR: 0.96; 95%CI: 0.95-0.98; P-value: 0.002), indicating that the increase of 1cmH2O in MEP reduces by 4% the risk of developing the syndrome.
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Affiliation(s)
- Ariana Oliveira Santos
- Universidade Estadual do Sudoeste da Bahia. Av. José Moreira Sobrinho s/n, Jequiezinho. 45205-490 Jequié BA Brasil.
| | - Marcos Henrique Fernandes
- Universidade Estadual do Sudoeste da Bahia. Av. José Moreira Sobrinho s/n, Jequiezinho. 45205-490 Jequié BA Brasil.
| | | | - Thaís Alves Brito
- Universidade Estadual do Sudoeste da Bahia. Av. José Moreira Sobrinho s/n, Jequiezinho. 45205-490 Jequié BA Brasil.
| | - Raildo da Silva Coqueiro
- Universidade Estadual do Sudoeste da Bahia. Av. José Moreira Sobrinho s/n, Jequiezinho. 45205-490 Jequié BA Brasil.
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Wu XL, Shen J, Danzeng CD, Xu XS, Cao ZX, Jiang W. CT psoas calculations on the prognosis prediction of emergency laparotomy: a single-center, retrospective cohort study in eastern Asian population. World J Emerg Surg 2022; 17:31. [PMID: 35655215 PMCID: PMC9164461 DOI: 10.1186/s13017-022-00435-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/25/2022] [Indexed: 12/01/2022] Open
Abstract
Background Emergency laparotomy (EL) has a high mortality rate. Clinically, frail patients have a poor tolerance for EL. In recent years, sarcopenia has been used as an important indicator of frailty and has received much attention. There have been five different calculation methods of psoas for computed tomography (CT) to measure sarcopenia, but lack of assessment of these calculation methods in Eastern Asian EL patients. Methods We conducted a 2-year retrospective cohort study of patients over 18 years of age who underwent EL in our institution. Five CT measurement values (PMI: psoas muscle index, PML3: psoas muscle to L3 vertebral body ratio, PMD: psoas muscle density, TPG: total psoas gauge, PBSA: psoas muscle to body face area ratio) were calculated to define sarcopenia. Patients with sarcopenia defined by the sex-specific lowest quartile of each measurement were compared with the rest of the cohort. The primary outcome was "ideal outcome", defined as: (1) No postoperative complications of Clavien-Dindo Grade ≥ 4; (2) No mortality within 30 days; (3) When discharged, no need for fluid resuscitation and assisted ventilation, semi-liquid diet tolerated, and able to mobilize independently. The second outcome was mortality at 30-days. Multivariate logistic regression and receiver operating characteristic (ROC) analysis were used. Results Two hundred and twenty-eight patients underwent EL met the inclusion criteria, 192 (84.2%) patients had an ideal outcome after surgery; 32 (14%) patients died within 30 days. Multivariate analysis showed that, except PMD, each calculation method of psoas was independently related to clinical outcome (ideal outcome: PML3, P < 0.001; PMI, P = 0.001; PMD, P = 0.157; TPG, P = 0.006; PBSA, P < 0.001; mortality at 30-days: PML3, P < 0.001; PMI, P = 0.002; PMD, P = 0.088; TPG, P = 0.002; PBSA, P = 0.001). In ROC analysis, the prediction model containing PML3 had the largest area under the curve (AUC) value (AUC value = 0.922 and 0.920, respectively). Conclusion The sarcopenia determined by CT psoas measurements is significantly related to the clinical outcome of EL. The calculation of CT psoas measurement is suitable for application in outcome prediction of EL. In the future, it is necessary to develop a scoring tool that includes sarcopenia to evaluate the risk of EL better. Supplementary Information The online version contains supplementary material available at 10.1186/s13017-022-00435-x.
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Affiliation(s)
- Xiao-Lin Wu
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China
| | - Jie Shen
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China
| | - Ci-Dian Danzeng
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China
| | - Xiang-Shang Xu
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China
| | - Zhi-Xin Cao
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China
| | - Wei Jiang
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Av., Wuhan, 430030, Hubei, People's Republic of China.
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Struijk EA, Fung TT, Rodríguez-Artalejo F, Bischoff-Ferrari HA, Hu FB, Willett WC, Lopez-Garcia E. Protein intake and risk of frailty among older women in the Nurses' Health Study. J Cachexia Sarcopenia Muscle 2022; 13:1752-1761. [PMID: 35318829 PMCID: PMC9178161 DOI: 10.1002/jcsm.12972] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/21/2022] [Accepted: 02/15/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is evidence that an overall healthy diet is associated with lower risk of frailty. However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women. METHODS We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow-up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss of ≥5%. The occurrence of frailty was assessed every 4 years from 1992 up to 2014. RESULTS During follow-up, we identified 13 279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; P-trend < 0.001]. In contrast, those with a higher intake of animal protein intake had a higher risk of frailty [relative risks across quintiles of consumption: 1.00, 0.98, 0.99, 1.00, and 1.07; P-trend 0.04]. The intake of total and dairy protein showed no significant association with frailty in the full model. Substituting 5% of energy from plant protein intake at the expense of animal protein, dairy protein, or non-dairy animal protein was associated with 38% (29%, 47%), 32% (21%, 42%), and 42% (33%, 50%) reduced risk of frailty. CONCLUSIONS A higher intake of plant protein, but not animal or dairy protein, was associated with a lower risk of frailty. Substitution of plant protein for animal protein, especially non-dairy animal protein, was associated with lower risk of frailty.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
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Prevalence of Undernutrition, Frailty and Sarcopenia in Community-Dwelling People Aged 50 Years and Above: Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14081537. [PMID: 35458101 PMCID: PMC9032775 DOI: 10.3390/nu14081537] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
The world’s population aged ≥65 is expected to rise from one in eleven in 2019 to one in six by 2050. People aged ≥65 are at a risk of undernutrition, frailty, and sarcopenia. The association between these conditions is investigated in a hospital setting. However, there is little understanding about the overlap and adverse health outcomes of these conditions in community-dwelling people. This systematic review aims to quantify the reported prevalence and incidence of undernutrition, frailty, and sarcopenia among older people aged ≥50 living in community dwellings. Searches were conducted using six databases (AMED, CENTRAL, EMBASE, Web of Science, MEDLINE, and CINAHL), and 37 studies were included. Meta-analyses produced weighted combined estimates of prevalence for each condition (Metaprop, Stata V16/MP). The combined undernutrition prevalence was 17% (95% CI 0.01, 0.46, studies n = 5; participants = 4214), frailty was 13% (95% CI 0.11, 0.17 studies n = 28; participants = 95,036), and sarcopenia was 14% (95% CI 0.09, 0.20, studies n = 9; participants = 7656). Four studies reported incidence rates, of which three included data on frailty. Nearly one in five of those aged ≥50 was considered either undernourished, frail, or sarcopenic, with a higher occurrence in women, which may reflect a longer life expectancy generally observed in females. Few studies measured incidence rates. Further work is required to understand population characteristics with these conditions and the overlap between them. PROSPERO registration No. CRD42019153806.
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Choi JH, Seo JW, Lee MY, Lee YT, Yoon KJ, Park CH. Association between Elevated Plasma Homocysteine and Low Skeletal Muscle Mass in Asymptomatic Adults. Endocrinol Metab (Seoul) 2022; 37:333-343. [PMID: 35144330 PMCID: PMC9081311 DOI: 10.3803/enm.2021.1202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/02/2021] [Accepted: 11/29/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Homocysteine has been drawing attention with a closed linkage with skeletal muscle. However, the association of hyperhomocysteinemia with decreased skeletal muscle mass remains unclear. We aimed to investigate the association of hyperhomocysteinemia with low skeletal muscle mass (LMM) in asymptomatic adults. METHODS This was a cross-sectional study of 114,583 community-dwelling adults without cancer, stroke, or cardiovascular diseases who underwent measurements of plasma homocysteine and body composition analysis from 2012 to 2018. Hyperhomocysteinemia was defined as >15 μmol/L. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)2. Participants were classified into three groups based on SMI: "normal," "mildly low," and "severely low." RESULTS The prevalence of hyperhomocysteinemia was the highest in subjects with severely LMM (12.9%), followed by those with mildly LMM (9.8%), and those with normal muscle mass (8.5%) (P for trend <0.001). In a multivariable logistic regression model, hyperhomocysteinemia was significantly associated with having a mildly LMM (odds ratio [OR], 1.305; 95% confidence interval [CI], 1.224 to 1.392) and severely LMM (OR, 1.958; 95% CI, 1.667 to 2.286), respectively. One unit increment of log-transformed homocysteine was associated with 1.360 and 2.169 times higher risk of having mildly LMM and severely LMM, respectively. CONCLUSION We demonstrated that elevated homocysteine has an independent association with LMM in asymptomatic adults, supporting that hyperhomocysteinemia itself can be a risk for decline in skeletal musculature.
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Affiliation(s)
- Jae-Hyeong Choi
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin-Woo Seo
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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O'Donoghue P, O'Halloran AM, Kenny RA, Romero-Ortuno R. Do the frail experience more adverse events from intensive blood pressure control? A 2-year prospective study in the Irish Longitudinal Study on Ageing (TILDA). EClinicalMedicine 2022; 45:101304. [PMID: 35243271 PMCID: PMC8860911 DOI: 10.1016/j.eclinm.2022.101304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for management of hypertension in adults aged ≥65 years recommend a blood pressure (BP) treatment target of 130-139/70-79 mmHg if tolerated. Randomised controlled trials have advocated for lower BP, but this may have adverse outcomes in the frail. Yet, definitions of frailty vary. METHODS Using a prospective, observational study design, we compared two frailty classifications in their ability to predict short-term adverse outcomes associated with intensive BP control (<130/70 mmHg) in The Irish Longitudinal Study on Ageing (TILDA). Data from participants aged ≥65 treated for hypertension in Wave 1 (W1) between October 2009 and June 2011 were analysed. Frailty was identified by Frailty Phenotype (FP) and the Clinical Frailty Scale (CFS). We formulated 8 participant groups based on frailty-BP combinations. Outcomes at wave 2 (W2) in 2012-2013 were analysed with adjusted binary logistic regression models. FINDINGS Of 1920 W1 participants aged ≥65 and treated for hypertension, 1229 had full BP/FP and 1282 BP/CFS data. While the FP only identified risk of hospitalisation associated with intensive BP treatment, intensively treated frail-by-CFS participants had no increased or decreased risk of adverse outcomes, but those treated above the target had a higher risk of falls/fractures. In the non-frail by FP, intensive blood pressure treatment was associated with reduced risk of falls/fractures. INTERPRETATION Different frailty classifications may have different prognostic implications for the purpose of the application of hypertension management guidelines. Our study had limited power due to low frailty prevalences, so further research is needed. Guidelines should specify the recommended frailty identification method/s. In the frail, therapy personalisation is needed.
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Affiliation(s)
- Patrick O'Donoghue
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, St. James's Hospital, Mercer's Institute for Successful Ageing, James's Street, Dublin 8, Dublin, Ireland
- Corresponding author at: Discipline of Medical Gerontology, St. James's Hospital, Mercer's Institute for Successful Ageing, James's Street, Dublin 8, Dublin, Ireland.
| | - Aisling M. O'Halloran
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, St. James's Hospital, Mercer's Institute for Successful Ageing, James's Street, Dublin 8, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, St. James's Hospital, Mercer's Institute for Successful Ageing, James's Street, Dublin 8, Dublin, Ireland
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Pujia R, Tarsitano MG, Arturi F, De Lorenzo A, Lenzi A, Pujia A, Montalcini T. Advances in Phenotyping Obesity and in Its Dietary and Pharmacological Treatment: A Narrative Review. Front Nutr 2022; 9:804719. [PMID: 35242796 PMCID: PMC8885626 DOI: 10.3389/fnut.2022.804719] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/21/2022] [Indexed: 12/20/2022] Open
Abstract
In recent times, it has become evident that there are individuals who, from a metabolic point of view, are affected by obesity but have a normal body mass index. There are also metabolically healthy individuals with a high body mass index who are thus are considered as to be affected by obesity obese. Understanding that individuals with obesity are phenotypically heterogeneous is a relatively novel concept which, although present in the scientific literature, unfortunately has not yet had an impact in clinical practice. However, common dietary approaches are not effective in treating large numbers of obese patients with obesity. This narrative review, based on the material searched via PubMed and the Web of Science up to October 2021, proposes a downsizing of the role of the body mass index in identifying the individual with "true obesity" since it is only partially useful, and suggests a new approach which also integrates the body composition and assessment of metabolic parameters. This approach leads to personalized therapies that work best for each obesity phenotype in reducing the risk of non-communicable diseases.
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Affiliation(s)
- Roberta Pujia
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Antonino De Lorenzo
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
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Struijk EA, Fung TT, Sotos-Prieto M, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Red meat consumption and risk of frailty in older women. J Cachexia Sarcopenia Muscle 2022; 13:210-219. [PMID: 34755477 PMCID: PMC8818608 DOI: 10.1002/jcsm.12852] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Red meat is a nutrient-dense source of protein fundamental for older adults; however, red meat is also high in detrimental components, including saturated fat. It is unclear whether habitual red meat consumption is associated with risk of frailty. This study aimed to examine the prospective association between the consumption of total, unprocessed, and processed red meat and the risk of frailty in older adults. METHODS We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Consumption of total, unprocessed, and processed red meat was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses, and unintentional weight loss ≥5%. The occurrence of frailty was assessed every four years from 1992 to 2014. RESULTS During 22 years of follow-up (median follow-up 14 years), we identified 13 279 incident cases of frailty. Women with a higher intake of red meat showed an increased risk of frailty after adjustment for lifestyle factors, medication use, and dietary factors. The relative risk (95% confidence interval) for one serving/day increment in consumption was 1.13 (1.08, 1.18) for total red meat, 1.08 (1.02, 1.15) for unprocessed red meat, and 1.26 (1.15, 1.39) for processed red meat. When each component of the frailty syndrome was individually examined, each of them was positively associated with total red meat consumption, except for the weight loss criterion. Replacing one serving/day of unprocessed red meat with other protein sources was associated with significantly lower risk of frailty; the risk reduction estimates were 22% for fish and 14% for nuts, while for replacement of processed red meat, the percentages were 33% for fish, 26% for nuts, 13% for legumes, and 16% for low-fat dairy. CONCLUSIONS Habitual consumption of unprocessed and processed red meat was associated with a higher risk of frailty. Replacement of red meat by other protein sources might reduce the risk of frailty. These findings are in line with dietary guidelines promoting diets that emphasize plant-based sources of protein.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
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Meng L, Shi H, Wang DG, Shi J, Wu WB, Dang YM, Fan GQ, Shen J, Yu PL, Dong J, Yang RY, Xi H. Specific Metabolites Involved in Antioxidation and Mitochondrial Function Are Correlated With Frailty in Elderly Men. Front Med (Lausanne) 2022; 9:816045. [PMID: 35155500 PMCID: PMC8833032 DOI: 10.3389/fmed.2022.816045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/04/2022] [Indexed: 01/14/2023] Open
Abstract
BackgroundAs an age-related syndrome, frailty may play a central role in poor health among older adults. Sarcopenia overlaps with the physical domain of frailty, and most existing studies have analyzed the associated factors of frailty and sarcopenia as an isolated state. Perturbations in metabolism may play an important role in the presence of frailty or sarcopenia; however, the metabolites associated with frailty, especially overlapping with sarcopenia remain unclear. In this study, we aimed to explore whether amino acids, carnitines, acylcarnitines and lysophosphatidylcholines, as specific panels, are significantly correlated with frailty, especially overlapping with sarcopenia, to gain insight into potential biomarkers and possible biological mechanisms and to facilitate their management.MethodsWe applied a targeted high-performance liquid chromatography-tandem mass spectrometry approach in serum samples from 246 Chinese older men (age 79.2 ± 7.8 years) with frailty (n = 150), non-frailty (n = 96), frailty and sarcopenia (n = 52), non-frail and non-sarcopenic control (n = 85). Frailty was evaluated using Freid phenotype criteria, sarcopenia was defined by diagnostic algorithm of Asian Working Group on Sarcopenia, and the participants were diagnosed as frailty and sarcopenia when they met the evaluation criteria of both frailty and sarcopenia. A panel of 29 metabolomic profiles was assayed and included different classes of amino acids, carnitines, acylcarnitines, and lysophosphatidylcholines (LPCs). Multivariate logistic regression was used to screen the metabolic factors contributing to frailty status, and orthogonal partial least squares discriminant analysis was used to explore important factors and distinguish different groups.ResultsIn older men demonstrating the frail phenotype, amino acid perturbations included lower tryptophan and higher glycine levels. With regard to lipid metabolism, the frailty phenotype was characterized by lower concentrations of isovalerylcarnitine (C5), LPC16:0 and LPC18:2, while higher levels of octanoyl-L-carnitine (C8), decanoyl-L-carnitine (C10), dodecanoyl-L-carnitine (C12) and tetradecanoyl-L-carnitine (C14). After adjusting for several clinical confounders, tryptophan, LPC18:2, LPC 16:0 and C5 were negatively correlated with frailty, and C8 and C12 were positively related to frailty. We preliminarily identified metabolic profiles (LPC16:0, LPC18:2, glycine and tryptophan) that may distinguish older men with frailty from those without frailty. Importantly, a set of serum amino acids and LPCs (LPC16:0, LPC18:2, and tryptophan) was characterized in the metabotype of older adults with an overlap of frailty and sarcopenia. The metabolites that were most discriminating of frailty status implied that the underlying mechanism might be involved in antioxidation and mitochondrial dysfunction.ConclusionsThese present metabolic analyses may provide valuable information on the potential biomarkers and possible biological mechanisms of frailty, and overlapping sarcopenia. The findings obtained may offer insight into their management in older adults.
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Affiliation(s)
- Li Meng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Shi
- Department of Geriatrics, National Clinical Research Center for Geriatrics, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Da-guang Wang
- Department of Laboratory Medicine, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Shi
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Wen-bin Wu
- Department of Geriatrics, National Clinical Research Center for Geriatrics, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ya-min Dang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Guo-qing Fan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Ji Shen
- Department of Geriatrics, National Clinical Research Center for Geriatrics, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Pu-lin Yu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Dong
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui-yue Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital/National Center of Gerontology of National Health Commission, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Rui-yue Yang
| | - Huan Xi
- Department of Geriatrics, National Clinical Research Center for Geriatrics, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Huan Xi
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Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S, Del Grande F, Sconfienza LM. Sarcopenia: imaging assessment and clinical application. Abdom Radiol (NY) 2022; 47:3205-3216. [PMID: 34687326 PMCID: PMC8536908 DOI: 10.1007/s00261-021-03294-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023]
Abstract
Sarcopenia is a progressive, generalized skeletal muscle disorder characterized by reduction of muscle mass and strength. It is associated with increased adverse outcomes including falls, fractures, physical disability, and mortality, particularly, in elderly patients. Nowadays, sarcopenia has become a specific imaging biomarker able to predict clinical outcomes of patients. Muscle fibre reduction has shown to be an unfavourable pre-operative predictive factor in patients with cancer, and is associated with worse clinical outcomes in terms of postoperative complications, morbidity, mortality, and lower tolerance of chemoradiation therapy. Several imaging modalities, including dual-energy X-ray absorptiometry, CT, MRI, and US can be used to estimate muscle mass and quality to reach the diagnosis of sarcopenia. This article reviews the clinical implications of sarcopenia, how this condition can be assessed through different imaging modalities, and future perspectives of imaging of sarcopenia.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland ,Ospedale Evangelico Betania, Napoli, Italy
| | - Domenico Albano
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy ,grid.10776.370000 0004 1762 5517Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Salvatore Gitto
- grid.4708.b0000 0004 1757 2822Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Gaetano Ruffo
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
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Wang M, Liang H, Cui L. Clinical practice of Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture: A propensity score matched analysis. Appl Nurs Res 2021; 62:151491. [PMID: 34814995 DOI: 10.1016/j.apnr.2021.151491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fragility hip fracture (FHF) is a significant cause of morbidity and mortality in older adults. In 2018, Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture (NSOF) were released by The International Collaboration of Orthopaedic Nursing (ICON). However, there are only limited clinical data about the application of this standard in clinical practice in China. AIMS To determine the clinical practice effect of the NSOF. METHODS A retrospective single-centre cohort study was performed from January 2016 to June 2020. Patients were divided into the standardized nursing care group (SN group) and the conventional nursing care group (CN group) depending on whether they were cared for according to the NSOF criteria. The propensity score matched (PSM) analysis was conducted in this study. The perioperative and follow-up outcomes between the two groups were analyzed. RESULTS A total of 204 patients diagnosed with FHF were included in the study. After a 1:1 matching, 56 cases were identified in the SN group as well as the CN group. Patients in the SN group had significantly shorter preoperative wait times for surgery (17.4 ± 4.6 vs. 24.4 ± 7.6 h, p < 0.05) and a higher proportion of individuals performing exercise within 24 h after surgery (94.6% vs. 66.1%, p < 0.05). Notably, patients in the SN group also had a significantly shorter length of stay than those in the CN group (9.4 ± 3.1 vs. 14.2 ± 5.1 days, p < 0.05). At the 6-month follow-up, the incidence of refracture was significantly lower (3.6% vs. 14.3%, p < 0.05), and the timed up and go mobility index was improved in the SN group compared to the CN group (20.3 ± 1.7 vs. 24.6 ± 2.2 s, p < 0.05). CONCLUSION This study showed that application of the NSOF resulted in a significant improvement in the treatment of older adults patients with FHF.
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Affiliation(s)
- Meng Wang
- Department of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China
| | - Hongyin Liang
- Department of General Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China
| | - Lin Cui
- Department of Orthopedic, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China.
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Takamura M, Sone T, Kawamura T, Suzuki R, Moriyama N, Yasumura S. A Cross-Sectional Study on the Characteristics of Physical Activity in Pre-Frail Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12328. [PMID: 34886059 PMCID: PMC8657243 DOI: 10.3390/ijerph182312328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/13/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022]
Abstract
This cross-sectional study aimed to characterize the physical activity (PA) of older adults with pre-frail status by examining sedentary behavior (SB) and PA using triaxial accelerometer data, with non-frail older adults as the control group. In this study, we divided the study participants into older adults who regularly participated in self-initiated citizen group exercise activities and those who did not. Data were collected between September and December 2017. We analyzed data from 256 older adults (women: 86.3%) aged ≥65 years. The interaction effect of participation status (participation and non-participation group) and frailty status (pre-frail and non-frail group) for moderate-to-vigorous PA (F = 9.178, p = 0.003) and daily mean number of steps (F = 9.351, p = 0.002) was significant. For the participation group, there was no difference between pre-frail older adults and non-frail older adults regarding length of SB and PA time, indicating that PA level was maintained in the participating pre-frail older adults. In contrast, moderate-to-vigorous PA and daily mean number of steps were low in pre-frail older adults who did not participate in the activities. The opportunity to participate in self-initiated group exercise activities and other PAs in the community may help pre-frail older adults maintain their PA.
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Affiliation(s)
- Motoaki Takamura
- Faculty of Health Sciences, Tohoku Fukushi University, Sendai 981-8522, Japan;
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan; (N.M.); (S.Y.)
| | - Toshimasa Sone
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima 960-1247, Japan;
| | - Takayuki Kawamura
- Faculty of Health Sciences, Tohoku Fukushi University, Sendai 981-8522, Japan;
- YOBOU-FUKUSHI Health Promotion Center, Tohoku Fukushi University, Sendai 981-8522, Japan;
| | - Reiko Suzuki
- YOBOU-FUKUSHI Health Promotion Center, Tohoku Fukushi University, Sendai 981-8522, Japan;
| | - Nobuaki Moriyama
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan; (N.M.); (S.Y.)
| | - Seiji Yasumura
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan; (N.M.); (S.Y.)
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Lee D, Kim M, Won CW. Common and different characteristics among combinations of physical frailty and sarcopenia in community-dwelling older adults: The Korean Frailty and Aging Cohort Study. Geriatr Gerontol Int 2021; 22:42-49. [PMID: 34816568 DOI: 10.1111/ggi.14314] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/21/2021] [Accepted: 11/02/2021] [Indexed: 12/15/2022]
Abstract
AIM Physical frailty and sarcopenia are geriatric syndromes associated with adverse health outcomes. However, the common and different conditions associated with physical frailty and sarcopenia remain unclear. This study aimed to compare the clinical characteristics of older adults with physical frailty and sarcopenia. METHODS This cross-sectional study analyzed 2028 community-dwelling older adults, aged 70-84 years (mean age 75.9 ± 4.0 years; 50.1% men). Physical frailty was defined using the Fried frailty phenotype, whereas sarcopenia was defined using the Asian Working Group for Sarcopenia 2014 and 2019 criteria. RESULTS The prevalence of physical frailty was 5.5%, whereas that of sarcopenia, using the Asian Working Group for Sarcopenia 2014 and 2019, was 9.1% and 17.5%, respectively. The concordance of physical frailty with sarcopenia was higher in the Asian Working Group for Sarcopenia 2019 criteria than in 2014. Frail-only participants had a higher incidence of disability, cognitive dysfunction, poor self-perceived health, and depressive symptoms than the sarcopenic-only participants. Frail-and-sarcopenic participants showed a lower body mass index (≥23 kg/m2 ) than frail-only participants. Furthermore, in frail-and-sarcopenic participants, recurrent falls (16.9% vs 5.5%) were higher than in the neither-frail-nor-sarcopenic participants; falls with fracture (11.5% vs 1.7%) and fear of falling (59.0% vs 36.7%) were higher in frail-and-sarcopenic participants than in sarcopenic-only participants. CONCLUSIONS This study showed significant differences between physical frailty and sarcopenia among community-dwelling older adults. Older adults with physical frailty and sarcopenia were more likely to have higher fall-related outcomes than the others. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Daehyun Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.,Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Gemikonakli G, Mach J, Hilmer SN. Interactions Between the Aging Gut Microbiome and Common Geriatric Giants: Polypharmacy, Frailty, and Dementia. J Gerontol A Biol Sci Med Sci 2021; 76:1019-1028. [PMID: 32064521 DOI: 10.1093/gerona/glaa047] [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: 07/26/2019] [Indexed: 12/13/2022] Open
Abstract
The gut microbiome has pervasive bidirectional relationships with pharmacotherapy, chronic disease, and physical and cognitive function. We conducted a narrative review of the current literature to examine the relationships between the gut microbiome, medication use, sarcopenia and frailty, and cognitive impairment. Data from in vitro experiments, in vivo experiments in invertebrates and complex organisms, and humans indicate associations between the gut microbiome and geriatric syndromes. Better understanding of the direct and indirect roles of the microbiome may inform future prevention and management of geriatric syndromes.
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Affiliation(s)
- Gizem Gemikonakli
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - John Mach
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Sarah Nicole Hilmer
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
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Reduced uremic metabolites are prominent feature of sarcopenia, distinct from antioxidative markers for frailty. Aging (Albany NY) 2021; 13:20915-20934. [PMID: 34492634 PMCID: PMC8457568 DOI: 10.18632/aging.203498] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/24/2021] [Indexed: 12/19/2022]
Abstract
Due to global aging, frailty and sarcopenia are increasing. Sarcopenia is defined as loss of volume and strength of skeletal muscle in elderlies, while frailty involves multiple domains of aging-related dysfunction, impaired cognition, hypomobility, and decreased social activity. However, little is known about the metabolic basis of sarcopenia, either shared with or discrete from frailty. Here we analyzed comprehensive metabolomic data of human blood in relation to sarcopenia, previously collected from 19 elderly participants in our frailty study. Among 131 metabolites, we identified 22 sarcopenia markers, distinct from 15 frailty markers, mainly including antioxidants, although sarcopenia overlaps clinically with physical frailty. Notably, 21 metabolites that decline in sarcopenia or low SMI are uremic compounds that increase in kidney dysfunction. These comprise TCA cycle, urea cycle, nitrogen, and methylated metabolites. Sarcopenia markers imply a close link between muscle and kidney function, while frailty markers define a state vulnerable to oxidative stress.
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47
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Gronek J, Boraczyński M, Gronek P, Wieliński D, Tarnas J, Marszałek S, Tang YY. Exercise in Aging: Be Balanced. Aging Dis 2021; 12:1140-1149. [PMID: 34341697 PMCID: PMC8279522 DOI: 10.14336/ad.2021.0107] [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: 10/28/2020] [Accepted: 01/07/2021] [Indexed: 01/12/2023] Open
Abstract
The beneficial effects of exercise are recognized for preventing physical and cognitive decline during the aging process. However, there is still a gap concerning recommended intensity, volume, frequency and mode of exercise especially for older people. The aim of this study was to investigate an appropriate type of physical activity (PA) model for healthy aging. A commentary of the influence of PA and exercise on healthy aging through an online search of the databases Web of Science, PubMed and Google Scholar. Two living groups can be considered as potential references: modern hunter-gatherer small-scale population and master athletes. Greater physical activity is proposed for healthy aging than that recommended by WHO. Additionally, mindfulness meditation techniques during exercise are recommended especially for persons practicing long-duration exercises. Complex and compound exercise and workouts should include challenging exercises adjusted and balanced to provide clients, especially older people, with noticeable changes and progress.
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Affiliation(s)
- Joanna Gronek
- 1Department of Dance, Poznań University of Physical Education, Poland
| | - Michał Boraczyński
- 2Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Poland
| | - Piotr Gronek
- 1Department of Dance, Poznań University of Physical Education, Poland
| | - Dariusz Wieliński
- 3Department of Anthropology and Biometry, Poznań University of Physical Education, Poland
| | - Jacek Tarnas
- 4Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poland
| | - Sławomir Marszałek
- 5Department of Physiotherapy, Poznań University of Physical Education, Poland.,6Department of Physiotherapy, Poznań University of Medical Sciences, Poland
| | - Yi-Yuan Tang
- 7Department of Psychological Sciences, Texas Tech University, USA
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48
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Feng H, Wang X, Mao L, Yu Z, Cui B, Lin L, Hui Y, Zhao X, Xu X, Fan X, Wang B, Yu Q, Jiang K, Sun C. Relationship between sarcopenia/myosteatosis and frailty in hospitalized patients with cirrhosis: a sex-stratified analysis. Ther Adv Chronic Dis 2021; 12:20406223211026996. [PMID: 34377386 PMCID: PMC8320564 DOI: 10.1177/20406223211026996] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/03/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Previous studies have shown that sarcopenia appears to be a significant contributor to physical frailty among outpatients with cirrhosis. However, the evidence is scant regarding the relationship between sarcopenia and multi-dimensional frailty among inpatients. We aimed to investigate the potential contribution of sarcopenia to frailty in hospitalized patients with cirrhosis in a sex-dependent manner. Methods: This cohort enrolled consecutive cirrhotics. Muscle quantity and quality were assessed using the computed tomography-based skeletal muscle index (SMI) and intramuscular adipose tissue content, respectively. Frailty phenotype was clarified by a self-reported Frailty Index. Multiple linear regression determined the association between sarcopenia and frailty phenotype. Results: A total of 202 cirrhotic patients with 48.5% male were included. The median Frailty Index was 0.13, rendering 17.3% subjects as frail. Among the 16 frail men, 68.8% had sarcopenia and 62.5% exhibited myosteatosis. In contrast, among the 19 frail women, 26.3% had sarcopenia and 15.8% exhibited myosteatosis. Frail patients had a significantly lower median SMI (42.80 cm2/m2) compared with those with pre-frailty (48.23 cm2/m2) and with robust status (50.82 cm2/m2) in the male but not the female group. In male patients, multivariate linear regression implicated age (β = 0.330, p < 0.001), SMI (β = −0.260, p < 0.001), albumin (β = −0.245, p = 0.005), and sodium (β = −0.179, p = 0.037) as independent risk factors for frailty. Conclusion: Sarcopenia is associated with multi-dimensional frailty in male patients with cirrhosis. It is tempting to incorporate sex-specific intervention with the purpose of mitigating frailty among inpatients.
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Affiliation(s)
- Hongjuan Feng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China Department of Nutriology, Tianjin Third Central Hospital, Tianjin, China
| | - Xiaoyu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lihong Mao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zihan Yu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Binxin Cui
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Lin Lin
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Yangyang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xingliang Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Xu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qingxiang Yu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
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Lee MC, Tu YT, Lee CC, Tsai SC, Hsu HY, Tsai TY, Liu TH, Young SL, Lin JS, Huang CC. Lactobacillus plantarum TWK10 Improves Muscle Mass and Functional Performance in Frail Older Adults: A Randomized, Double-Blind Clinical Trial. Microorganisms 2021; 9:microorganisms9071466. [PMID: 34361902 PMCID: PMC8305125 DOI: 10.3390/microorganisms9071466] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 12/27/2022] Open
Abstract
Sarcopenia is a condition in which there is a loss of muscle caused by aging and it is one of the most significant factors that affects physical fragility. In recent years, the role of the gut–muscle axis has garnered attention as, along with the gut microbiota, it potentially plays a significant role in muscle regeneration, in addition to nutritional supplements and exercise training. Past studies have found that supplementation with Lactobacillus plantarum TWK10 could effectively increase the muscle mass of animals or adult humans. Therefore, in this study, we investigated whether the supplementation of L. plantarum TWK10 produces increased muscle mass and improves the functional performance of elderly persons with mild fragility. A total of 68 elderly subjects were recruited, of which 13 subjects were excluded or withdrew from the study. We adopted a double-blind design, and the 55 subjects were randomly divided into three groups: the placebo group, the TWK10 low-dose group (2 × 1010 CFU/day) (TWK10-L), and the TWK10 high-dose group (6 × 1010 colony-forming unit (CFU)/day) (TWK10-H). For 18 weeks, all subjects were required to regularly take experimental samples, perform functional activity testing, and have their body composition analyzed before the study and every six weeks after the intervention. Finally, 17 subjects in the placebo group, 12 subjects in the TWK10-L group, and 13 subjects in the TWK10-H group finished the study. It was found that supplementation with TWK10 had a tendency to increase and improve muscle mass, left hand grip strength, lower limb muscle strength, and gait speed and balance after the sixth week, especially in the TWK10-H group, and, as the supplement time was longer up to the 18th week, it had an even greater effect (p < 0.05). In conclusion, consecutive supplementation of L. plantarum TWK10 for more than six weeks could effectively improve the muscle strength and endurance of the elderly, reducing sarcopenia and physical fragility. This trial was registered as NCT04893746.
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Affiliation(s)
- Mon-Chien Lee
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (M.-C.L.); (Y.-T.T.)
| | - Yu-Tsai Tu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (M.-C.L.); (Y.-T.T.)
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Zhongxiao Branch, Taipei City 11556, Taiwan
| | - Chia-Chia Lee
- Culture Collection & Research Institute, SYNBIO TECH INC., Kaohsiung City 82151, Taiwan; (C.-C.L.); (H.-Y.H.); (S.-L.Y.)
| | - Shiow-Chwen Tsai
- Institute of Sports Sciences, University of Taipei, Taipei City 112, Taiwan;
| | - Han-Yin Hsu
- Culture Collection & Research Institute, SYNBIO TECH INC., Kaohsiung City 82151, Taiwan; (C.-C.L.); (H.-Y.H.); (S.-L.Y.)
| | - Tsung-Yu Tsai
- Department of Food Science, Fu Jen Catholic University, New Taipei City 24205, Taiwan; (T.-Y.T.); (T.-H.L.)
| | - Te-Hua Liu
- Department of Food Science, Fu Jen Catholic University, New Taipei City 24205, Taiwan; (T.-Y.T.); (T.-H.L.)
| | - San-Land Young
- Culture Collection & Research Institute, SYNBIO TECH INC., Kaohsiung City 82151, Taiwan; (C.-C.L.); (H.-Y.H.); (S.-L.Y.)
| | - Jin-Seng Lin
- Culture Collection & Research Institute, SYNBIO TECH INC., Kaohsiung City 82151, Taiwan; (C.-C.L.); (H.-Y.H.); (S.-L.Y.)
- Correspondence: (J.-S.L.); (C.-C.H.); Tel.: +886-7-6955680 (J.-S.L.); +886-3-328-3201 (ext. 2604) (C.-C.H.)
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (M.-C.L.); (Y.-T.T.)
- Correspondence: (J.-S.L.); (C.-C.H.); Tel.: +886-7-6955680 (J.-S.L.); +886-3-328-3201 (ext. 2604) (C.-C.H.)
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50
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Roberts S, Collins P, Rattray M. Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review. Nutrients 2021; 13:nu13072316. [PMID: 34371823 PMCID: PMC8308465 DOI: 10.3390/nu13072316] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022] Open
Abstract
Malnutrition, frailty and sarcopenia are becoming increasingly prevalent among community-dwelling older adults; yet are often unidentified and untreated in community settings. There is an urgent need for community-based healthcare professionals (HCPs) from all disciplines, including medicine, nursing and allied health, to be aware of, and to be able to recognise and appropriately manage these conditions. This paper provides a comprehensive overview of malnutrition, frailty and sarcopenia in the community, including their definitions, prevalence, impacts and causes/risk factors; and guidance on how these conditions may be identified and managed by HCPs in the community. A detailed description of the care process, including screening and referral, assessment and diagnosis, intervention, and monitoring and evaluation, relevant to the community context, is also provided. Further research exploring the barriers/enablers to delivering high-quality nutrition care to older community-dwelling adults who are malnourished, frail or sarcopenic is recommended, to inform the development of specific guidance for HCPs in identifying and managing these conditions in the community.
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Affiliation(s)
- Shelley Roberts
- School of Health Sciences and Social Work, Griffith University, Gold Coast 4222, Australia;
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
- Allied Health Research, Gold Coast Hospital and Health Service, Gold Coast 4219, Australia
- Correspondence: ; Tel.: +61-7-5552-9557
| | - Peter Collins
- Dietetics and Food Services, Mater Health, Brisbane 4101, Australia;
- Mater Research Institute, University of Queensland, Brisbane 4101, Australia
| | - Megan Rattray
- School of Health Sciences and Social Work, Griffith University, Gold Coast 4222, Australia;
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