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Okoye C, Morelli V, Franchi R, Mazzarone T, Guarino D, Maccioni L, Cargiolli C, Calsolaro V, Niccolai F, Virdis A. Usefulness of the SARC-F questionnaire and the measurement of the hand grip strength in predicting short-term mortality in older patients hospitalized for acute heart failure. Eur Geriatr Med 2024:10.1007/s41999-024-01054-2. [PMID: 39333443 DOI: 10.1007/s41999-024-01054-2] [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: 04/08/2024] [Accepted: 08/29/2024] [Indexed: 09/29/2024]
Abstract
PURPOSE Sarcopenia is a potentially reversible syndrome that increases the risk of cardiogenic cachexia and adverse outcomes in older patients with heart failure (HF). Despite its clinical significance, sarcopenia remains underdiagnosed due to the complexities of comprehensive assessment in patients with acute HF. This study aimed to evaluate whether the SARC-F questionnaire, its inviduals components, and the handgrip strength test (HGS) can predict short-term prognostic risk in very old patients recently discharged after acute HF. METHODS We consecutively enrolled patients aged 75 years or older hospitalized with acute HF in the Geriatrics Unit of a tertiary care hospital. All patients underwent physical examination, complete blood tests, point-of-care ultrasound, and a comprehensive geriatric assessment, including physical performance through SARC-F and HGS. The thirty-day post-discharge mortality rate was assessed by phone interview. RESULTS Out of 184 patients hospitalized with acute HF who were enrolled in the study (mean [SD], 86.8 [5.9] years, 60.3% female), 47 died within 30 days after discharge. By multivariate logistic analysis, HGS (β = - 0.73 ± 0.03, p = 0.008) and SARC-F [adjusted OR = 1.18 (CI 95% 1.03-1.33), p = 0.003] resulted independently associated with mortality. Furthermore, two SARC-F sub-items, namely, limitation in rising from a chair and history of falls [aOR: 3.26 (CI95% 1.27-8.34), p = 0.008; aOR: 3.30 (CI 95% 1.28-8.49), p = 0.01; respectively] emerged as determinants of 30-days mortality. CONCLUSION SARC-F and HGS test independently predict 30-day post-discharge mortality in oldest-old patients hospitalized for acute HF.
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Affiliation(s)
- Chukwuma Okoye
- School of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milano, MI, Italy.
- Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
| | - Virginia Morelli
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | | | - Tessa Mazzarone
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Daniela Guarino
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Lorenzo Maccioni
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Cristina Cargiolli
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Valeria Calsolaro
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Filippo Niccolai
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Agostino Virdis
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy
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Noda T, Kamiya K. Response to the Letter to the editor - 'Labeling sarcopenia in cardiovascular patients with SARC-F? A definite faux pas' by Abdulsalam et al. Eur J Cardiovasc Nurs 2024; 23:e119-e120. [PMID: 38788699 DOI: 10.1093/eurjcn/zvae079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Takumi Noda
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, Japan
- Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0329, Japan
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Noda T, Kamiya K, Hamazaki N, Yamashita M, Miki T, Nozaki K, Uchida S, Ueno K, Maekawa E, Terada T, Reed JL, Yamaoka-Tojo M, Matsunaga A, Ako J. Screening for sarcopenia with SARC-F in older patients hospitalized with cardiovascular disease. Eur J Cardiovasc Nurs 2024; 23:675-684. [PMID: 38315615 DOI: 10.1093/eurjcn/zvae017] [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: 06/14/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
AIMS SARC-F ≥ 4 points are used for detecting sarcopenia; however, finding a lower SARC-F cut-off value may lead to early detection of sarcopenia. We investigated the SARC-F score with the highest sensitivity and specificity values to identify sarcopenia in older patients with cardiovascular disease (CVD). Motor performances were also examined for each SARC-F score. METHODS AND RESULTS This retrospective cross-sectional study examined the sensitivity and specificity of every 1-point increase in the SARC-F score to predict sarcopenia. Eligible participants included patients with CVD (≥65 years old) who were admitted for acute CVD treatment and participated in cardiac rehabilitation. Patients completed the SARC-F questionnaire and the sarcopenia assessment. Area under the curves (AUCs) were investigated for the ability to predict sarcopenia. Multivariable linear regression was used to compare the mean value of physical functions (e.g. walking speed, leg strength, and 6 min walking distance) of each SARC-F score. A total of 1066 participants (63.8% male; median age: 76 years) were included. Sarcopenia was present in 401 patients. A SARC-F cut-off ≥2 presented the optimal balance between sensitivity (68.3%) and specificity (55.6%) to detect sarcopenia (AUCs = 0.658; 95% confidence interval: 0.625-0.691). When the patients had low scores (1-3), every 1 point increase in the SARC-F score was associated with lower physical functions such as lower muscle strength and shorter walking distance (all P < 0.001). CONCLUSION A SARC-F cut-off ≥2 was optimal for screening sarcopenia, and even a low SARC-F score is useful in detecting sarcopenia and low physical function at an early stage in patients with CVD.
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Affiliation(s)
- Takumi Noda
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street Ottawa, Ontario K1Y 4W7, Canada
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0329, Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Division of Research, ARCE Inc., 4-2-1F Sakae-cho, Minami-ku, Sagamihara 252-0306, Japan
| | - Takashi Miki
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375, Japan
| | - Shota Uchida
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Kensuke Ueno
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375, Japan
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street Ottawa, Ontario K1Y 4W7, Canada
- School of Life Sciences, Physiology, Metabolism & Nutrition Research Group, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street Ottawa, Ontario K1Y 4W7, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Montpetit Hall 125 University, Room 240, Ottawa, Ontario K1N 6N5, Canada
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0329, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0329, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375, Japan
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Fukushima T, Katsushima U, Ogushi N, Hase K, Nakano J. Physical activity and prognosis and factors associated with low physical activity in patients with advanced or recurrent lung cancer: a retrospective, observational study. BMJ Support Palliat Care 2024:spcare-2024-005122. [PMID: 39237354 DOI: 10.1136/spcare-2024-005122] [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: 08/06/2024] [Accepted: 08/18/2024] [Indexed: 09/07/2024]
Abstract
OBJECTIVES To investigate the relationship between physical activity and prognosis, and the significant factors associated with physical activity in patients with advanced or recurrent lung cancer. METHODS This retrospective, observational study enrolled 50 outpatients with lung cancer who received chemotherapy. Patients were evaluated for physical function, physical activity (International Physical Activity Questionnaire-Short Form), and nutritional status (Mini Nutritional Assessment-Short Form [MNA-SF]). The relationship between physical activity and prognosis was examined using the log-rank test and Cox proportional hazards model. Multivariate logistic regression analysis was performed to examine factors associated with low physical activity. A receiver operating characteristic curve was used to calculate the MNA-SF cut-off value for low physical activity. RESULTS Low physical activity was significantly associated with survival (HR, 4.35; 95% confidence interval [CI], 1.16-16.27; p=0.029). The MNA-SF was a significant factor associated with low physical activity (OR, 0.71; 95% CI, 0.52 to 0.98; p=0.038). The MNA-SF cut-off value for low physical activity was 9.5 points. CONCLUSIONS Low physical activity may be a prognostic factor in lung cancer, with nutritional status associated with low physical activity. Regular assessments using the MNA-SF cut-off and physical activity interventions considering nutrition are needed in clinical practice.
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Affiliation(s)
- Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
| | - Utae Katsushima
- Department of Thoracic Oncology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Naoya Ogushi
- Department of Rehabilitation, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - Kimitaka Hase
- Department of Physical Medicine & Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Osaka, Japan
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Varjan M, Žiška Böhmerová Ľ, Oreská Ľ, Schickhofer P, Hamar D. In elderly individuals, the effectiveness of sensorimotor training on postural control and muscular strength is comparable to resistance-endurance training. Front Physiol 2024; 15:1386537. [PMID: 39234306 PMCID: PMC11371677 DOI: 10.3389/fphys.2024.1386537] [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: 02/15/2024] [Accepted: 08/06/2024] [Indexed: 09/06/2024] Open
Abstract
While classical resistance exercise is an effective way to improve strength and control postural sway, it may not be suitable for some elderly individuals with specific health disorders (e.g., aneurysms). Therefore, there is a need to explore alternative modalities. The study aimed to evaluate the effects of sensorimotor training on muscle strength and postural control in the female elderly population and subsequently compare these effects with a traditional combined resistance-endurance training program. A total of 34 healthy, active elderly women aged from 65 to 75 years, (average age 72.7 ± 4.4 years, height 161.6 ± 5.1 cm, and weight 66.9 ± 8.4 kg) were randomly assigned to three groups undergoing different 10-week interventions: the resistance-endurance training (RET, n = 11), the sensorimotor training (SMT, n = 12) and the control group (COG, n = 11). Prior to and after the interventions all participants underwent tests of maximal voluntary contraction of the dominant and non-dominant leg; postural sway tests with open and closed eyes; novel visual feedback balance test; 10-meter maximal walking speed (10 mMWS) and stair climb test. A T-test and repeated measures ANOVA were used, followed by the Bonferroni post hoc test, to compare the pre and post-measurements and assess differences in gains between groups. Results showed a significant main effect of time on strength (p < 0.001). In addition, significant differences in time × group interaction on strength (p < 0.01), postural control (p < 01), and ascendant and descended vertical speed (p < 0.001) were observed. Besides, the RET group improved significantly the maximal voluntary contraction of both dominant (16.3%, p ≤ 0.01) and non-dominant leg (10.9%, p ≤ 0.05). SMT group improved maximal voluntary contraction of both dominant (16.6%, p ≤ 0.001) and non-dominant leg (12.7%, p ≤ 0.01). In addition, they also improved mean velocity of the centre of pressure (COP) in postural sway test with eyes open (24.2%, p ≤ 0.05) as well as eyes closed (29.2%, p ≤ 0.05), mean distance of COP in novel visual feedback balance test (37.5%, p ≤ 0.001), ascendant and descended vertical velocity (13.6%, p ≤ 0.001 and 17.8%, p ≤ 0.001, respectively). Results show not only resistance training but sensorimotor intervention boosts strength too. This intervention also enhances postural control and functional abilities for both ascending and descending movements.
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Affiliation(s)
- Mikuláš Varjan
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
- Centre of Active Ageing, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Ľubica Žiška Böhmerová
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Ľudmila Oreská
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Peter Schickhofer
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
| | - Dušan Hamar
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
- Centre of Active Ageing, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia
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Nguyen TV, Nguyen TD, Cao Dinh H, Nguyen TD, Ngo TTK, Do DV, Le TD. Association between SARC-F scores and risk of adverse outcomes in older patients with cardiovascular disease: a prospective study at a tertiary hospital in the south of Vietnam. Front Med (Lausanne) 2024; 11:1406007. [PMID: 39026554 PMCID: PMC11254660 DOI: 10.3389/fmed.2024.1406007] [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: 03/24/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Older patients typically face elevated mortality rates and greater medical resource utilization during hospitalizations compared to their younger counterparts. Sarcopenia, serving as a prognostic indicator, is related to disability, diminished quality of life, and increased mortality. The SARC-F questionnaire, known for its cost-effectiveness, offers a valuable means of assessing sarcopenia. This study aims to explore the association between SARC-F scores and risk of adverse outcomes in elderly patients with cardiovascular disease at a Ho Chi Minh City hospital. Method Participants aged 60 and above, admitted to the Department of Cardiology - Interventional and Cardiovascular Emergency of Thong Nhat Hospital in Ho Chi Minh City from November 2021 to June 2022, were recruited for the prospective, single-center study. The prognostic outcomes included all-cause death and the initial occurrence of emergency re-hospitalization within 6 months' post-discharge. The Kaplan-Meier analysis compared the overall survival rates between different SARC-F score groups. Results The study enrolled 285 patients with a median age of 74 (67, 81). During a 6-month follow-up period, there were 14 cases of mortality. A SARC-F score of 4 or higher was significantly associated with an increased risk of all-cause mortality, with HR of 2.02 (95% CI: 1.39-2.92, p < 0.001), and higher incidence of re-hospitalization events with RR of 1.66 (95% CI: 1.06 to 2.59, p = 0.026). Kaplan-Meier survival analysis indicated a notably higher mortality rate in the patients with high SARC-F scores (p < 0.001). Conclusion In elderly patients with cardiovascular disease, the SARC-F questionnaire could serve as a simple and cost-effective method for detecting mortality and the risk of re-hospitalization.
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Affiliation(s)
- Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Tuan Dinh Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hung Cao Dinh
- Department of Internal Medicine, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tuan Dinh Nguyen
- Department of Internal Medicine, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Trinh Thi Kim Ngo
- Department of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Dung Viet Do
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Thanh Dinh Le
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
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Murakami K, Koh J, Ogami S, Aoki Y, Hori K, Emori S, Matsumoto T, Taruya J, Yorozu S, Sakata M, Nakayama Y, Miyamoto K, Ito H. Prevalence, Impact, and Screening Methods of Sarcopenia in Japanese Patients With Parkinson's Disease: A Prospective Cross-Sectional Study. Cureus 2024; 16:e65316. [PMID: 39184585 PMCID: PMC11344630 DOI: 10.7759/cureus.65316] [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] [Accepted: 07/23/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Sarcopenia is a skeletal muscle disease manifesting as low muscle mass and impaired muscle function. It has been reported that sarcopenia correlates with a low quality of life (QOL) and an increased risk of falls in patients with Parkinson's disease (PD). Nevertheless, few studies have investigated the prevalence, impact, and screening methods of sarcopenia in Japanese patients with PD. METHODS Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 consensus. We compared demographic characteristics, severity of PD, levodopa equivalent daily dose, QOL, fatigue, impulsive and compulsive behaviors, body mass index (BMI), calf circumference, skeletal muscle mass index (SMI), handgrip strength, a 4-meter gait speed, a five-time sit-to-stand test (FTSST), short physical performance battery, and SARC-F questionnaire scores between sarcopenia and non-sarcopenia groups. Furthermore, to investigate the best tool for screening sarcopenia in PD, the sensitivity and specificity of calf circumference, handgrip strength, FTSST, and SARC-F questionnaire were compared. RESULTS The prevalence of sarcopenia in PD was 31.9% (15/47). The sarcopenia group showed significantly higher age (77.3 ± 5.12 versus 70.3 ± 8.17, p = 0.0042), lower BMI (19.3 ± 2.99 versus 23.3 ± 3.18, p = 0.0002), higher rate of decreased calf circumference (86.6% versus 34.3%, p = 0.0013) and SMI (100% versus 6.25%, p < 0.0001), and worse FTSST (15.5 ± 5.57 versus 12.0 ± 4.12, p = 0.0219). The other parameters were not significantly different. Among screening tools, calf circumference had the highest sensitivity (86%) and specificity (65%). All screening tools had higher sensitivity and specificity in men than in women. The SARC-F questionnaire was not useful in distinguishing sarcopenia but was significantly correlated with the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Part 3 (r = 0.41, p = 0.0037) and the 39-item Parkinson's Disease QOL Scale (r = 0.71, p < 0.0001). CONCLUSION This study investigated the characteristics of PD patients with sarcopenia in Japan. Calf circumference was found to be the most useful tool for screening sarcopenia in PD. Handgrip strength and FTSST also showed high sensitivities, particularly in men. Conversely, the SARC-F questionnaire is not suitable for diagnosing sarcopenia in PD.
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Affiliation(s)
- Keishu Murakami
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
- Department of Neurology, National Hospital Organization Wakayama Hospital, Wakayama, JPN
| | - Jinsoo Koh
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Shuhei Ogami
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
- Department of Neurology, National Hospital Organization Wakayama Hospital, Wakayama, JPN
| | - Yohei Aoki
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Kohei Hori
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Seiji Emori
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Takuya Matsumoto
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Junko Taruya
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Shoko Yorozu
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Mayumi Sakata
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | | | | | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
- Department of Occupational Therapy, Kansai University of Health Sciences, Osaka, JPN
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Kumar S, Conners KM, Shearer JJ, Joo J, Turecamo S, Sampson M, Wolska A, Remaley AT, Connelly MA, Otvos JD, Larson NB, Bielinski SJ, Roger VL. Frailty and Metabolic Vulnerability in Heart Failure: A Community Cohort Study. J Am Heart Assoc 2024; 13:e031616. [PMID: 38533960 PMCID: PMC11262513 DOI: 10.1161/jaha.123.031616] [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: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Frailty is common in heart failure (HF) and is associated with death but not routinely captured clinically. Frailty is linked with inflammation and malnutrition, which can be assessed by a novel plasma multimarker score: the metabolic vulnerability index (MVX). We sought to evaluate the associations between frailty and MVX and their prognostic impact. METHODS AND RESULTS In an HF community cohort (2003-2012), we measured frailty as a proportion of deficits present out of 32 physical limitations and comorbidities, MVX by nuclear magnetic resonance spectroscopy, and collected extensive longitudinal clinical data. Patients were categorized by frailty score (≤0.14, >0.14 and ≤0.27, >0.27) and MVX score (≤50, >50 and ≤60, >60 and ≤70, >70). Cox models estimated associations of frailty and MVX with death, adjusted for Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score and NT-proBNP (N-terminal pro-B-type natriuretic peptide). Uno's C-statistic measured the incremental value of MVX beyond frailty and clinical factors. Weibull's accelerated failure time regression assessed whether MVX mediated the association between frailty and death. We studied 985 patients (median age, 77; 48% women). Frailty and MVX were weakly correlated (Spearman's ρ=0.21). The highest frailty group experienced an increased rate of death, independent of MVX, MAGGIC score, and NT-proBNP (hazard ratio, 3.3 [95% CI, 2.5-4.2]). Frailty improved Uno's c-statistic beyond MAGGIC score and NT-proBNP (0.69-0.73). MVX only mediated 3.3% and 4.5% of the association between high and medium frailty groups and death, respectively. CONCLUSIONS In this HF cohort, frailty and MVX are weakly correlated. Both independently contribute to stratifying the risk of death, suggesting that they capture distinct domains of vulnerability in HF.
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Affiliation(s)
- Sant Kumar
- Medstar Georgetown University HospitalWashingtonDC
| | - Katherine M. Conners
- Heart Disease Phenomics Laboratory, Epidemiology and Community Health BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Joseph J. Shearer
- Heart Disease Phenomics Laboratory, Epidemiology and Community Health BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Jungnam Joo
- Office of Biostatistics ResearchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Sarah Turecamo
- Heart Disease Phenomics Laboratory, Epidemiology and Community Health BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Maureen Sampson
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Anna Wolska
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Alan T. Remaley
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | | | | | - Nicholas B. Larson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health SciencesMayo ClinicRochesterMN
| | - Suzette J. Bielinski
- Division of Epidemiology, Department of Quantitative Health SciencesMayo ClinicRochesterMN
| | - Véronique L. Roger
- Heart Disease Phenomics Laboratory, Epidemiology and Community Health BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
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Kakiuchi M, Inoue T, Kobayashi H, Ebina A, Nakano G, Kakehi T, Tanaka T, Nishihara M. Sarcopenia assessed using a questionnaire can predict in-hospital mortality in older patients with pulmonary tuberculosis. Clin Nutr ESPEN 2024; 60:217-222. [PMID: 38479913 DOI: 10.1016/j.clnesp.2024.02.007] [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: 11/16/2023] [Revised: 01/08/2024] [Accepted: 02/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Pulmonary tuberculosis is a severe disease with a high mortality rate. However, whether sarcopenia is a risk factor for in-hospital mortality remains unclear. The SARC-F (five items: strength, assistance in walking, rising from a chair, climbing stairs, and falls) is a questionnaire developed to screen for sarcopenia. This study aimed to determine whether the high risk of sarcopenia, assessed using the SARC-F questionnaire, affects in-hospital mortality in older patients with pulmonary tuberculosis. METHODS This was a retrospective, observational study. We included patients with active pulmonary tuberculosis aged ≥65 years who required inpatient treatment between 30 April 2021 and 30 November 2022. We assessed sarcopenia using SARC-F, and SARC-F ≥ 4 points at admission was defined as a high risk of sarcopenia. The primary outcome was all-cause mortality during hospitalisation. We extracted information on age, sex, body mass index, comorbidities, blood and biochemical tests, modified Glasgow Prognostic Score, calf circumference, geriatric nutritional risk index, physiotherapy, and length of hospital stay from medical records. RESULTS We included 147 patients (mean age: 83.0 ± 7.8 years; males: 61.9%). Ninety-three (63.3%) patients had a high risk of developing sarcopenia. Patients with a high risk of sarcopenia were significantly older (mean: 85.0 ± 7.1 years), had a lower body mass index (median: 18.1 kg/m2, range: 16.1-20.5 kg/m2), had a higher modified Glasgow Prognostic Score (median: 2, range: 2-2), and had a lower calf circumference (mean: 26.8 ± 3.6 cm), had a lower geriatric nutritional risk index (mean: 72.2 ± 12.9) than those without high-risk sarcopenia. More patients with a high risk of sarcopenia underwent physiotherapy (93.5%) than those without high-risk sarcopenia (P < 0.01, all). Kaplan-Meier survival curves showed that patients with a high risk of sarcopenia had significantly lower overall survival than those without high-risk sarcopenia (log-rank test, P = 0.001). Logistic regression analysis for in-hospital mortality showed that a high risk of sarcopenia significantly affected in-hospital mortality (odds ratio [OR]: 6.425, 95% confidence interval [CI]: 1.399-47.299). In addition, logistic regression analysis for each item of SARC-F showed that assistance in walking (OR: 3.931, 95% CI: 1.816-9.617) and rising from a chair (OR: 2.458, 95% CI: 1.235-5.330) significantly affected in-hospital mortality. CONCLUSION A high risk of sarcopenia, as assessed using SARC-F at admission, was a risk factor for in-hospital mortality in older patients with pulmonary tuberculosis. Among the SARC-F items, assistance in walking and rising from a chair were the risk factors for in-hospital mortality.
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Affiliation(s)
- Masayoshi Kakiuchi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398, Shimami-cho, Kita-ku, Niigata-shi, Niigata-ken, 950-3198, Japan.
| | - Hikaru Kobayashi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Aoi Ebina
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Gen Nakano
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Tetsuya Kakehi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Toshiaki Tanaka
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Masamitsu Nishihara
- Department of Neurosurgery, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
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Kera T, Osuka Y, Kawai H, Ejiri M, Ito K, Hirano H, Fujiwara Y, Ihara K, Obuchi S. Development and validation of a rapid sarcopenia screening questionnaire: The Otassha study. Geriatr Gerontol Int 2023; 23:945-950. [PMID: 37963490 DOI: 10.1111/ggi.14730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/07/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023]
Abstract
AIM To develop a rapid and easy screening tool to detect sarcopenia. METHODS In total, 683 community-dwelling older adults who participated in our cohort study, the "Otassha Study," in 2019, completely responded to a questionnaire, and were diagnosed with sarcopenia were included. Participants responded to a nine-item questionnaire, including candidate items for a new sarcopenia screening tool named rapid sarcopenia screening, based on items of the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. To select appropriate items for the new screeening tool, multiple logistic regression analyses were performed, with sarcopenia as the dependent variable and questionnaire responses as independent variables. The area under the curve using 10 000 bootstraps was used to assess the rapid sarcopenia screening diagnostic ability for detecting sarcopenia. RESULTS Responses to question nos 2 (how much can you squeeze a wet towel?), 5 (how much muscle strength do you think you have compared with that of people of your age and sex?), 7 (how fast do you usually walk?), and 9 (age-related item) were related to sarcopenia in multiple logistic regression analysis. The area under the curve of the total score of rapid sarcopenia screening was 0.82, 0.80, and 0.81 for men, women, and overall, respectively. At a cut-off value of 14/15, the sensitivity and specificity for sarcopenia detection were 0.73 and 0.73, respectively. CONCLUSIONS The newly developed sarcopenia screening tool has a better diagnostic ability for sarcopenia than the SARC-F. Rapid sarcopenia screening does not require physical function measurements, making it a useful and accessible tool among older adults to detect sarcopenia. Geriatr Gerontol Int 2023; 23: 945-950.
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Affiliation(s)
- Takeshi Kera
- Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Japan
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kumiko Ito
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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11
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Ahmad F, Fountotos R, Goldfarb M, Bharaj N, Munir H, Marsala J, Rudski LG, Afilalo J. De-frailing intervention for hospitalized cardiovascular patients in the TARGET-EFT randomized clinical trial. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2023; 9:482-489. [PMID: 36026532 PMCID: PMC10405162 DOI: 10.1093/ehjqcco/qcac050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/01/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
AIMS Frailty is disproportionately prevalent in cardiovascular disease patients and exacerbated during hospital admissions, heightening the risk for adverse events and functional decline. Using the Essential Frailty Toolset (EFT) to target physical weakness, cognitive impairment, malnourishment, and anaemia, we tested a multicomponent targeted intervention to de-frail older adults with acute cardiovascular conditions during their hospital admission. METHODS AND RESULTS The TARGET-EFT trial was a single-center randomized clinical trial at the Jewish General Hospital, Montreal, Canada. We compared a multicomponent de-frailing intervention with usual clinical care. Intervention group patients received exercise, cognitive stimulation, protein supplementation, and iron replacement, as required. In this study, the primary outcome was frailty, as assessed by the SPPB score (Short Physical Performance Battery) at discharge, and the secondary outcome was the SARC-F score (Strength, Assistance walking, Rising from chair, Climbing, Falls) assessed 30 days later. The analysis consisted of 135 patients (mean age of 79.3 years; 54% female) who survived and completed the frailty assessments.Compared with control patients, intervention group patients had a 1.52-point superior SPPB score and a 0.74-point superior SARC-F score. Subgroup analysis suggested that patients with low left ventricular ejection fraction may have attenuated benefits, and that patients who underwent invasive cardiac procedures had the greatest benefits from the intervention. CONCLUSION We achieved our objective of de-frailing older cardiac inpatients on a short-term basis by improving their physical performance and functioning using a pragmatic multicomponent intervention. This could have positive impacts on their clinical outcomes and ability to maintain independent living in the future. ONE SENTENCE SUMMARY The multicomponent intervention targeted to the deficits of vulnerable older adults hospitalized with acute cardiovascular diseases successfully de-frailed them on a short-term basis, which can have positive implications on their post-discharge health outcomes.
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Affiliation(s)
- Fayeza Ahmad
- Division of Experimental Medicine, McGill University, Montreal,QC H4A 3J1,Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2,Canada
| | - Rosie Fountotos
- Division of Experimental Medicine, McGill University, Montreal,QC H4A 3J1,Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2,Canada
| | - Michael Goldfarb
- Division of Experimental Medicine, McGill University, Montreal,QC H4A 3J1,Canada
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2,Canada
| | - Neetika Bharaj
- Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2,Canada
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC H2W 1S4, Canada. Institution of research trial: Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Haroon Munir
- Division of Experimental Medicine, McGill University, Montreal,QC H4A 3J1,Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2,Canada
| | - John Marsala
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2,Canada
| | - Lawrence G Rudski
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2,Canada
| | - Jonathan Afilalo
- Division of Experimental Medicine, McGill University, Montreal,QC H4A 3J1,Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2,Canada
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2,Canada
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Canick J, Campbell JC, Cohen SM, Jones HN, Leiman DA, Raman S, Starr KNP. Preoperative dysphagia risk in community-dwelling adults aged ≥50 years: Prevalence and risk factors. Nutr Clin Pract 2023; 38:157-166. [PMID: 35788985 PMCID: PMC10026185 DOI: 10.1002/ncp.10889] [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: 03/03/2022] [Revised: 05/04/2022] [Accepted: 06/05/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Preoperative dysphagia screening is rare. The purpose of this study was to assess the prevalence and potential risk factors of preoperative dysphagia risk in adults preparing for surgery. METHODS The Eating Assessment Tool (EAT-10), Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), and Sarcopenia Screening Tool (SARC-F) were self-administered in adults preparing for surgery to identify dysphagia, malnutrition, and sarcopenia risk, respectively. Other variables collected include clinical demographics, fall risk, and surgical history associated with increased dysphagia risk. Descriptive summary statistics, univariate analysis, and logistic regression were performed as appropriate. RESULTS The median age was 69 years and preoperative dysphagia risk was 9.6%. Among 357 patients completing both EAT-10 and PG-SGA SF or SARC-F, 7.3% had preoperative dysphagia and malnutrition risk and 7.2% had preoperative dysphagia and sarcopenia risk. Preoperative dysphagia risk was 2.7 times greater in those with prior surgical history associated with increased risk of dysphagia, 2.2 times higher in women, and almost twice as high in Black patients and patients with fall risk. Logistic regression revealed significant odds ratios (ORs) for prior surgical history associated with increased risk of dysphagia (OR, 2.95; 95% CI, 1.62-5.40) and male sex (OR, 0.52; 95% CI, 0.29-0.94), and a significant relationship between preoperative dysphagia and malnutrition risk (OR, 4.56; 95% CI, 2.02-10.28) when controlling for clinical variables. CONCLUSION The high prevalence of dysphagia risk alone and in combination with malnutrition and sarcopenia risk in community-dwelling adults underscores the need for standardized preoperative screening and optimization prior to surgery.
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Affiliation(s)
| | - James C. Campbell
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Seth M. Cohen
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Harrison N. Jones
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - David A. Leiman
- Department of Medicine, Division of Gastroenterology, Duke University School of Medicine and Duke Clinical Research Institute, Durham, NC
| | - Sudha Raman
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Kathryn N. Porter Starr
- Department of Medicine, Division of Geriatrics, Duke University School of Medicine and Duke Clinical Research Institute, Durham, NC
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
- Durham VA Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, NC
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13
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Ueno K, Maekawa E, Terada T, Reed JL, Yamaoka-Tojo M, Matsunaga A, Ako J. SARC-F predicts poor motor function, quality of life, and prognosis in older patients with cardiovascular disease and cognitive impairment. Exp Gerontol 2023; 171:112021. [PMID: 36356692 DOI: 10.1016/j.exger.2022.112021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We investigated whether SARC-F scores were associated with motor function, quality of life (QOL) related to physical function, and prognosis in older patients with cardiovascular disease (CVD) and cognitive impairment. METHODS This was a retrospective cross-sectional cohort study. The study population consisted of 408 patients with CVD (≥60 years old) who completed the SARC-F questionnaire and Mini-Cog, a cognitive function test, at discharge. Sarcopenia was defined as a total SARC-F score ≥ 4 points. Patients who were cognitively-preserved (Mini-Cog score ≥ 3 points) were excluded. Patients completed the handgrip strength, leg strength, usual gait speed, 6-minute walking distance, short physical performance battery score, and 36-item Short-Form Health Survey Physical Functioning (SF-36PF) tests before discharge. Associations of SARC-F with physical function, QOL, and prognoses (i.e., composite of all-cause death and emergency CVD rehospitalization and the number of CVD rehospitalizations) were investigated. RESULTS Sarcopenia (SARC-F score ≥ 4 points) was associated with poorer motor function test outcomes and SF-36PF scores (all P < 0.001). The correlations remained significant after adjusting for comorbidities (e.g., anemia, prior heart failure, and renal dysfunction). Sarcopenia was also associated with a poorer prognosis (hazard ratio: 1.574; 95 % confidence interval [CI], 1.011-2.445) and an increased risk of CVD rehospitalization (incidence rate ratio: 1.911; 95 % CI, 1.312-2.782) after adjusting for comorbidities. CONCLUSIONS AND IMPLICATIONS In older patients with CVD and cognitive impairment, the SARC-F questionnaire may be a simple and inexpensive tool for identifying patients with decreased motor function and a poor prognosis.
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Affiliation(s)
- Takumi Noda
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Division of Research, ARCE Inc., Sagamihara, Japan
| | - Shota Uchida
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Kensuke Ueno
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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14
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Association between premorbid sarcopenia and neurological deterioration in patients with acute ischemic stroke. Clin Neurol Neurosurg 2022; 224:107527. [PMID: 36455301 DOI: 10.1016/j.clineuro.2022.107527] [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: 05/22/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Sarcopenia is associated with poor outcomes in patients with stroke. This study aimed to investigate the association between premorbid sarcopenia and neurological deterioration (ND) in patients with acute ischemic stroke. To the best of our knowledge, there have been no studies on this topic. METHODS In this prospective longitudinal study, we assessed premorbid sarcopenia using the SARC-F questionnaire, and the incidence of ND was defined by an increase of ≥ 1 point on the National Institutes of Health Stroke Scale (NIHSS) or the occurrence of any new neurological symptoms/signs. Logistic regression analysis was used to investigate the relationship between premorbid sarcopenia and ND. RESULTS Of the 290 patients enrolled, 46 and 244 patients experienced and did not experience ND 1 week after admission (ND and non-ND groups, respectively). The prevalence of sarcopenia was significantly higher in the ND group than in the non-ND group (39% vs. 17%). In the adjusted model, premorbid sarcopenia was significantly associated with ND (adjusted odds ratio: 3.06, 95% confidence interval: 1.11-8.40; p = 0.03). CONCLUSION Premorbid sarcopenia is independently associated with ND in patients with acute ischemic stroke. Therefore, it is necessary to detect premorbid sarcopenia to predict ND in these patients.
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15
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Albano D, Gitto S, Vitale J, Bernareggi S, Aliprandi A, Sconfienza LM, Messina C. Comparison between magnetic resonance imaging and electrical impedance myography for evaluating lumbar skeletal muscle composition. BMC Musculoskelet Disord 2022; 23:970. [DOI: 10.1186/s12891-022-05902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare electrical impedance myography (EIM) and MRI in assessing lumbar skeletal muscle composition.
Methods
One hundred forty-one patients (78 females, mean age 57 ± 19 years) were prospectively enrolled and underwent lumbar spine MRI, EIM with Skulpt®, and clinical evaluation including the questionnaire SARC-F. MRIs were reviewed to assess the Goutallier score of paravertebral muscles at L3 level and to calculate the cross sectional area (CSA) of both psoas, quadratus lumborum, erector spinae, and multifidus muscles on a single axial slice at L3 level, in order to calculate the skeletal muscle index (SMI=CSA/height2). We tested the correlation between EIM-derived parameters [body fat percentage (BF%) and muscle quality] and body mass index (BMI), Goutallier score (1–4), SMI, and SARC-F scores (0–10) using the Pearson correlation coefficient. The strength of association was considered large (0.5 to 1.0), medium (0.3 to 0.5), small (0.1 to 0.3).
Results
Pearson’s correlation coefficient showed small (0.26) but significant (p < 0.01) positive correlation between BF% obtained with EIM and Goutallier score. Small negative correlation (− 0.22, p < 0.01) was found between EIM muscle quality and Goutallier Score. Large negative correlation (− 0.56, p < 0.01) was found between SMI and Goutallier Score, while SMI showed small negative correlation with SARC-F (− 0.29, p < 0.01). Medium positive correlation was found between Goutallier Score and SARC-F (0.41, p < 0.01). BMI showed medium positive correlation with SMI (r = 0.369, p < 0.01) and small correlation with EIM muscle quality (r = − 0.291, p < 0.05) and BF% (r = 0.227, p < 0.05). We found a substantial increase of the strength of associations of BF% and muscle quality with Goutallier in the 18–40 years (r = 0.485 and r = − 0.401, respectively) and in the 41–70 years group (r = 0.448 and r = − 0.365, respectively).
Conclusions
Muscle quality and BF% measured by EIM device showed only small strength of correlation with other quantitative parameters for assessing muscle mass and fat infiltration. Interesting results have been found in younger patients, but Skulpt Chisel™ should be applied cautiously to assess lumbar skeletal muscle composition. This point deserves further investigation and other studies are warranted.
Trial registration
The registration number of this study is 107/INT/2019.
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Fujita K, Hiyama T, Wada K, Aihara T, Matsumura Y, Hamatsuka T, Yoshinaka Y, Kimura M, Kuzuya M. Machine learning-based muscle mass estimation using gait parameters in community-dwelling older adults: A cross-sectional study. Arch Gerontol Geriatr 2022; 103:104793. [PMID: 35987032 DOI: 10.1016/j.archger.2022.104793] [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: 06/02/2022] [Revised: 08/03/2022] [Accepted: 08/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Loss of skeletal muscle mass is associated with numerous factors such as metabolic diseases, lack of independence, and mortality in older adults. Therefore, developing simple, safe, and reliable tools for assessing skeletal muscle mass is needed. Some studies recently reported that the risks of the incidence of geriatric conditions could be estimated by analyzing older adults' gait; however, no studies have assessed the association between gait parameters and skeletal muscle loss in older adults. In this study, we applied machine learning approach to the gait parameters derived from three-dimensional skeletal models to distinguish older adults' low skeletal muscle mass. We also identified the most important gait parameters for detecting low muscle mass. METHODS Sixty-six community-dwelling older adults were recruited. Thirty-two gait parameters were created using a three-dimensional skeletal model involving 10-meter comfortable walking. After skeletal muscle mass measurement using a bioimpedance analyzer, low muscle mass was judged in accordance with the guideline of the Asia Working Group for Sarcopenia. The eXtreme gradient boosting (XGBoost) model was applied to discriminate between low and high skeletal muscle mass. RESULTS Eleven subjects had a low muscle mass. The c-statistics, sensitivity, specificity, precision of the final model were 0.7, 59.5%, 81.4%, and 70.5%, respectively. The top three dominant gait parameters were, in order of strongest effect, stride length, hip dynamic range of motion, and trunk rotation variability. CONCLUSION Machine learning-based gait analysis is a useful approach to determine the low skeletal muscle mass of community-dwelling older adults.
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Affiliation(s)
- Kosuke Fujita
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan; Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Takahiro Hiyama
- Technology Division, Panasonic Holdings Corporation, Kadoma, Japan
| | - Kengo Wada
- Electric Works Company, Panasonic Corporation, Kadoma, Japan
| | - Takahiro Aihara
- Electric Works Company, Panasonic Corporation, Kadoma, Japan
| | | | | | - Yasuko Yoshinaka
- Department of Bioenvironment, Kyoto University of Advanced Science, Kameoka, Japan
| | - Misaka Kimura
- Department of Bioenvironment, Kyoto University of Advanced Science, Kameoka, Japan; Doshisha Women's College of Liberal Arts, Graduate School of Nursing, Kyotanabe, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Albano D, Gitto S, Vitale J, Bernareggi S, Lamorte S, Aliprandi A, Sconfienza LM, Messina C. Knee Muscles Composition Using Electrical Impedance Myography and Magnetic Resonance Imaging. Diagnostics (Basel) 2022; 12:diagnostics12092217. [PMID: 36140617 PMCID: PMC9497744 DOI: 10.3390/diagnostics12092217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 11/29/2022] Open
Abstract
We evaluated the correlation of electrical impedance myography (EIM) measurements of knee muscles composition using Skulpt ChiselTM with MRI data retrieved from muscles segmentation. A total of 140 patients (71 females, 52 ± 21 years) underwent knee MRI, EIM with Skulpt®, and clinical evaluation (SARC-F questionnaire). MRIs were reviewed to assess the cross-sectional area (CSA) and skeletal muscle index (SMI = CSA/height2) of vastus medialis, vastus lateralis, biceps, semimembranosus, and sartorius. We tested the correlations of EIM-derived parameters [body fat-percentage (BF%) and muscle quality] with total CSA, CSA of each muscle, SMI, and SARC-F scores (0−10) using Pearson correlation coefficient. We found medium negative correlation of BF% with SMI (r = −0.430, p < 0.001) and total CSA (r = −0.445, p < 0.001), particularly with biceps (r = −0.479, p < 0.001), sartorius (r = −0.440, p < 0.001), and semimembranosus (r = −0.357, p < 0.001). EIM-derived muscle quality showed small-to-medium positive correlation with MRI measurements, ranging from r = 0.234 of biceps (p = 0.006) to r = 0.302 of total CSA (p < 0.001), except for vastus lateralis (r = 0.014, p = 0.873). SARC-F scores showed small correlations with EIM and MRI data, ranging from r = −0.132 (p = 0.121) with EIM muscle quality to r = −0.288 (p = 0.001) with CSA of vastus medialis. Hence, we observed small-to-medium correlations of muscle parameters derived from Skulpt ChiselTM with SARC-F scores and MRI parameters. We recommend using Skulpt ChiselTM with caution for assessing knee skeletal muscles composition.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-333-240-1189
| | - Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Jacopo Vitale
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | | | - Sveva Lamorte
- Scuola di Specializzazione in Radiodiagnostica, Università di Parma, 43121 Parma, Italy
| | - Alberto Aliprandi
- Unità Operativa di Radiologia, Istituti Clinici Zucchi, 20052 Monza, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
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Kera T, Saida K, Higuchi D, Shinohara T, Onozawa H, Kawai H, Obuchi S. Utility of SARC-F in daycare facilities for older people. Geriatr Gerontol Int 2022; 22:889-893. [PMID: 36059047 DOI: 10.1111/ggi.14464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
AIM SARC-F, a sarcopenia screening tool, has limited use but may be beneficial for detecting sarcopenia in frail older people. This study aimed to clarify the validity of the SARC-F questionnaire in older people. METHODS In this validation study, 74 (36 men; age, 81.9 ± 6.7 years, 38 women; age, 83 ± 6.2 years) community-dwelling older people who attended a daycare facility participated in our study. Participants completed the SARC-F and SARC-calf circumference (SARC-CalF) questionnaires, and their body composition, walk speed and grip strength were measured. Sarcopenia was determined using the Asian Working Group for Sarcopenia criteria, and the participants were divided into non-sarcopenia and sarcopenia groups. SARC-F and SARC-CalF scores were evaluated using receiver operating characteristic curve analysis for sarcopenia considering the area under the curve. Internal consistency was evaluated using Cronbach's alpha. RESULTS The prevalence of sarcopenia, defined by physical characteristics, was 60.0% in men and 48.1% in women. The area under the curve of the SARC-F for sarcopenia was 0.703 (95% confidence interval [CI]: 0.585-0.821, P = 0.001). Cronbach's alpha was 0.81, and the internal consistency was high. SARC-F had lower sensitivity (0.47; 95% CI: 0.31-0.64) but higher specificity (0.78; 95% CI: 0.60-0.89) than the sensitivity and specificity of SARC-CalF, respectively, and the sensitivity of SARC-F was higher than that reported in previous studies. CONCLUSION The SARC-F questionnaire is more sensitive in assessing sarcopenia in low-functioning populations and can be used as a screening tool for sarcopenia in long-term daycare facilities for older people rather than in community-based healthcare activities. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Takeshi Kera
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan.,Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kosuke Saida
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Daisuke Higuchi
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | | | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Nozoe M, Noguchi M, Kubo H, Kanai M, Shimada S. Association between the coexistence of premorbid sarcopenia, frailty, and disability and functional outcome in older patients with acute stroke. Geriatr Gerontol Int 2022; 22:642-647. [PMID: 35848637 DOI: 10.1111/ggi.14432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/26/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effects of coexisting conditions such as premorbid sarcopenia, frailty, and disability on functional outcomes in older patients with acute stroke. METHODS This prospective cohort study included older patients (aged ≥65 years) hospitalized for acute stroke at a single neurosurgical hospital. Premorbid sarcopenia, frailty, and disability were diagnosed using the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire, frailty index, and modified Rankin Scale (mRS) on admission. The primary outcome was the mRS score 3 months after stroke, and a poor outcome was defined as mRS ≥4. RESULTS This study included 317 older patients with acute stroke (median [interquartile range] age: 76 [12] years). Premorbid sarcopenia, frailty, and disability (mRS = 2 or 3) were identified in 59 (19%), 27 (9%), and 54 (17%) patients, respectively. Two coexisting conditions were observed in 26 patients (8%), and three were observed in 18 patients (6%). Adjusted logistic regression analysis revealed that coexisting conditions were independently associated with poor outcomes (one condition, adjusted OR: 3.20 [95%CI: 0.98-10.45]; two conditions, adjusted OR: 6.57 [95%CI: 1.74-24.87]; three conditions, adjusted OR: 12.70 [95%CI: 2.65-60.91]). CONCLUSIONS The coexistence of premorbid sarcopenia, frailty, and disability was associated with poor functional outcomes in older patients with acute stroke. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Madoka Noguchi
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Shinichi Shimada
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan
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Asaishi K, Matsui M, Nishikawa H, Goto M, Asai A, Ushiro K, Ogura T, Takeuchi T, Nakamura S, Kakimoto K, Miyazaki T, Fukunishi S, Ohama H, Yokohama K, Yasuoka H, Higuchi K. Grip Strength in Patients with Gastrointestinal Diseases. J Clin Med 2022; 11:jcm11082079. [PMID: 35456173 PMCID: PMC9025528 DOI: 10.3390/jcm11082079] [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: 02/10/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
We sought to elucidate factors contributing to the grip strength (GS) decline in patients with gastrointestinal diseases (Ga-Ds, n = 602, 379 males, median age = 72 years). The GS decline in males and females was defined as <28 kg and <18 kg, respectively, following the current Asian guidelines. The median GS (male) was 28.8 kg, and GS decline (male) was found in 169 patients (44.6%). The median GS (female) was 17.5 kg, and GS decline (female) was found in 122 patients (54.7%). Advanced cancer was identified in 145 patients (24.1%). In terms of the univariate analysis of parameters of the GS decline, age (p < 0.0001), gender (p = 0.0181), body mass index (BMI, p = 0.0002), ECOG-PS (p < 0.0001), SARC-F score (p < 0.0001), hemoglobin value (p < 0.0001), total lymphocyte count (p < 0.0001), serum albumin value (p < 0.0001), C reactive protein (CRP) value (p < 0.0001), and estimated glomerular filtration rate were statistically significant. In terms of the multivariate analysis, age (p < 0.0001), BMI (p = 0.0223), hemoglobin value (p = 0.0186), serum albumin value (p = 0.0284), the SARC-F score (p = 0.0003), and CRP value (p < 0.0001) were independent parameters. In conclusion, the GS decline in patients with Ga-Ds is closely associated with not only the primary factor (i.e., aging) but also secondary factors such as inflammatory factors and nutritional factors.
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Affiliation(s)
- Ken Asaishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Masahiro Matsui
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hiroki Nishikawa
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
- Correspondence: ; Tel.: +81-726-83-1221
| | - Masahiro Goto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Akira Asai
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kosuke Ushiro
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takeshi Ogura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Toshihisa Takeuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Shiro Nakamura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuki Kakimoto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takako Miyazaki
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Shinya Fukunishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Hideko Ohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Keisuke Yokohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hidetaka Yasuoka
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuhide Higuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
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21
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The Relevance in the Neutrophil to Lymphocyte Ratio and the SARC-F Score in Gastrointestinal Diseases. J Clin Med 2022; 11:jcm11072012. [PMID: 35407620 PMCID: PMC8999347 DOI: 10.3390/jcm11072012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023] Open
Abstract
We sought to clarify the relevance in the neutrophil to lymphocyte ratio (NLR) and the SARC-F score in patients with gastrointestinal diseases (G-Ds, n = 672, median age = 73 years). Univariate and multivariate analysis for the SARC-F score were performed. Advanced malignancy was identified in 162 patients (24.1%). The median of NLR for all cases was 2.65. The median of NLR in ECOG-PS 0 (n = 436), 1 (n = 128), 2 (n = 49) and 3 or 4 (n = 59) was 2.26, 2.97, 4.41 and 5.99 (overall p < 0.0001). NLR had a significant correlation with the SARC-F score (r = 0.54, p < 0.0001). The median of NLR in the SARC-F score ≥4 (recommended value for sarcopenia, n = 84) and <4 (n = 588) was 5.87 and 2.48 (p < 0.0001). In all subgroup analyses, similar trends were seen. In the multivariate analysis, ECOG-PS (p < 0.0001) and NLR (p < 0.0001) were independent factors, while age had a trend for significance (p = 0.0686). In conclusion, we would like to emphasize the usefulness of NLR, a simple marker assessed only by blood tests, in predicting the possibility for sarcopenia by the SARC-F in G-Ds.
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Hanada M, Sakamoto N, Ishimoto H, Kido T, Miyamura T, Oikawa M, Nagura H, Takeuchi R, Kawazoe Y, Sato S, Hassan SA, Ishimatsu Y, Takahata H, Mukae H, Kozu R. A comparative study of the sarcopenia screening in older patients with interstitial lung disease. BMC Pulm Med 2022; 22:45. [PMID: 35078452 PMCID: PMC8790854 DOI: 10.1186/s12890-022-01840-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background The Asian Working Group for Sarcopenia 2019 (AWGS 2019) is the gold standard diagnostic criteria for sarcopenia in Asian populations. The calf circumference (CalF), the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) and the SARC-CalF questionnaires for sarcopenia screening have been used by AWGS 2019. The aim of this study was to assess accuracy of these three sarcopenia screening tools in patients with interstitial lung disease. Methods In this cross-sectional study, stable patients with interstitial lung disease were enrolled. The SARC-F, SARC-CalF, and CalF, used in patients with interstitial lung disease, were compared to the diagnostic criteria proposed by AWGS 2019. The accuracy of screening tools was compared using sensitivity and specificity. Moreover, areas under the receiver operating characteristic curves (AUC) were computed. Results Seventy eight patients were analyzed, and sarcopenia was identified in 25 (32.1%) patients with interstitial lung disease by the AWGS 2019 criteria. The sensitivity of the CalF was highest (96%) of the three screening tools, while the specificity was 60%. The sensitivity of SARC-F and SARC-CalF were 24% and 68%, while the specificity were 92% and 66%, respectively. The AUCs of CalF, SARC-F, and SARC-CalF in all patients were 0.78, 0.58, and 0.67, respectively. Conclusions The CalF is most suitable for screening sarcopenia in patients with interstitial lung disease, while SARC-F and SARC-CalF are not.
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The Relationship between the SARC-F Score and the Controlling Nutritional Status Score in Gastrointestinal Diseases. J Clin Med 2022; 11:jcm11030582. [PMID: 35160034 PMCID: PMC8836691 DOI: 10.3390/jcm11030582] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
We sought to examine the relationship between the SARC-F score and the Controlling Nutritional Status (CONUT) score in patients with gastrointestinal diseases (GDs, n = 735, median age = 71 years, and 188 advanced cancer cases). The SARC-F score ≥ 4 (highly suspicious of sarcopenia) was found in 93 cases (12.7%). Mild malnutritional condition was seen in 310 cases (42.2%), moderate in 127 (17.3%) and severe in 27 (3.7%). The median SARC-F scores in categories of normal, mild, moderate and severe malnutritional condition were 0, 0, 1 and 1 (overall p < 0.0001). The percentage of SARC-F score ≥ 4 in categories of normal, mild, moderate and severe malnutritional condition were 4.4%, 12.9%, 26.8% and 25.9% (overall p < 0.0001). The SARC-F score was an independent factor for both the CONUT score ≥ 2 (mild, moderate or severe malnutrition) and ≥5 (moderate or severe malnutrition). In the receiver operating characteristic (ROC) curve analysis for the CONUT score ≥ 2, C reactive protein (CRP) had the highest area under the ROC (AUC = 0.70), followed by the SARC-F score (AUC = 0.60). In the ROC analysis for the CONUT score ≥ 5, CRP had the highest AUC (AUC = 0.79), followed by the SARC-F score (AUC = 0.63). In conclusion, the SARC-F score in patients with GDs can reflect malnutritional status.
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Matsui M, Nishikawa H, Goto M, Asai A, Ushiro K, Ogura T, Takeuchi T, Nakamura S, Kakimoto K, Miyazaki T, Fukunishi S, Ohama H, Yokohama K, Yasuoka H, Higuchi K. Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers. Cancers (Basel) 2021; 14:cancers14010010. [PMID: 35008175 PMCID: PMC8749778 DOI: 10.3390/cancers14010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary There have been few reports with regard to the relevance between the SARC-F score and the prognosis in patients with gastrointestinal advanced cancers, and we aimed to elucidate these issues (n = 421, median age = 73 years). During the follow-up period, 145 patients (34.4%) died. The 1-year cumulative overall survival rate in patients with SARC-F ≥ 4 (recommended cutoff point, n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the overall survival, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score 1 (p = 0.0147) and 2 (p < 0.0001), ECOG-PS 2 (p < 0.0001), and 3 (p < 0.0001) and 4 (p < 0.0001) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and the best cutoff point of the SARC-F score was two. The SARC-F score appears to be useful in patients with gastrointestinal advanced malignancies. Abstract We sought to elucidate the prognostic impact of the SARC-F score among patients with gastrointestinal advanced malignancies (n = 421). A SARC-F score ≥ 4 was judged to have a strong suspicion for sarcopenia. In patients with ECOG-PS 4 (n = 43), 3 (n = 61), and 0–2 (n = 317), 42 (97.7%), 53 (86.9%) and 8 (2.5%) had the SARC-F score ≥ 4. During the follow-up period, 145 patients (34.4%) died. All deaths were cancer-related. The 1-year cumulative overall survival (OS) rate in patients with SARC-F ≥ 4 (n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the OS, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score (GPS) 1 (p = 0.0147, GPS 0 as a standard), GPS 2 (p < 0.0001, GPS 0 as a standard), ECOG-PS 2 (p < 0.0001, ECOG-PS 0 as a standard), ECOG-PS 3 (p < 0.0001, ECOG-PS 0 as a standard), and ECOG-PS 4 (p < 0.0001, ECOG-PS 0 as a standard) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and best cutoff point of the SARC-F score was two. In conclusion, the SARC-F score is useful in patients with gastrointestinal advanced malignancies.
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Affiliation(s)
- Masahiro Matsui
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hiroki Nishikawa
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
- Correspondence: ; Tel.: +81-726-831-221
| | - Masahiro Goto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Akira Asai
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kosuke Ushiro
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takeshi Ogura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Toshihisa Takeuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Shiro Nakamura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuki Kakimoto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takako Miyazaki
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Shinya Fukunishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Hideko Ohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Keisuke Yokohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hidetaka Yasuoka
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuhide Higuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
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Nozoe M, Kubo H, Kanai M, Yamamoto M. Relationships between Pre-Stroke SARC-F Scores, Disability, and Risk of Malnutrition and Functional Outcomes after Stroke-A Prospective Cohort Study. Nutrients 2021; 13:nu13103586. [PMID: 34684587 PMCID: PMC8537569 DOI: 10.3390/nu13103586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was the modified Rankin Scale (mRS) 3 months after stroke. The relationship between SARC-F scores and poor functional outcomes was examined using a logistic regression analysis. Furthermore, the applicability of SARC-F scores to the assessment of poor functional outcomes was analyzed based on the area under the receiver operating curve (ROC). Eighty-one out of the 324 patients enrolled in the present study (25%) had poor functional outcomes (mRS ≥ 4). The results of the multivariate analysis revealed a correlation between SARC-F scores (OR = 1.29, 95% CI = 1.05–1.59, p = 0.02) and poor functional outcomes. A cut-off SARC-F score ≥ 4 had low-to-moderate sensitivity (47.4%) and high specificity (87.3%). The present results suggest that the measurement of pre-stroke SARC-F scores is useful for predicting the outcomes of stroke patients.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
- Correspondence: ; Tel.: +81-78-413-3584
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
| | - Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
| | - Miho Yamamoto
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
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Comparison of SARC-F Score among Gastrointestinal Diseases. J Clin Med 2021; 10:jcm10184099. [PMID: 34575208 PMCID: PMC8469770 DOI: 10.3390/jcm10184099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023] Open
Abstract
SARC-F is a screening tool for sarcopenia. We sought to compare the SARC-F scores of patients with different gastrointestinal diseases (n = 1282 (762 males): upper gastrointestinal disease (UGD, n = 326), lower gastrointestinal disease (LGD, n = 357), biliary and pancreatic disease (BPD, n = 416), and liver disease (LD, n = 183)). Factors associated with SARC-F ≥4 points (highly suspicious of sarcopenia) were also examined. The median age was 71 years. Patients with SARC-F ≥4 points were found in 197 (15.4%). Advanced cancer was found in 339 patients (26.4%). The proportion of SARC-F ≥4 points in groups of UGD, LGD, BPD, and LD were 17.5% (57/326) in UGD, 12.0% (43/357) in LGD, 17.3% (72/416) in BPD, and 13.7% (25/183) in LD, respectively (overall p = 0.1235). In patients with and without advanced cancer, similar tendencies were observed. In the multivariate analysis, age (p < 0.0001), gender (p = 0.0011), serum albumin (p < 0.0001), lymphocyte count (p = 0.0019), C reactive protein (p = 0.0197), and the presence of advanced cancer (p = 0.0424) were significant factors linked to SARC-F ≥4 points. In patients with advanced cancer, SARC-F scores correlated well with their Glasgow prognostic scores. In conclusion, sarcopenia in gastrointestinal diseases may be affected not by disease type (i.e., the primary origin of the disease) but by aging, nutritional condition, inflammatory condition, and cancer burden.
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Wu WY, Dong JJ, Huang XC, Chen ZJ, Chen XL, Dong QT, Bai YY. AWGS2019 vs EWGSOP2 for diagnosing sarcopenia to predict long-term prognosis in Chinese patients with gastric cancer after radical gastrectomy. World J Clin Cases 2021; 9:4668-4680. [PMID: 34222433 PMCID: PMC8223822 DOI: 10.12998/wjcc.v9.i18.4668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/23/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the long-term overall survival (OS) of patients with gastric cancer. Its diagnostic criterion is critical to clinical diagnosis and treatment. However, previous research reported widely differing sarcopenia prevalence due to different criteria. AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.
AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.
METHODS An observational study was conducted from July 2014 to January 2017, which included 648 consecutive gastric cancer patients who underwent radical gastrectomy. The sarcopenia elements (skeletal muscle index, handgrip strength, and gait speed) were measured within 1 mo or 7 d before surgery. The patients were followed at fixed intervals to gain the outcomes. Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately. The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index (C-index) and area under the time-dependent receiver operating characteristic curve (AUC). The Akaike information criterion (AIC) was applied to compare model fits.
RESULTS The prevalence of sarcopenia was 20.5% and 11.3% according to AWGS2019 and EWGSOP2, respectively. Sarcopenia was an independent risk factor for the long-term OS no matter based on AWGS2019 or EWGSOP2, but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio (HR) [2.150 (1.547-2.988)] than EWGSOP2-sarcopenia [HR 1.599 (1.092-2.339)]. Meanwhile, the model with AWGS2019-sarcopenia [C-index 0.773 (0.742-0.804); AIC 2193.7; time-dependent AUC 0.812 (0.756-0.867) for 1-year OS, 0.815 (0.778-0.852) for 3-year OS, and 0.809 (0.759-0.859) for 5-year OS] had better predictive power and model fits than the model with EWGSOP2-sarcopenia [C-index 0.762 (0.729-0.795); AIC 2215.2; time-dependent AUC 0.797 (0.741-0.854) for 1-year OS, 0.804 (0.767-0.842) for 3-year OS, and 0.799 (0.748-0.850) for 5-year OS].
CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy. The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia. AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
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Affiliation(s)
- Wen-Yi Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jiao-Jiao Dong
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xin-Ce Huang
- Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Zhe-Jing Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xiao-Lei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Qian-Tong Dong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Yong-Yu Bai
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Do JY, Seo JH, Kang SH. Validation of the SARC-F for Assessing Sarcopenia in Patients on Peritoneal Dialysis. J Ren Nutr 2021; 32:341-346. [PMID: 34053820 DOI: 10.1053/j.jrn.2021.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Proper screening or diagnosis of sarcopenia (SP) is important to obtain favorable outcomes in patients on peritoneal dialysis (PD). Previous studies have shown that the SARC-F is associated with various parameters of SP in elderly populations. In this study, we aimed to validate the SARC-F questionnaire for predicting SP in patients on PD. METHODS This cross-sectional study was conducted at a tertiary medical center. We identified all patients prevalent on PD patients (n = 127). A version of the original SARC-F was used to assess the questionnaire. Patients with a total score of ≥4 points were defined as the high group and those with <4 points were defined as the normal group. The hand grip strength and appendicular skeletal muscle mass index were measured in all patients. SP was defined as previously reported. RESULTS Of the 127 total patients, 29 (22.8%, high group) had an SARC-F score of ≥4. The sensitivity and specificity of the SARC-F for predicting SP were 70.0% and 81.2%, respectively. The negative predictive and positive predictive values were 96.9% and 24.1%, respectively. The area under curve of the SARC-F score for SP was 0.791 (0.709-0.858, P < .001). The hand grip strength of the normal and high groups was 26.4 ± 8.5 and 19.5 ± 6.8 kg, respectively (P < .001). The appendicular skeletal muscle mass index in the normal and high groups was 7.6 ± 1.3 and 7.2 ± 1.8 kg/m2, respectively (P = .152). An increase in the SARC-F score as a continuous variable or classification into the high group as a categorical variable was associated with a higher odds ratio for SP in univariate and multivariate analyses. CONCLUSION The SARC-F has a high negative predictive value and a high specificity for predicting SP in patients on PD.
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Affiliation(s)
- Jun Young Do
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jun Hyuk Seo
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
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Chew STH, Kayambu G, Lew CCH, Ng TP, Ong F, Tan J, Tan NC, Tham SL. Singapore multidisciplinary consensus recommendations on muscle health in older adults: assessment and multimodal targeted intervention across the continuum of care. BMC Geriatr 2021; 21:314. [PMID: 34001023 PMCID: PMC8127264 DOI: 10.1186/s12877-021-02240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rapidly aging societies worldwide and in Singapore present a unique challenge, requiring an integrated multidisciplinary approach to address high-value targets such as muscle health. We propose pragmatic evidence-based multidisciplinary consensus recommendations for the assessment and multi-modal management of muscle health in older adults (≥65 years) across the continuum of care. METHODS The recommendations are derived from an in-depth review of published literature by a multidisciplinary working group with clinical experience in the care of the older population in both acute and community settings. RESULTS The panel recommends screening for muscle impairment using the SARC-F questionnaire, followed by assessment for low muscle strength (handgrip strength or 5-times chair stand test ≥10 s as a surrogate for lower limb strength) to diagnose possible/probable sarcopenia. For uncomplicated cases, lifestyle modifications in exercise and diet can be initiated in the community setting without further assessment. Where indicated, individuals diagnosed with possible/probable sarcopenia should undergo further assessment. Diagnosis of sarcopenia should be based on low muscle strength and low muscle mass (bioimpedance analysis, dual-energy X-ray absorptiometry or calf circumference as a surrogate). The severity of sarcopenia should be determined by assessment of physical performance (gait speed or 5-times chair stand test ≥12 s as a surrogate for gait speed). To treat sarcopenia, we recommend a combination of progressive resistance-based exercise training and optimization of nutritional intake (energy, protein and functional ingredients). High quality protein in sufficient quantity, to overcome anabolic resistance in older adults, and distributed throughout the day to enable maximum muscle protein synthesis, is essential. The addition of resistance-based exercise training is synergistic in improving the sensitivity of muscle protein synthesis response to the provision of amino acids and reducing anabolic resistance. An expected dose-response relationship between the intensity of resistance-based training, lean mass and muscle strength is described. CONCLUSIONS Reviewed and endorsed by the Society of Rehabilitation Medicine Singapore and the Singapore Nutrition and Dietetics Association, these multidisciplinary consensus recommendations can provide guidance in the formulation of comprehensive and pragmatic management plans to improve muscle health in older adults in Singapore and Asia.
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Affiliation(s)
- Samuel T H Chew
- Department of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
- Society for Geriatric Medicine Singapore, Singapore, Singapore.
| | - Geetha Kayambu
- Department of Rehabilitation, National University Hospital, Singapore, Singapore
| | | | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fangyi Ong
- Singapore Nutrition and Dietetics Association, Singapore, Singapore
| | - Jonathan Tan
- Mount Elizabeth Novena Hospital, Singapore, Singapore
| | - Ngiap Chuan Tan
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
| | - Shuen-Loong Tham
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Society of Rehabilitation Medicine, Singapore, Singapore
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Ozer FF, Akin S, Tasci İ, Tasar PT, Savas S, Cincin AT, Yavuzer H, Erdincler DS, Balci C, Esme M, Ozturk ZA, Sezgin G, Nalbant S, Varli M, Karan MA, Saka B. Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey. Eur Geriatr Med 2021; 12:863-870. [PMID: 33866525 DOI: 10.1007/s41999-021-00499-z] [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: 11/23/2020] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the risk of sarcopenia in hospitalized older patients and to assess the associations between sarcopenia risk and health care outcomes including dependency, malnutrition, and dysphagia. METHODS This multicenter cross-sectional study was a part of the annual National Prevalence Measurement of Quality of Care (LPZ) in Turkey. Hospitalized patients age 65 and older were included in the study. The SARC-F was used to assess risk of sarcopenia. Dependency was appraised according to the Care Dependency Scale (CDS). Nutritional status was established with respect to the Malnutrition Universal Screening Tool (MUST). Dysphagia was screened by two structured questions. RESULTS A total of 492 patients were included in the analysis. Two hundred and forty patients (48.8%) were at risk of sarcopenia. Sarcopenia risk was more prevalent among women (p = 0.007) and patients with risk of sarcopenia were older (p < 0.001). Hospital stay was longer and malnutrition and dysphagia were more prevalent in patients with sarcopenia risk than without (all p < 0.001). All nutritional interventions were applied mostly to patients with sarcopenia risk than without. In multivariate analysis, advanced age (OR: 1.068, CI 1.032-1.104, p < 0.001), female gender (OR: 2.414, CI 1.510-3.857, p < 0.001), and dependency (OR: 5.022, CI 2.922-8.632, p < 0.001) were independently associated with sarcopenia risk. CONCLUSIONS Sarcopenia risk is related with unfavorable outcomes in hospitalized patients. Primarily older female patients are at risk for sarcopenia. It is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. The SARC-F may be a useful tool for screening sarcopenia risk in hospitalized patients.
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Affiliation(s)
- Firuzan Fırat Ozer
- Department of Geriatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey.
- Department of Geriatrics, Kayseri City Hospital, Kocasinan, 38080, Kayseri, Turkey.
| | - Sibel Akin
- Department of Geriatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - İlker Tasci
- Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Pinar Tosun Tasar
- Department of Internal Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Sumru Savas
- Department of Geriatrics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Asli Tufan Cincin
- Department of Geriatrics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Yavuzer
- Department of Geriatrics, Cerrahpasa University Faculty of Medicine, Istanbul, Turkey
| | - Deniz Suna Erdincler
- Department of Geriatrics, Cerrahpasa University Faculty of Medicine, Istanbul, Turkey
| | - Cafer Balci
- Department of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mert Esme
- Department of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zeynel Abidin Ozturk
- Department of Geriatrics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Gulbuz Sezgin
- Department of Internal Medicine, Maltepe University Faculty of Medicine, Istanbul, Turkey
| | - Selim Nalbant
- Department of Internal Medicine, Maltepe University Faculty of Medicine, Istanbul, Turkey
| | - Murat Varli
- Department of Geriatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Akif Karan
- Department of Geriatrics, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Bülent Saka
- Department of Geriatrics, İstanbul University Faculty of Medicine, Istanbul, Turkey
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Ida S, Kaneko R, Imataka K, Okubo K, Shirakura Y, Azuma K, Fujiwara R, Takahashi H, Murata K. Verification of the predictive validity for mortality of the SARC-F questionnaire based on a meta-analysis. Aging Clin Exp Res 2021; 33:835-842. [PMID: 32451963 DOI: 10.1007/s40520-020-01585-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/27/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Although the association between SARC-F questionnaire positivity and mortality has previously been studied, the results are inconsistent. Testing the predictive validity of the SARC-F questionnaire for clinically relevant outcomes of vital prognoses is important. AIM The objective of this study was to test the predictive validity of SARC-F by conducting a meta-analysis on the association between SARC-F, a screening tool for sarcopenia, and mortality. METHODS This meta-analysis used the MEDLINE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Google Scholar databases for literature searches. Studies that examined the relationship between SARC-F questionnaire positivity and mortality and reported hazard ratios or odds ratios and 95% confidence intervals were included. A random-effects model was used for statistical analyses, and pooled hazard ratios, pooled odds ratios, and 95% confidence intervals were calculated. RESULTS Through the literature search, we found five studies (7501 individuals) that met the eligibility criteria for this study. The pooled hazard ratio for SARC-F questionnaire positivity and mortality was 1.87 (95% confidence interval 1.41-2.46; P < 0.001), indicating a significant association. The pooled odds ratio for SARC-F questionnaire positivity and mortality was 1.97 (95% confidence intervals 1.10-3.53; P = 0.02), showing a significant association. CONCLUSIONS There was a significant association between SARC-F positivity and future mortality, indicating the predictive validity of the SARC-F questionnaire. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Satoshi Ida
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan.
| | - Ryutaro Kaneko
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Kanako Imataka
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Kaoru Okubo
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Yoshitaka Shirakura
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Kentaro Azuma
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Ryoko Fujiwara
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Hiroka Takahashi
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
| | - Kazuya Murata
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-21-chome, Ise-shi, FunaeMie, 516-8512, Japan
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Ito A, Ishizaka M, Kobayashi K, Sawaya Y, Hara T, Nagasaka Y, Yakabi A, Watanabe M, Kubo A. Changes in the screening efficacy of lower calf circumference, SARC-F score, and SARC-CalF score following update from AWGS 2014 to 2019 sarcopenia diagnostic criteria in community-dwelling older adults. J Phys Ther Sci 2021; 33:241-245. [PMID: 33814711 PMCID: PMC8012190 DOI: 10.1589/jpts.33.241] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022] Open
Abstract
[Purpose] To identify changes in the efficacy of the Asia Working Group for Sarcopenia (AWGS) screening tools and the differences between the different screening tools following the updates from the AWGS 2014 to 2019 criteria for community-dwelling older adults. [Participants and Methods] We included 139 community-dwelling older adults aged ≥65 years. We assessed the lower calf circumference, SARC-F score, SARC-CalF score, skeletal muscle mass, grip strength, and gait speed. Moreover, we investigated the sensitivity, specificity, likelihood ratios, and area under the ROC curve of the lower calf circumference, SARC-F score, and SARC-CalF score using the AWGS 2014 and 2019 criteria for sarcopenia diagnosis. [Results] The prevalences of sarcopenia were 10.8% and 12.9%, and 5.0% using the AWGS 2014 and 2019, and 2019 severe sarcopenia diagnostic criteria, respectively. Using AWGS 2014 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score, were 86.7% and 62.1%, 13.3% and 91.9%, and 66.7% and 80.6%, respectively. Using AWGS 2019 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 83.3% and 62.8%, 11.1% and 91.7%, and 66.7% and 81.8%, respectively. Using AWGS 2019 severe sarcopenia criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 100% and 59.8%, 14.3% and 91.7%, and 71.4% and 78.0%, respectively. [Conclusion] All screening tools used in AWGS 2014 and 2019 were similar in terms of efficacy; however, the AWGS 2019 severe sarcopenia criteria had different characteristics.
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Affiliation(s)
- Akihiro Ito
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Yoshihisa Nagasaka
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Science,
International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi
324-8501, Japan
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Sarcopenia Risk Evaluation in a Sample of Hospitalized Elderly Men and Women: Combined Use of the Mini Sarcopenia Risk Assessment (MSRA) and the SARC-F. Nutrients 2021; 13:nu13020635. [PMID: 33669277 PMCID: PMC7920060 DOI: 10.3390/nu13020635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: SARC-F and Mini Sarcopenia Risk Assessment (MSRA) questionnaires have been proposed as screening tools to identify patients at risk of sarcopenia. The aim of this study is to test the use of SARC-F and MSRA, alone and combined, as a pre-screening tool for sarcopenia in geriatric inpatients. Methods: 152 subjects, 94 men and 58 women, aged 70 to 94, underwent muscle mass evaluation by dual energy X-ray absorptiometry (DXA), muscle strength evaluation by handgrip, and completed the MSRA, SARC-F and Activity of daily living (ADL) questionnaires. Results: 66 subjects (43.4%) were classified as sarcopenic according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The 7-item SARC-F and MRSA and 5-item MSRA showed an area under the curve (AUC) of 0.666 (95% confidence interval (CI): 0.542–0.789), 0.730 (95% CI: 0.617–0.842) and 0.710 (95% CI: 0.593–0.827), respectively. The optimal cut-off points for sarcopenia detection were determined for each questionnaire using the Youden index method. The newly calculated cut-off points were ≤25 and ≤40 for MSRA 7- and 5-items, respectively. The ideal cut-off for the SARC-F was a score ≥3. Applying this new cut-off in our study population, sensitivity and specificity of the 7-item MSRA were 0.757 and 0.651, and 0.688 and 0.679 for the 5-item MSRA, respectively. Sensitivity and specificity of SARC-F were 0.524 and 0.765, respectively. The combined use of the 7-item SARC-F and MSRA improved the accuracy in sarcopenia diagnosis, with a specificity and sensitivity of 1.00 and 0.636. Conclusion: 7-item SARC-F and MSRA may be co-administered in hospital wards as an easy, feasible, first-line tool to identify sarcopenic subjects.
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Nozoe M, Kubo H, Kanai M, Yamamoto M, Okakita M, Suzuki H, Shimada S, Mase K. Reliability and validity of measuring temporal muscle thickness as the evaluation of sarcopenia risk and the relationship with functional outcome in older patients with acute stroke. Clin Neurol Neurosurg 2021; 201:106444. [PMID: 33395619 DOI: 10.1016/j.clineuro.2020.106444] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pre-stroke sarcopenia associated with poor functional outcomes. However, diagnosis of pre-stroke sarcopenia is often difficult in patients with acute stroke. Thus, we investigated the reliability and validity of measuring temporal muscle thickness (TMT) as an indicator of sarcopenia risk and its relationship with functional outcome in older patients with acute stroke. METHODS We conducted a cross-sectional and longitudinal study of the patients with acute elderly stroke in a single neurosurgical hospital. We measured TMT manually using brain computed tomography (CT) by two examiners. Sarcopenia risk, malnutrition risk, inflammation, comorbidities, and modified Rankin Scale (mRS) scores at 3 months after stroke were additionally assessed. Inter-rater reliability of TMT was determined by calculating the intra-class correlation coefficient ([ICC] 2,1). Multiple linear regression analyses was used to determine whether sarcopenia risk was independently associated with TMT, and logistic regression was used to evaluate the relationship between TMT and poor functional outcome (mRS > 3). RESULTS A total 289 acute elderly stroke patients (163 men and 126 women; mean age: 76 years) were enrolled in this study. Regarding the reproducibility of TMT, good reliability was found; ICC2,1 = 0.759 (95 % confidence interval = 0.705-0.804). Multiple linear regression analyses for TMT after adjusting for potential confounders showed that sarcopenia risk was independently associated with TMT in older patients with acute stroke (β = -0.138, p = 0.02). After adjusting for variables, disease severity and comorbidities were the only independent predictors for poor functional outcome, but not TMT. CONCLUSIONS TMT measurement using brain CT is a reliable and variable method to evaluate sarcopenia risk, but is not related to functional outcome in older patients with acute stroke.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Miho Yamamoto
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Masaki Okakita
- Department of Radiology, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Hidetsugu Suzuki
- Department of Radiology, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Shinichi Shimada
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
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Prognostic utility of dynapenia in patients with cardiovascular disease. Clin Nutr 2020; 40:2210-2218. [PMID: 33873266 DOI: 10.1016/j.clnu.2020.09.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/05/2020] [Accepted: 09/29/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dynapenia, defined as age-associated loss of skeletal muscle strength, is associated with increased mortality rate, poor activities of daily living, and reduced quality of life. Therefore, dynapenia appears to be a better independent predictor of mortality than sarcopenia in the elderly. However, the prognostic utility of dynapenia in patients with cardiovascular disease (CVD) is not clear. This study was performed to examine the prognostic utility of dynapenia defined by the criteria of Manini et al. in patients with CVD. METHODS The findings of 4192 consecutive patients ≥30 years old (median [interquartile range (IQR)] age 69 [60-76] years, 2874 males) with CVD were reviewed. Grip strength and quadriceps isometric strength (QIS) were measured just before hospital discharge, and low grip strength (<26 kg in males and <18 kg in females), low QIS (<45.0% body mass [BM] and <35.0% BM in males and females, respectively) were considered to indicate dynapenia. The endpoint was all-cause mortality. RESULTS A total of 507 deaths occurred during follow-up (median 2.0 years, IQR 0.8-4.4 years). The overall prevalence of dynapenia was 33.6% and increased with age (p for trend < 0.01). Females showed a significantly higher prevalence rate of dynapenia than males (43.3% vs. 29.2%, respectively; p < 0.01). Patients with dynapenia showed higher all-cause mortality rate than non-dynapenia patients (adjusted hazard ratio: 1.84; 95% confidence interval: 1.51-2.23; p < 0.01). CONCLUSIONS Dynapenia has a high prevalence among patients with CVD and is associated with increased mortality rate.
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Sarcopenia risk and diabetes mellitus are independent factors for lower limb muscle strength in older patients with acute stroke: A cross-sectional study. Nutrition 2020; 84:111025. [PMID: 33109453 DOI: 10.1016/j.nut.2020.111025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Lower extremity (LE) muscle strength is an important factor for functional outcome in patients with stroke. However, to our knowledge, the factors influencing LE muscle strength in older patients with acute stroke have not been studied. The aim of this study was to investigate the relationships between prestroke sarcopenia risk and comorbidities with LE muscle strength in older patients with acute stroke. METHODS In this cross-sectional study, we assessed LE muscle strength using the Motricity IUndex (MI), and prestroke sarcopenia risk using SARC-F, a questionnaire for sarcopenia. Multivariate regression analysis was used to investigate the relationship of MI with sarcopenia risk, neurologic deficit assessed by the National Institutes of Health Stroke Scale (NIHSS), and comorbidities in these patients. RESULTS We enrolled 223 patients aged 65 and over with acute stroke (127 men and 96 women; mean age 76 y). Multivariate analyses for MI after adjusting for potential confounders, NIHSS score, diabetes mellitus, and the presence of sarcopenia risk were independently and negatively associated with MI in older patients with stroke (β = -0.775, P < 0.001; β = -0109, P = 0.010; β = -0.097, P = 0.030, respectively). CONCLUSIONS Prestroke sarcopenia and diabetes mellitus are associated with LE muscle strength in older patients with acute stroke, and these assessments would be useful for clinicians.
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Medina Victoria DA, Laverde LA, Alviz Conde LK, Galvis JC. Prevalencia de dinapenia (disminución de la fuerza), sarcopenia y posibles biomarcadores en rehabilitación cardíaca. REPERTORIO DE MEDICINA Y CIRUGÍA 2020. [DOI: 10.31260/repertmedcir.01217372.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: la relación entre dinapenia y sarcopenia da como resultado un aumento adicional en el riesgo de morbimortalidad en la población general, con un incremento progresivo de acuerdo con la edad. A partir de los 30 años debido a la disminución de la masa muscular y de la fuerza, se afecta la capacidad de ejercicio, la calidad de vida y el estado de ánimo. Objetivo: determinar la prevalencia de dinapenia y sarcopenia en los pacientes en rehabilitación cardíaca de un hospital colombiano, con mediciones de la fuerza y de los marcadores bioquímicos. Métodos: estudio de corte transversal en mayores de 40 años en rehabilitación cardíaca con controles al menos una vez por semana. La medición de la fuerza se realizó con dinamómetro de mano, la masa muscular con impedanciómetro bipolar y velocidad de la marcha con la prueba de caminata de 6 metros. Se tomaron mediciones de hormona de crecimiento (GH), testosterona libre, somatomedina IGF-1 y cortisol. Resultados: la disminución de la fuerza muscular fue prevalente en hombres (n=15, 19.4%; mujeres n=5, 10%). La prevalencia de dinapenia fue 15,7% y sarcopenia 0%. Los resultados obtenidos fueron GH 0.27 (0.08-1.18), testosterona 5.9 (0.3-8.5), IGF-1 126 (95.5-169) cortisol 13.9 (11.2-18.4). Las patologías más frecuentes de los pacientes del programa fueron infarto del miocardio, angioplastia e implantación de stent. Conclusiones: la prevalencia de dinapenia fue 15.7%. No se encontró diferencia alguna de los marcadores bioquímicos en los pacientes con y sin dinapenia.
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Fujita K, Nakashima H, Kako M, Shibata A, Yu-Ting C, Tanaka S, Nishida Y, Kuzuya M. Short physical performance battery discriminates clinical outcomes in hospitalized patients aged 75 years and over. Arch Gerontol Geriatr 2020; 90:104155. [PMID: 32585555 DOI: 10.1016/j.archger.2020.104155] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/01/2023]
Abstract
AIM Low physical function is associated with poor outcomes in hospitalized patients; however, little is known about vulnerable populations such as those aged ≥ 75 years. We examined whether the Short Physical Performance Battery (SPPB) was associated with clinical outcomes in hospitalized patients aged ≥ 75 years. METHODS In total, 147 patients aged ≥ 75 years (mean age, 86.5 ± 4.7 years; 89 males) completed the SPPB and Mini-Mental State Examination (MMSE) before hospital discharge. Patients were divided into three groups by SPPB score: 0 (unable to perform SPPB), 1-6 (low performance), and 7-12 (high performance). The first occurrence of all-cause unplanned readmission or all-cause mortality within 1 year after discharge was set as the endpoint. RESULTS The median SPPB score of the study population was 2; 41 % were unable to perform SPPB, 33 % had low performance, and 26 % had high performance. High SPPB was associated with younger age, higher body weight, and higher MMSE score. During the follow-up period, 35 (23.8 %) patients were readmitted to hospital and 19 (12.9 %) died. Even after adjusting for covariates, SPPB score was a significant and independent predictor of poor outcomes (hazard ratio for 1 point increase in SPPB, 0.88; P = .002). The subgroup analysis showed SPPB was inversely associated with the occurrence of poor outcomes in patients with cognitive impairment. CONCLUSIONS SPPB is inversely associated with risks for readmission and mortality in hospitalized patients aged ≥ 75 years, especially those with cognitive impairment. The present results indicate the SPPB is useful for accurate prognosis in hospital settings.
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Affiliation(s)
- Kosuke Fujita
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masato Kako
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Atsushi Shibata
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Cheng Yu-Ting
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan; Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Gade J, Quick AA, Beck AM, Rønholt F, Vinther A. SARC-F in hospitalized, geriatric medical patients - Feasibility, prevalence of risk of sarcopenia, and characteristics of the risk group, including one-year follow-up. Clin Nutr ESPEN 2020; 37:80-86. [PMID: 32359760 DOI: 10.1016/j.clnesp.2020.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/12/2020] [Accepted: 03/18/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES SARC-F is an interview-based screening-tool recommended to rapidly screen for risk of sarcopenia - the loss of muscle mass and strength. Not previously investigated, this observational study aimed to assess the feasibility of the SARC-F screening tool in Danish geriatric medical patients, estimate the prevalence of risk, and investigate associations to predefined variables. METHODS This was an observational cohort study with a one-year follow-up. All non-isolated patients ≥65 years, understanding Danish and admitted to a Danish geriatric medical ward in the capital region of Denmark, were recruited. If readmitted during the study period, they were not included again. The following data were collected upon recruitment; demographics, nutritional risk screening (NRS-2002), BMI, calf-circumference, Barthel-index, health-related Quality of life (QoL), hand-grip strength (HGS), and length of hospital admission. Additionally, the one-year follow-up included mortality, admission(s) to hospital, and visits to the emergency-room. RESULTS From September 2017 to February 2018, 461 patients were admitted, 377 eligible, and 301 included. Study feasibility was 80%, and estimated feasibility if implemented in daily clinical practice was 85%, as some patients had to be excluded from screening due to cognitive impairment. The prevalence of the risk of sarcopenia upon admission for participants were 64.5%. Being at risk were characterized by significantly lower HGS, Barthel-index, and QoL, as well as longer admissions (men only), and one-year mortality (female only) (P ≤ 0.05). CONCLUSION Use of SARC-F is feasible in a geriatric setting, but only in older adults without severe cognitive problems. Risk of sarcopenia among geriatric patients ≥65 years is high, and the risk group is characterized by lower strength, functional- and QoL measurements, longer hospitalization (men only), and increased mortality (women only).
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Affiliation(s)
- Josephine Gade
- Dietetics and Clinical Nutrition Research Unit, Herlev and Gentofte University Hospital, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen University, Denmark.
| | | | - Anne Marie Beck
- Dietetics and Clinical Nutrition Research Unit, Herlev and Gentofte University Hospital, Denmark; University College Copenhagen, Denmark
| | - Finn Rønholt
- Medical Department, Herlev and Gentofte University Hospital, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Herlev and Gentofte University Hospital, Denmark; QD-Research Unit, Herlev and Gentofte University Hospital, Denmark
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Van Nguyen T, Tran KD, Bui KX, Le D, Nguyen TN. A preliminary study to identify the likely risk for sarcopenia in older hospitalised patients with cardiovascular disease in Vietnam. Australas J Ageing 2020; 39:e315-e321. [PMID: 32270595 DOI: 10.1111/ajag.12789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the prevalence of sarcopenia, its associated factors and its impact on readmission in older hospitalised patients with cardiovascular diseases (CVD) in Vietnam. METHODS Patients aged ≥60 with CVD were recruited from 12/2018 to 6/2019 at a tertiary hospital in Vietnam. Sarcopenia was defined by the criteria proposed by the Asian Working Group for Sarcopenia (AWGS). RESULTS There were 251 participants, with a mean age of 73.7 ± 8.8, 39.4% were female, and 34.3% had sarcopenia. On multivariable logistic regression, heart failure, chronic kidney disease and being currently unmarried were significantly associated with sarcopenia. The incidence of 5-month readmission was 35.7% (50.0% in sarcopenic participants and 27.9% in non-sarcopenic participants, P = .001). Sarcopenia independently increased the risk of readmission (adjusted OR 2.19, 95% CI 1.08-4.42). CONCLUSION Sarcopenia was present in one-third of older hospitalised patients with CVD and increased their risk of readmission. This finding suggests the need to raise awareness of sarcopenia among clinicians and older patients in Vietnam.
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Affiliation(s)
- Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Khuong Dang Tran
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Khai Xuan Bui
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Duong Le
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Tu Ngoc Nguyen
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020; 21:300-307.e2. [PMID: 32033882 DOI: 10.1016/j.jamda.2019.12.012] [Citation(s) in RCA: 2880] [Impact Index Per Article: 720.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022]
Abstract
Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong S.A.R., China.
| | - Prasert Assantachai
- Division of Geriatric Medicine, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tung-Wai Auyeung
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Ming-Yueh Chou
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Jenny S W Lee
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Chih-Kuang Liang
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wee Shiong Lim
- Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ken Sugimoto
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoki Tanaka
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Teimei Zhang
- Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Health, Beijing, China
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
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Ishida Y, Maeda K, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Mori N. Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults. Nutrients 2020; 12:nu12020541. [PMID: 32093144 PMCID: PMC7071417 DOI: 10.3390/nu12020541] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
Malnutrition leads to poor prognoses, including a predisposition to falls. Few studies have investigated the relationship between malnutrition and falls during hospitalization. This study aimed to determine malnutrition’s association with falls during hospitalization. A retrospective observational study was conducted. Patients aged ≥65 years that were admitted to and discharged from a university hospital between April 2018 and March 2019 were examined. Patients with independent basic activities of daily living were included. Diagnosis of malnutrition was based on the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria at admission. Disease information such as the Charlson Comorbidity Index (CCI) and reasons for hospitalization were reviewed. Kaplan–Meier curve and multivariate Cox regression analyses were performed. Data from 6081 patients (mean age: 74.4 ± 6.1 years; males: 58.1%) were analyzed. The mean CCI was 2.3 ± 2.8 points. Malnutrition was detected in 668 (11.0%) and falls occurred in 55 (0.9%) patients. Malnourished patients experienced a higher fall rate than those without malnutrition (2.4% vs. 0.7%, log-rank test p < 0.001). In multivariate analysis, malnutrition had the highest hazard ratio for falls among covariates (hazard ratio 2.78, 95% confidence interval 1.51–5.00, p = 0.001). In conclusion, malnutrition at the time of admission to hospital predicts in-hospital falls.
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Affiliation(s)
- Yuria Ishida
- Department of Nutrition, Aichi Medical University Hospital, Nagakute 480-1195, Japan;
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Correspondence: ; Tel.: +81-561-62-3311; Fax: +81-561-78-6364
| | - Tomoyuki Nonogaki
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8511, Japan;
| | - Yosuke Yamanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Ryoko Kato
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
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43
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Affiliation(s)
- Jüergen M Bauer
- Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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Ha YC, Won Won C, Kim M, Chun KJ, Yoo JI. SARC-F as a Useful Tool for Screening Sarcopenia in Elderly Patients with Hip Fractures. J Nutr Health Aging 2020; 24:78-82. [PMID: 31886812 DOI: 10.1007/s12603-019-1307-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND SARC-F is recommended as a sarcopenia screening tool and comprised of five assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. OBJECTIVE The purpose of this study was to assess whether the SARC-F questionnaire in elderly patients with hip fractures was a valid screening tool for sarcopenia by comparison of the results with criteria from the Europe, Asia, and international working groups. MEASUREMENTS 115 men and woman with hip fractures were assessed. The SARC-F self-reported questionnaire scores range from 0 to 10 and a score ≥ 4 defines sarcopenia. These survey questions were used to calculate the SARC-F score. Measurements, including appendicular muscle mass, were taken using dual-energy X-ray and grip strength using a dynamometer. Classification using the SARC-F score was compared using the consensus panel criteria from the international, European, and Asian sarcopenia working groups. The performance of all four methods was compared by examining the predictive ability using a ROC curve. RESULTS A total of 115 subjects were included and the sarcopenia prevalence rate (SARC-F score ≥ 4) was 63.5 percent. The sensitivity, specificity, positive predictive value, negative predictive value PPV with the EWGSOP-2 criteria in Older People as the reference standard were 95.35 %, 56.94 %, 56.94%, 95.35%, and 71.3%, respectively. In addition, we found similar results for sensitivity and specificity as studies using the EWGSOP and AWGS criteria. CONCLUSIONS The SARC-F questionnaire is a useful screening tool for elderly patients with hip fractures. This finding supports the recommendation of SARC-F as a screening tool for sarcopenia from the EWGSOP2.
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Affiliation(s)
- Y-C Ha
- Jun-Il Yoo, MD, Department of Orthopaedic Surgery, Gyeongsang National University Hospital, 90 Chilamdong, Jinju, Gyeongnamdo 660-702, Republic of Korea. Tel: +82-10-3242-4980E-mail:
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Gade J, Beck AM, Rønholt F, Andersen HE, Munk T, Vinther A. Validation of the Danish SARC-F in Hospitalized, Geriatric Medical Patients. J Nutr Health Aging 2020; 24:1120-1127. [PMID: 33244571 DOI: 10.1007/s12603-020-1453-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Validation of the Danish version of the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) for hospitalized geriatric medical patients, compared against the original EWGSOP (European Working Group on Sarcopenia in Older People) and revised EWGSOP2 definition for sarcopenia. Additionally, investigation of the ability of SARC-F to individually identify low strength/function and muscle mass. DESIGN Cross-sectional analysis of data from an RCT. SETTING Hospital, Medical Department. PARTICIPANTS 122 geriatric medical patients (65.6% women) ≥ 70 years of age with mixed medical conditions. MEASUREMENTS SARC-F screening, diagnostic assessment of sarcopenia (hand-grip strength, muscle mass measured by dual-frequency bio-impedance analysis, and 4-m usual gait speed). RESULTS The prevalence of risk of sarcopenia (SARC-F ≥ 4) was 48.3%, while it was diagnosed in 65.8% and 21.7%, with EWGSOP and EWGSOP2, respectively. The sensitivity, specificity, positive predictive value, negative predictive value according to EWGSOP were 50.0 %, 53.7 %, 67.2% and 36.1%, while they were 53.8 %, 53.2 %, 24.1% and 80.6%, according to EWGSOP2 (all participants). The ability of SARC-F to predict reduced strength, function, and muscle mass was modest. There was a significant negative linear, yet weak, relationship between total SARC-F score and hand-grip strength (R2=0.033) and 4-m gait speed (R2=0.111), but not muscle mass (R2=0.004). CONCLUSION SARC-F does not seem to be a suitable screening tool for identifying and excluding non-sarcopenic geriatric patients. Furthermore, the SARC-F score was more strongly correlated with reduced muscle strength and physical function than with low muscle mass.
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Affiliation(s)
- J Gade
- Anders Vinther, Dept. Physiotherapy and Occupational therapy, Borgmester Ib Juuls Vej 29, DK-2730 Herlev, Denmark, Phone: +45-26808710 and E-mail:
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46
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Prestroke sarcopenia and functional outcomes in elderly patients who have had an acute stroke: A prospective cohort study. Nutrition 2019; 66:44-47. [DOI: 10.1016/j.nut.2019.04.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/25/2022]
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Kera T, Kawai H, Hirano H, Kojima M, Watanabe Y, Motokawa K, Fujiwara Y, Osuka Y, Kojima N, Kim H, Ihara K, Obuchi S. Limitations of SARC-F in the diagnosis of sarcopenia in community-dwelling older adults. Arch Gerontol Geriatr 2019; 87:103959. [PMID: 31945638 DOI: 10.1016/j.archger.2019.103959] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE The SARC-F is a recommended screening tool for sarcopenia; however, its sensitivity is reported to be very low. This study aimed to confirm the diagnostic efficacy of the SARC-F and whether it is affected by population characteristics. METHODS In this study, 2 cohorts of 1060 community-dwelling older adults, who were monitored by the Tokyo Metropolitan Institute of Gerontology, were included. In addition to the overall dataset, receiver operating characteristic curve analysis was performed to obtain the SARC-F results for sarcopenia among the datasets for only those older in age (over 75 years), those with higher frailty points (above the median total score for the Kihon Checklist points), those with lower grip strength (below the median), lower gait speed (below the median), and those with comorbidities (hypertension, cerebral vascular disease, heart disease, and diabetes mellitus). RESULTS In the overall dataset, sensitivity and specificity were 3.9% and 97.3%, respectively. In analyzing the area under the curve, sensitivity and specificity for older age and low physical function datasets were significant, but had low values. The diabetes dataset had higher values but did not effectively diagnose sarcopenia at a cutoff value of 4. CONCLUSION The SARC-F had high specificity for the diagnosis of sarcopenia in community-dwelling older adults with low physical function. However, its sensitivity was low. Despite these limitations, it may be used as a screening tool for sarcopenia in selected populations, such as adults in hospitals or nursing homes.
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Affiliation(s)
- Takeshi Kera
- Takasaki University of Health and Welfare, Gunma, Japan; Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | | | | | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | - Yosuke Osuka
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Narumi Kojima
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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48
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Kera T, Kawai H, Hirano H, Kojima M, Watanabe Y, Motokawa K, Fujiwara Y, Ihara K, Kim H, Obuchi S. SARC-F: A validation study with community-dwelling older Japanese adults. Geriatr Gerontol Int 2019; 19:1172-1178. [PMID: 31535433 DOI: 10.1111/ggi.13768] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/18/2019] [Accepted: 08/10/2019] [Indexed: 12/16/2022]
Abstract
AIM The SARC-F is a useful clinical index for sarcopenia screening; however, this measure has low sensitivity. Furthermore, this tool has never been validated on community-dwelling older Japanese adults. The goal of the present study was to validate a Japanese version of the SARC-F and confirm its suitability for Japanese samples. METHODS Participants were 734 community-dwelling older adults in the Itabashi Ward, Japan. Bioimpedance measures, walking speed, grip strength and instrumental activities of daily living (IADL) were measured. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People, the Asian Working Group for Sarcopenia criteria and Japanese-adjusted Asian Working Group for Sarcopenia. SARC-F receiver operating characteristic curves for each sarcopenia measure were used to evaluate diagnostic accuracy. Physical functioning, IADL and sarcopenia screening tools were compared with the SARC-F. RESULTS A total of nine men (3.1%) and 15 women (3.4%) were classified into a SARC-F sarcopenia group. The sarcopenia group had lower physical functioning and Mini Sarcopenia Risk Assessment scores and higher frailty status than the control group. The Cronbach's alpha for the SARC-F was 0.610, suggesting insufficient internal consistency. SARC-F scores were related to physical functioning, IADL, and Mini Sarcopenia Risk Assessment scores. Receiver operating characteristic analyses of the SARC-F based on each criterion showed low sensitivity, but high specificity. CONCLUSIONS The Japanese version of the SARC-F appears to be a useful index for reflecting physical functioning and IADL. However, it is necessary to further determine whether this tool is useful for detecting sarcopenia among community-dwelling older adults. Geriatr Gerontol Int 2019; 19: 1172-1178.
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Affiliation(s)
- Takeshi Kera
- Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Japan.,Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Department of Oral Surgery and Dentistry, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.,Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motonaga Kojima
- Department of Physical Therapy, University of Tokyo Health Sciences, Tokyo, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan.,Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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49
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Morley JE, Vellas B. Patient-Centered (P4) Medicine and the Older Person. J Am Med Dir Assoc 2019; 18:455-459. [PMID: 28549701 DOI: 10.1016/j.jamda.2017.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/04/2017] [Indexed: 12/25/2022]
Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO.
| | - Bruno Vellas
- Gérontopôle, CHU Toulouse University Hospital and INSERM U1027, Toulouse, France
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50
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Yamamoto S, Matsuzawa R, Harada M, Watanabe T, Shimoda T, Suzuki Y, Kamiya K, Osada S, Yoshida A, Matsunaga A. SARC-F Questionnaire: Rapid and Easy Tool for Identifying Physical Limitations in Hemodialysis Patients. JCSM CLINICAL REPORTS 2019. [DOI: 10.17987/jcsm-cr.v4i1.74] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background:SARC-F is a simple questionnaire for rapidly assessing physical function and screening for sarcopenia. This study aimed to determine whether the SARC-F questionnaire is useful for identifying impaired physical function and the risk of physical limitations in hemodialysis patients.Methods:This cross-sectional study included 281 patients undergoing hemodialysis at two dialysis units.SARC-F, handgrip strength, leg strength, one-leg standing time, usual gait speed, and short physical performance battery (SPPB) score were measured. Patients were classified according to the SARC-F score (SARC-F <4 and SARC-F ≥4), indicating the risk of sarcopenia. Furthermore, we defined physical limitations as handgrip strength of <26 kg for men and <18 kg for women, leg strength of <40%, usual gait speed of ≤0.8 m/s, and SPPB score of ≤8 points. To calculate the areas under the curves (AUCs) of the SARC-F score for physical limitations, receiver-operating characteristic curve analysis was performed.Results:SARC-F ≥4 was observed in 75 (26.7 %) hemodialysis patients. The SARC-F ≥4 group had a significantly lower handgrip and leg strength, shorter one-leg standing time, slower usual gait speed, and lower SPPB score than the SARC-F <4 group, even after adjusting for potential confounders (all P<0.001). Further, SARC-F demonstrated good accuracy in identifying the risk of physical limitations (all AUCs > 0.75).Conclusions:The SARC-F questionnaire is useful for screening impaired physical function and for identifying the risk of physical limitations in hemodialysis patients and can be easily and rapidly administered to this patient group in clinical practice.
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