Sarcopenia: a clinical review

Validation of the Chinese version of the Mini Sarcopenia Risk Assessment questionnaire in community-dwelling older adults

A new sarcopenia screening tool named Mini Sarcopenia Risk Assessment (MSRA) has recently been developed, which showed a reasonable sensitivity and specificity.We cross-culturally adapted and validated the Chinese version of the MSRA in a population of community-dwelling older adults.We conducted a cross-sectional study in a community in Chengdu, China. Older adults aged 60 years or older were included. A Chinese translation of the MSRA was created. The Chinese version of the MSRA included 2 questionnaires named C-MSRA-7 (containing 7 items) and C-MSRA-5 (containing 5 items). For C-MSRA-7 and C-MSRA-5, total scores of ≤ 30 and 45, respectively, indicate that the subject has sarcopenia. Using 4 common diagnostic criteria of sarcopenia (the European Working Group on Sarcopenia in Older People, Asia Working Group for Sarcopenia, International Working Group on Sarcopenia, and Foundation for the National Institutes of Health criteria) as the "gold standard"; the sensitivity and specificity of the C-MSRA-7 and C-MSRA-5 were examined. We applied the receiver operating characteristic curve to compare the overall accuracy of the C-MSRA-7 and C-MSRA-5 for screening sarcopenia.We recruited 384 participants (mean age: 71.5 ± 5.8 years). Using different criteria as the "gold standard," both C-MSRA-7 and C-MSRA-5 have acceptable sensitivity (ranging from 78.0% [95% confidence interval [CI]: 66.3-87.7] to 86.9% [95% CI: 75.87-94.2] for C-MSRA-7 and from 80.2% [95% CI: 70.8-87.6] to 90.2% [95% CI: 79.8-96.3] for C-MSRA-5) for screening sarcopenia. However, compared with the C-MSRA-7, the C-MSRA-5 is simpler and has better specificity (ranging from 55.9% to 70.6% for C-MSRA-5; and 38.3% to 41.0% for C-MSRA-7) and overall diagnostic accuracy.The MSRA scale was successfully adapted to the Chinese language and validated in Chinese community-dwelling older adults. Compared with C-MSRA-7, C-MSRA-5 is the better tool for screening sarcopenia.

Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients

A new term, malnutrition-sarcopenia syndrome (MSS), was recently coined to describe the clinical presentation of both malnutrition and sarcopenia. The aim of this study was to investigate the association between MSS and long-term mortality in older inpatients. We conducted a prospective study in acute geriatric wards of two local hospitals in China. Muscle mass and malnutrition were estimated by anthropometric measures and the Mini Nutritional Assessment (MNA). Of the 453 participants, 14 (3.1%) had sarcopenia with normal nutrition, 139 (30.7%) had malnutrition risk without sarcopenia, 48 (10.6%) had malnutrition risk with sarcopenia, 25 (5.5%) had malnutrition without sarcopenia, and 22 (4.9%) had MSS at baseline. Compared with non-sarcopenic subjects with normal nutrition, subjects with MSS and subjects with malnutrition risk and sarcopenia were more than four times more likely to die (hazard ratio [HR], 4.78; 95% confidence interval [CI], 2.09-10.97; and HR, 4.25; 95% CI, 2.22-8.12, respectively); non-sarcopenic subjects with malnutrition risk were more than two times more likely to die (HR, 2.41; 95% CI, 1.32-4.39). In conclusion, MSS may serve as a prognostic factor in the management of hospitalized older patients.

Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study

Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.

Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas

OBJECTIVES

To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia.

DESIGN

A cross-sectional study.

SETTING

Urban and rural communities in western China.

PARTICIPANTS

A total of 887 community-dwelling elderly adults aged 60 years or older.

MEASUREMENT

Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively.

RESULTS

A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia.

CONCLUSIONS

Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies.