Sarcopenia and mortality risk in community-dwelling Brazilian older adults

Body composition of older adults with normal body mass index. Cross-sectional analysis of the Toulouse Frailty clinic

BACKGROUND

Body mass index (BMI) determines general corpulence and health, whatever age, sex or clinical background. Normal BMI (18.5-24.9 kgm2) is defined as healthy, normal, weight leading to a false impression that no intervention is needed.

OBJECTIVES

Assess the prevalence of body impairments in the presence of normal BMI.

DESIGN

Cross-sectional design. Bivariate and a multivariate regression analysis assessed the association of body composition with clinical parameters in the presence of normal BMI.

SETTING

Community dwelling older adults attending the Toulouse Frailty Clinic at the University Hospital, Toulouse.

PARTICIPANTS

876 community dwelling, autonomous older adults, 70 years and over.

MEASUREMENTS

Dual X-ray Absorptiometry (DXA) assessment, and cognitive, physical, nutritional, and demographic evaluations were included in the present analysis.

RESULTS

Of the initial sample, 347 (39.61 %) patients had normal BMI, and among them, 152 (43.80 %) had low lean mass, 144 (41.49 %) were osteoporotic and 2 (0.58 %) increased fat mass. A poor nutritional status (Mini-Nutritional Assessment score, MNA-score, <24) was the only independent variable associated with body impairments in the presence of normal BMI (Odd Ratio 2.83; 95 % Confidence Interval 1.64-4.89).

CONCLUSION

Nearly 70 % of the adults with normal BMI had at least one impairment in body composition (low lean mass, osteoporosis, or obesity). In the light of the present study, older adults with normal BMI and an MNA-score under 24 should be assessed with DXA to identify the age-associated impairments in body composition in order to lead to specific interventions.

The effect of resistance training on patients with secondary sarcopenia: a systematic review and meta-analysis

To analyse the effectiveness of resistance training on secondary sarcopenia, we conducted a meta-analysis to elucidate the effects of resistance training (RT) on muscle strength (handgrip strength [HGS]), muscle mass (Skeletal muscle mass index [SMI]), and physical function (Gait speed [GS]) in patients with secondary sarcopenia. All studies published between 2015 and January 2024 on the effects of resistance training on patients with secondary sarcopenia were retrieved from 6 electronic databases: PubMed, Web of Science Core Collection, Embase, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) Core journals and the Wanfang Database. Two researchers independently extracted and evaluated studies that met the inclusion and exclusion criteria. Finally, 12 randomized controlled trials were included. Pooled analyses of baseline data and results were performed using Review Manager 5.3 with standardized mean variance (SMD) and random effects model. The study included 12 randomized controlled trials involving 639 patients (mean age 57.28 ± 2.66 to 79.6 ± 5.4 years). There are five types of complications among the patients: obesity, type 2 diabetes, Alzheimer's disease, hemodiaysis, and pancreatic cancer. Compared with the control group, RT effectively improved HGS [SMD = 2.47, 95% CI (1.50, 3.43), p < 0.01, I2 = 94%]; SMI [SMD = 0.94, 95% CI (0.52, 1.36), p < 0.01, I2 = 56%]; and GS [SMD = 2.18, 95% CI (-0.01, 4.37), p ≥ 0.05, I2 = 97%]. Further subgroup analysis of the results showed that the intervention effect on grip strength was greater for non-elastic band resistance [SMD = 2.40, 95% CI (1.05, 3.75), p < 0.01, I2 = 94%] than for elastic band resistance (EBRT) [SMD = 1.22, 95% CI (-0.14, 2.58), p < 0.01, I2 = 95%]. The intervention effect of RT on grip strength is more significant in patients with T2D [SMD = 0.59, 95%CI (0.26-0.93, p < 0.01, I2 = 27%] and obesity [SMD = 0.74, 95%CI (0.32-1.15, p < 0.01, I2 = 0%]. For patients with secondary sarcopenia, Resistance training (RT) can effectively enhance muscle strength and muscle mass; however, it does not significantly improve physical function. Different RT intervention methods have different effects on patients, such as elastic band training and non-elastic band training (bounce ball RT; equipment RT, etc.). Different types of complications may influence the effectiveness of RT intervention.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

INTRODUCTION

Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru.

METHODS

This cross-sectional study was conducted between 2018 and 2020. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS2) guidelines. We measured muscle strength by maximum handgrip strength and muscle mass using bioelectrical impedance analyzer. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.

RESULTS

The study participants had a mean age of 66.2 years (SD 7.1), age range between 60 to 92 years old, of which 621 (53.9%) were men. Among the sample, 41.7% were classified as obese (BMI ≥30.0 kg/m²). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI: 25.2-30.4) using the AWGS2 criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS2 criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).

CONCLUSION

Our findings reveal substantial variation in the prevalence of sarcopenia and SO, underscoring the necessity for context-specific cut-off values. Although the prevalence of SO was relatively low, this result may be underestimated. Furthermore, the consistently high proportion of probable sarcopenia and sarcopenia point to a substantial public health burden.

Associations of physical activity intensity, frequency, duration, and volume with the incidence of sarcopenia in middle-aged and older adults: a 4-year longitudinal study in China

BACKGROUND

Physical activity (PA) plays an important role in the process of several chronic diseases. It may be also associated with the incidence of sarcopenia. This study aimed to determine the association of PA from different components including frequency, duration, intensity, and volume with the incidence of sarcopenia in middle-aged and older adults.

METHODS

This study used data from the China Health and Retirement Longitudinal Study in 2011 and 2015. A total of 3,760 individuals aged ≥ 40 years were involved in this study. Sarcopenia was diagnosed using muscle mass, strength and physical performance according to the Asian Working Group for Sarcopenia. PA information including frequency, duration, intensity, and volume was obtained by a self-reported questionnaire. Logistic regression analysis was employed to examine the association between PA and the incidence of sarcopenia at 4-year follow-up.

RESULTS

The incidence of sarcopenia was 5.9% during the 4-year follow-up. Compared to sedentary individuals, those taking 1-2 days or more per week, or a minimum of 10 min each time on vigorous-intensity PA (VPA) had a lower incidence of sarcopenia. Adults spending 3 days or more each week, a minimum of 30 min each time, or 150 min or more per week on moderate-intensity PA (MPA) had a lower presence of sarcopenia than sedentary adults. Adults taking 3 days or more per week, at least 30 min each time, or 150 min or more each week on light-intensity PA (LPA) tended to have a lower incidence of sarcopenia than sedentary individuals. Sensitivity analyses confirmed the robustness of the findings after removing persons with hypertension, dyslipidemia, or diabetes.

CONCLUSIONS

These findings suggest that the frequency, duration, and volume of VPA or MPA are negatively associated with the presence of sarcopenia. Participation in LPA tends to have a lower incidence of sarcopenia in middle-aged and older adults.

Sarcopenic Obesity as a Risk Factor for Cardiovascular Disease: An Underrecognized Clinical Entity

Sarcopenic obesity (SO) is a chronic condition and an emerging health challenge, in view of the growing elderly population and the obesity epidemic. Due to a lack of awareness among treating doctors and the non-specific nauture of the associated symptoms, SO remains grossly underdiagnosed. There is no consensus yet on a standard definition or diagnostic criteria for SO, which limits the estimation of the global prevalence of this condition. It has been linked to numerous metabolic derangements, cardiovascular disease (CVD) and mortality. The treatment of SO is multimodal and requires expertise across multiple specialties. While dietary modifications and exercise regimens have shown a potential therapeutic benefit, there is currently no proven pharmacological management for SO. However, numerous drugs and the role of bariatric surgery are still under trial, and have great scope for further research. This article covers the available literature regarding the definition, diagnostic criteria, and prevalence of SO, with available evidence linking it to CVD, metabolic disease and mortality, and an overview of current directives on management.

Factors Associated with Sarcopenia among Elderly Individuals Residing in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis

To investigate the factors associated with sarcopenia in elderly individuals residing in nursing homes and community settings, we conducted a systematic search of databases, including MEDLINE, EMBASE, PubMed, Web of Science and Cochrane, up to May 2023. We incorporated a total of 70 studies into our analysis. Our findings revealed that the prevalence of sarcopenia in nursing homes ranged from 25% to 73.7%, while in community settings, it varied from 5.2% to 62.7%. The factors associated with sarcopenia in both nursing homes and community settings included male gender, BMI, malnutrition, and osteoarthritis. In community settings, these factors comprised age, poor nutrition status, small calf circumference, smoking, physical inactivity, cognitive impairment, diabetes, depression and heart disease. Currently, both the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGS) standards are widely utilized in nursing homes and community settings, with the EWGSOP standard being more applicable to nursing homes. Identifying factors associated with sarcopenia is of paramount significance, particularly considering that some of them can be modified and managed. Further research is warranted to investigate the impact of preventive measures on these factors in the management of sarcopenia among elderly individuals residing in nursing homes and community settings.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

Background

Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. However, there remains a lack of consensus on the criteria and cut-off thresholds for assessing sarcopenia and SO. Moreover, limited data are available on the prevalence of these conditions in Latin American countries. To address this evidence gap, we aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥ 55 years in Lima, Peru.

Methods

Data collection for this cross-sectional study was conducted between 2018 and 2020 in two urban low-resource settings in Lima, Peru. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS) guidelines. We measured muscle strength by maximum handgrip strength; muscle mass using a whole-body single-frequency bioelectrical impedance analyzer, and physical performance using the Short Physical Performance Battery and 4-meter gait speed. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.

Results

The study participants had a mean age of 66.2 years (SD 7.1), of which 621 (53.9%) were men, and 41.7% were classified as obese (BMI ≥ 30.0 kg/m2). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI:25.2-30.4) using the AWGS criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).

Conclusions

Our findings reveal substantial variation in the prevalence of sarcopenia and SO when using different guidelines, underscoring the necessity for context-specific cut-off values. Nevertheless, regardless of the chosen guideline, the prevalence of probable sarcopenia and sarcopenia among community-dwelling older adults in Peru remains noteworthy.