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Shi Y, Stanmore E, McGarrigle L, Wang X, Wang X, Li Y, Todd C. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. Maturitas 2024; 186:108027. [PMID: 38820935 DOI: 10.1016/j.maturitas.2024.108027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES There is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. STUDY DESIGN Using guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). MAIN OUTCOME MEASURES This study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. RESULTS The health education included seven videos of 4-6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and "dosage" of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = -5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. CONCLUSIONS The social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Nursing, School of Public Health, Yangzhou University, 225009 Yangzhou, Jiangsu Province, China; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Xiuhua Wang
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China.
| | - Xiaoqing Wang
- Department of Geriatrics, the Second Xiangya Affiliated Hospital, Central South University, 410011 Changsha, Hunan Province, China
| | - Yuhua Li
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
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Shi Y, Stanmore E, McGarrigle L, Todd C. Social-media based Health Education plus Exercise Programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia in China: A study protocol for intervention development. PLoS One 2024; 19:e0286490. [PMID: 38547178 PMCID: PMC10977808 DOI: 10.1371/journal.pone.0286490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 02/07/2024] [Indexed: 04/02/2024] Open
Abstract
Possible sarcopenia refers to low muscle strength. Prevalence of possible sarcopenia is estimated to be significantly higher in community-dwelling older adults than that of confirmed or severe sarcopenia. However, there are currently far fewer non-pharmacological intervention strategies for possible sarcopenia than for sarcopenia in the community. Meanwhile, one type of non-pharmacological intervention in sarcopenic area, health education, is under-researched, and older people's awareness about sarcopenia is extremely low, necessitating an immediate dissemination tool for prevention. Social media may be a potential, scalable, low-cost tool for this. This study protocol outlines how a social media-based multicomponent intervention will be co-designed with stakeholders to address this evidence gap. Guided by the Medical Research Council's framework, the proposed research covers two phases that employ a co-design approach to develop a theory-based multicomponent intervention to increase sarcopenia prevention in the community. The participants will be recruited from young-old adults (60~69) with possible sarcopenia in the community of Changsha, China. Maximum sample size will be 45 participants in total, with 18~25 participants in the development phase and 15~20 participants in the pre-test phase. During two rounds of focus groups with older adults, a social-media based intervention strategy will be developed from a theory-based conceptual model and an initial intervention plan formulated by the research group. After this, there will be a three-week pre-test phase, followed by a semi-structured interview to further modify the theory-based conceptual model and the social-media based intervention strategy. The focus of the data analysis will be on thematic analysis of qualitative data primarily derived from the group interview and the semi-structured interview with key stakeholders.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Verstraeten LM, Mashni A, van Wijngaarden JP, Meskers CG, Maier AB. Sarcopenia knowledge of geriatric rehabilitation patients is low while they are willing to start sarcopenia treatment: EMPOWER-GR. J Cachexia Sarcopenia Muscle 2024; 15:352-360. [PMID: 38124340 PMCID: PMC10834324 DOI: 10.1002/jcsm.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 10/18/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sarcopenia is prevalent in 20-50% of geriatric rehabilitation inpatients and is associated with functional dependence and mortality. The aim is to assess knowledge of geriatric rehabilitation inpatients on sarcopenia and their willingness and perceived barriers to start treatment. METHODS Enhancing Muscle POWER in Geriatric Rehabilitation (EMPOWER-GR) is an observational cohort of geriatric rehabilitation inpatients in Amsterdam, the Netherlands. Knowledge of sarcopenia, willingness and perceived barriers to treatment were assessed with a survey among inpatients. Importance of and self-perceived muscle health were rated using a visual analogue scale from 0 to 10. Descriptive statistics were used. RESULTS Inpatients' (n = 157, 59.9% female) mean age was 80.5 years (SD 7.3). Sarcopenia (European Working Group on Sarcopenia in Older People 2) prevalence was 21.7%. Five inpatients (3.2%) had heard of sarcopenia and had knowledge of its definition. Median muscle health was rated as 6 (interquartile range: 4-7). After explanation of treatment options, 67.1% were willing to start resistance exercise training (RET), 61.1% a high-protein diet and 55.7% oral nutritional supplements (ONS). Inpatients with sarcopenia were less willing (51.6%) to start a high-protein diet compared with inpatients without sarcopenia (77.8%) (P = 0.002); there was no difference for RET and ONS. Most reported barriers to treatment were ONS dislike (17.0%), too many other health issues (13.6%), doubts about treatment effectiveness/importance (12.9%) and RET intensity/difficulty (10.2%). CONCLUSIONS Knowledge of sarcopenia was low, while the majority of inpatients showed willingness to start treatment. A dislike of ONS, RET difficulty and too many other health issues may reduce willingness to start treatment. Education is important to increase sarcopenia-related health issues in geriatric rehabilitation inpatients.
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Affiliation(s)
- Laure M.G. Verstraeten
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
| | - Amir Mashni
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
| | | | - Carel G.M. Meskers
- Department of Rehabilitation MedicineAmsterdam University Medical Centre, Amsterdam Movement SciencesAmsterdamThe Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
- Department of Medicine and Aged Care@AgeMelbourne, The Royal Melbourne Hospital, The University of MelbourneParkvilleVictoriaAustralia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Centre for Healthy Longevity@AgeSingapore, National University Health SystemSingapore
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Hart A, Cordova-Rivera L, Barker F, Sayer AA, Granic A, Yarnall AJ. The prevalence of sarcopenia in Parkinson's disease and related disorders- a systematic review. Neurol Sci 2023; 44:4205-4217. [PMID: 37594550 PMCID: PMC10641055 DOI: 10.1007/s10072-023-07007-0] [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: 02/17/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND The prevalence of sarcopenia (reduced skeletal muscle strength and mass), Parkinson's disease (PD) and Parkinson's related disorders (PRD) all increase with age. They also share risk factors and pathogenetic features. An increased prevalence of sarcopenia in PD and PRD than the general population was thus postulated. METHODS Four databases were searched using predefined literature search strategies. Studies conducted in participants with PD or PRD reporting the prevalence of sarcopenia and those providing data to compute the prevalence were included. Pre-sarcopenia, probable/possible sarcopenia and confirmed sarcopenia were defined according to the main sarcopenia working groups. Risk of bias was assessed using the AXIS tool. RESULTS 1978 studies were identified; 97 assessed in full; 14 met inclusion criteria. The median study quality score was 15/20. The range of probable sarcopenia was 23.9 to 66.7%, and it did not change after excluding PRD participants. The prevalence of confirmed sarcopenia in participants with any parkinsonian disorder ranged from 2 to 31.4%. Including just PD participants, the range was 10.9 to 31.4%. In studies with controls, sarcopenia was more prevalent in PD and PRD. There was a positive non-significant trend between severity of motor symptoms and prevalence of sarcopenia or components of sarcopenia. High heterogeneity precluded meta-analysis, therefore there was insufficient evidence to conclude whether sarcopenia is more prevalent in PD or PRD. CONCLUSIONS Probable and confirmed sarcopenia are common in PD and PRD and they may be associated with disease severity. This co-occurrence supports the value of screening for sarcopenia in parkinsonian populations.
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Affiliation(s)
- Ashley Hart
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Laura Cordova-Rivera
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Centre for Rehabilitation, Teesside University, Middlesbrough, UK
| | - Fred Barker
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Antoneta Granic
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne, UK
| | - Alison J Yarnall
- Brain and Movement Research Group, Campus for Ageing and Vitality, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
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Lee SC, Chiu HL, Lai HW, Feng J, Chen TY, Lin MC, Lin CF. Development and validation of a new tool: The sarcopenia knowledge questionnaire. Geriatr Nurs 2023; 53:90-95. [PMID: 37454424 DOI: 10.1016/j.gerinurse.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
We developed a new questionnaire-the Sarcopenia Knowledge Questionnaire (SKQ)-to evaluate the level of awareness about sarcopenia among older adults and tested the reliability and validity of this tool. A total of 293 older adults completed the questionnaire. The SKQ comprises three domains including 23 items: screening and diagnosis (10 items), sarcopenia outcomes (7 items), and lifestyle factors (6 items). The Cronbach's α value was 0.969, which indicated excellent internal consistency. The SKQ correlated well with the Mandarin Multidimensional Health Literacy Questionnaire (r = 0.511; p < 0.001), confirming its moderate convergent validity. The absolute values of the critical ratio ranged from 9.90 to 25.82 (p < 0.001), indicating satisfactory item discrimination. Thus, the SKQ appears to be a valid and reliable instrument for evaluating the knowledge of older adults about sarcopenia.
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Affiliation(s)
- Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei City, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Huei-Ling Chiu
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei City, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Hsiao-Wen Lai
- Section of Nurse Practitioner, Department of Medical Administration, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jie Feng
- Department of Global Public Health, Karolinska Institutet, Sweden; Department of Hospital Infection-Control, Tongde Hospital of Zhejiang Province, China
| | - Tzu-Ying Chen
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chin Lin
- Graduate Institute of Biomedical Informatics, College of Medical Science Technology, Taipei Medical University, Taipei, Taiwan; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Taipei Neuroscience Institute, Taipei Medical University, Taipei City, Taiwan; Center of Osteoporosis, Sarcopenia and Frailty (COSaF), Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chiou-Fen Lin
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
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Bogucka A, Kopiczko A, Charzewska J. Sarcopenia: prevalence and its main risk factors in older women. ANTHROPOLOGICAL REVIEW 2023. [DOI: 10.18778/1898-6773.86.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Introduction: Sarcopenia is a major public health concern. It is defined as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of falls, fractures, physical disability, and ultimately, premature death.
Objective: The aim of the study was to assess the prevalence and determine the role of physical activity, nutrient intake, and selected risk factors for the development of sarcopenia in older women.
Methods: The study involved 302 women aged ≥65 years (mean age: 72.1± 5.9 years). Bioelectrical impedance analysis of body composition, static muscle strength measurements, Timed Up and Go test, and the assessment of current physical activity using accelerometers were performed. Diets were assessed using the 24-h recall method from two non-consecutive days. The energy and nutrient content of diets was calculated using the computer program DIETA 6.
Results: Sarcopenia was present in 28.8% of the women studied. The most important factor in the decrease in the risk of sarcopenia was protein intake ≥ 0.9 g/kg b.m. (OR=0.08;p<0.001), and physical activity ≥ 4000 steps/day. However, these results were not statistically significant (OR=0.58; p=0.08). Furthermore, the risk of developing sarcopenia increased as BMI (OR=1.36; p<0.001) or percent of body fat (OR=1.29; p<0.001) increased.
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Zanker J, Sim M, Anderson K, Balogun S, Brennan-Olsen SL, Dent E, Duque G, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle 2023; 14:142-156. [PMID: 36349684 PMCID: PMC9891980 DOI: 10.1002/jcsm.13115] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/18/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand. METHODS A four-phase modified Delphi process involving topic experts and informed by consumers, was undertaken between July 2020 and August 2021. Phase 1 involved a structured meeting of 29 Task Force members and a systematic literature search from which the Phase 2 online survey was developed (Qualtrics). Topic experts responded to 18 statements, using 11-point Likert scales with agreement threshold set a priori at >80%, and five multiple-choice questions. Statements with moderate agreement (70%-80%) were revised and re-introduced in Phase 3, and statements with low agreement (<70%) were rejected. In Phase 3, topic experts responded to six revised statements and three additional questions, incorporating results from a parallel Consumer Expert Delphi study. Phase 4 involved finalization of consensus statements. RESULTS Topic experts from Australia (n = 62, 92.5%) and New Zealand (n = 5, 7.5%) with a mean ± SD age of 45.7 ± 11.8 years participated in Phase 2; 38 (56.7%) were women, 38 (56.7%) were health professionals and 27 (40.3%) were researchers/academics. In Phase 2, 15 of 18 (83.3%) statements on sarcopenia prevention, screening, assessment, management and future research were accepted with strong agreement. The strongest agreement related to encouraging a healthy lifestyle (100%) and offering tailored resistance training to people with sarcopenia (92.5%). Forty-seven experts participated in Phase 3; 5/6 (83.3%) revised statements on prevention, assessment and management were accepted with strong agreement. A majority of experts (87.9%) preferred the revised European Working Group for Sarcopenia in Older Persons (EWGSOP2) definition. Seventeen statements with strong agreement (>80%) were confirmed by the Task Force in Phase 4. CONCLUSIONS The ANZSSFR Task Force present 17 sarcopenia management and research recommendations for use by health professionals and researchers which includes the recommendation to adopt the EWGSOP2 sarcopenia definition in Australia and New Zealand. This rigorous Delphi process that combined evidence, consumer expert opinion and topic expert consensus can inform similar initiatives in countries/regions lacking consensus on sarcopenia.
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Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Anderson
- Institute for Health Transformation - Determinants of Health, Faculty of Health, Deakin University, Burwood, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Saliu Balogun
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Elsa Dent
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Christian M Girgis
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Mathis Grossmann
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Institute for Health and Sport (IHeS), Victoria University, Footscray, Victoria, Australia
| | - Tim Henwood
- Human Movement and Nutritional Science, University of Queensland, Brisbane, Queensland, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - Charles Inderjeeth
- North Metropolitan Health Service & University of Western Australia, Perth, Western Australia, Australia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie A Pasco
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Steven Phu
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Falls, Balance, and Injury Research Centre, Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
| | - Nicholas Russell
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Debra L Waters
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Daly RM, Iuliano S, Fyfe JJ, Scott D, Kirk B, Thompson MQ, Dent E, Fetterplace K, Wright ORL, Lynch GS, Zanker J, Yu S, Kurrle S, Visvanathan R, Maier AB. Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group. J Nutr Health Aging 2022; 26:637-651. [PMID: 35718874 DOI: 10.1007/s12603-022-1801-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sarcopenia and frailty are highly prevalent conditions in older hospitalized patients, which are associated with a myriad of adverse clinical outcomes. This paper, prepared by a multidisciplinary expert working group from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR), provides an up-to-date overview of current evidence and recommendations based on a narrative review of the literature for the screening, diagnosis, and management of sarcopenia and frailty in older patients within the hospital setting. It also includes suggestions on potential pathways to implement change to encourage widespread adoption of these evidence-informed recommendations within hospital settings. The expert working group concluded there was insufficient evidence to support any specific screening tool for sarcopenia and recommends an assessment of probable sarcopenia/sarcopenia using established criteria for all older (≥65 years) hospitalized patients or in younger patients with conditions (e.g., comorbidities) that may increase their risk of sarcopenia. Diagnosis of probable sarcopenia should be based on an assessment of low muscle strength (grip strength or five times sit-to-stand) with sarcopenia diagnosis including low muscle mass quantified from dual energy X-ray absorptiometry, bioelectrical impedance analysis or in the absence of diagnostic devices, calf circumference as a proxy measure. Severe sarcopenia is represented by the addition of impaired physical performance (slow gait speed). All patients with probable sarcopenia or sarcopenia should be investigated for causes (e.g., chronic/acute disease or malnutrition), and treated accordingly. For frailty, it is recommended that all hospitalized patients aged 70 years and older be screened using a validated tool [Clinical Frailty Scale (CFS), Hospital Frailty Risk Score, the FRAIL scale or the Frailty Index]. Patients screened as positive for frailty should undergo further clinical assessment using the Frailty Phenotype, Frailty Index or information collected from a Comprehensive Geriatric Assessment (CGA). All patients identified as frail should receive follow up by a health practitioner(s) for an individualized care plan. To treat older hospitalized patients with probable sarcopenia, sarcopenia, or frailty, it is recommended that a structured and supervised multi-component exercise program incorporating elements of resistance (muscle strengthening), challenging balance, and functional mobility training be prescribed as early as possible combined with nutritional support to optimize energy and protein intake and correct any deficiencies. There is insufficient evidence to recommend pharmacological agents for the treatment of sarcopenia or frailty. Finally, to facilitate integration of these recommendations into hospital settings organization-wide approaches are needed, with the Spread and Sustain framework recommended to facilitate organizational culture change, with the help of 'champions' to drive these changes. A multidisciplinary team approach incorporating awareness and education initiatives for healthcare professionals is recommended to ensure that screening, diagnosis and management approaches for sarcopenia and frailty are embedded and sustained within hospital settings. Finally, patients and caregivers' education should be integrated into the care pathway to facilitate adherence to prescribed management approaches for sarcopenia and frailty.
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Affiliation(s)
- R M Daly
- Professor Robin M. Daly, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria, Australia 3125, Phone: +61 3 9244 6040, , ORCID ID: 0000-0002-9897-1598
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Xu J, Reijnierse EM, Pacifico J, Wan CS, Maier AB. Sarcopenia is associated with 3-month and 1-year mortality in geriatric rehabilitation inpatients: RESORT. Age Ageing 2021; 50:2147-2156. [PMID: 34260683 PMCID: PMC8581377 DOI: 10.1093/ageing/afab134] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background Sarcopenia is highly prevalent in geriatric rehabilitation patients and can worsen prognosis. This study aimed to investigate the association of sarcopenia and components of sarcopenia with 3-month and 1-year post-discharge mortality in geriatric rehabilitation inpatients. Methods REStORing health of acutely unwell adulTs (RESORT) is an observational, prospective longitudinal cohort of geriatric rehabilitation inpatients. Sex-stratified Cox proportional-hazards analyses were used to associate sarcopenia (and its components) at admission, by the European Working Group on Sarcopenia in Older People (EWGSOP, EWGSOP2) and the Asian Working Group for Sarcopenia 2019 (AWGS 2019), with 3-month and 1-year post-discharge all-cause mortality. Results Patients (n = 1,406) had a median interquartile ranges [IQR] age of 83.0 [77.4–88.2] years (58% females). Sarcopenia was significantly associated with 3-month and 1-year mortality in females (EWGSOP, EWGSOP2 and AWGS 2019) and males (EWGSOP2, AWGS 2019). In females, low muscle mass (EWGSOP, EWGSOP2 and AWGS 2019) was significantly associated with 3-month and 1-year mortality; low muscle strength (EWGSOP, EWGSOP2 and AWGS 2019) was significantly associated with 1-year mortality. For males, low muscle mass (EWGSOP2, AWGS 2019) was significantly associated with 3-month and 1-year mortality; low muscle strength (EWGSOP2, AWGS 2019) was significantly associated with 3-month mortality. The association between physical performance with mortality was not analysed due to less than five events (death) in patients with normal physical performance. Conclusions Sarcopenia, low muscle mass and low muscle strength at admission are associated with a significantly higher risk of mortality post-discharge from geriatric rehabilitation, highlighting the need to measure muscle mass and strength in clinical practice.
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Affiliation(s)
- Jane Xu
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jacob Pacifico
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Ching S Wan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Melbourne, VIC, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore
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Ida S, Kaneko R, Imataka K, Fujiwara R, Katsuta M, Shirakura Y, Okubo K, Azuma K, Murata K. [Multimodal treatment program for elderly diabetic patients with sarcopenia improves the muscle strength and physical function]. Nihon Ronen Igakkai Zasshi 2021; 58:143-151. [PMID: 33627551 DOI: 10.3143/geriatrics.58.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the effects of a multimodal treatment program on the muscle strength, physical function, and skeletal muscle mass in elderly diabetic patients with sarcopenia. METHODS Diabetic patients over 65 years old attending the Department of Diabetes and Metabolism, Ise Red Cross Hospital, were included. The diagnosis of sarcopenia was based on the Asian Working Group for Sarcopenia 2019. The measurement of extremity skeletal muscle mass was assessed by the multi-frequency bioelectrical impedance method, muscle strength was assessed by the grip strength, and the physical function was assessed by the 5-time chair stand test. The muscle strength, physical function, extremity skeletal muscle mass, and other parameters were assessed before and after 12 weeks of the multimodal treatment program (optimization of protein intake, resistance training, and patient education on sarcopenia) and then compared. Paired t-tests were used for the statistical analysis. RESULTS Fourteen patients (3 men and 11 women) were included in the analysis of this study. The mean age was 74.4±4.7 years old. Significant improvements in the grip strength (male, 23.2±5.6 kg to 25.6±5.5 kg, P=0.014; female, 15.5±5.0 kg to 18.9±5.0 kg, P<0.001) and 5-time chair stand test (11.2±2.5 seconds to 8.6±1.7 seconds, P=0.002) were found with the multimodal treatment program. There was also a significant decrease in HbA1c (8.1±0.7% to 7.7±0.9%, P=0.004). However, although an increasing trend in the amount of extremity skeletal muscle mass was noted, there was no significant difference. CONCLUSIONS A multimodal treatment program for elderly diabetic patients with sarcopenia showed an improvement in the muscle strength and physical function.
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Affiliation(s)
- Satoshi Ida
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Ryutaro Kaneko
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Kanako Imataka
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Ryoko Fujiwara
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Mai Katsuta
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | | | - Kaoru Okubo
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Kentaro Azuma
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
| | - Kazuya Murata
- Department of Diabetes and Metabolism, Ise Red Cross Hospital
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González Correa CH, Marulanda Mejía F, Castaño González PA, Vidarte Claros JA, Castiblanco Arroyabe HD. Bioelectrical impedance analysis and dual x-ray absorptiometry agreement for skeletal muscle mass index evaluation in sarcopenia diagnosis. Physiol Meas 2020; 41:064005. [PMID: 32348971 DOI: 10.1088/1361-6579/ab8e5f] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND All definitions for diagnosing sarcopenia include the estimation of muscle mass. This can be made using bioelectrical impedance analysis (BIA) or dual x-ray absorptiometry (DXA). BIA is a portable and inexpensive method suitable for clinical settings, while DXA is cumbersome, more expensive and less available. OBJECTIVES To evaluate the interchangeability of both techniques for skeletal muscle mass index (SMI) estimation, and assess whether the two methods are comparable for the diagnosis of sarcopenia. APPROACH Prospective, cross-sectional study. SETTING Faculty for Health Sciences, Universidad de Caldas, Colombia. PARTICIPANTS Seventy-two subjects aged 65-80 years were recruited. MEASUREMENTS BIA and DXA for SMI estimation and sarcopenia diagnoses using the definition of the European Working Group on Sarcopenia in Older People (EWGSOP). Of the 72 patients, 28 were diagnosed with sarcopenia by BIA and corroborated by DXA were included in the study. To establish the agreement between techniques, the intraclass correlation coefficient and the concordance correlation coefficient were calculated. A Bland-Altman plot evaluated the agreement. To evaluate agreement on the diagnosis of sarcopenia, a Cohen's kappa test was performed. MAIN RESULTS Agreement between SMI by BIA and DXA was good according to the intraclass correlation coefficient (ICC 0.7 95% CI 0.5 to 0.8) but poor when the concordance correlation coefficient was used (CCC 0.4 was calculated 95% CI 0.3 to 0.5). The Bland-Altman analysis showed a clinically unacceptable discrepancy between the methods; the confidence intervals were too wide; the difference between methods tends to get larger as the average increases and the scatter around the bias line get larger as the average gets higher. Cohen's kappa test was 0.2 (SEE: 0.1). SIGNIFICANCE The agreement between BIA and DXA was weak. We concluded that, in this studied population, the methods were not interchangeable. Results may improve if a specific formula in a greater sample size is used.
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Van Ancum JM, Alcazar J, Meskers CGM, Nielsen BR, Suetta C, Maier AB. Impact of using the updated EWGSOP2 definition in diagnosing sarcopenia: A clinical perspective. Arch Gerontol Geriatr 2020; 90:104125. [PMID: 32534364 DOI: 10.1016/j.archger.2020.104125] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE The revised European Working Group on Sarcopenia in Older People (EWGSOP2, version 2019) definition of sarcopenia differs with respect to the EWGSOP (version 2010) definition in applied criteria and their cut-off values. We aimed to investigate the impact of the new definition on sarcopenia prevalence in various populations of older adults. METHODS Eight cohorts, including community-dwelling older adults, geriatric outpatients and patients admitted to acute and subacute inpatient wards were assessed on sarcopenia prevalence. RESULTS A total of 2256 participants (56.4 % female) were included with a median age of the cohorts of 71.7-83.3 years. In males, sarcopenia prevalence was 31.9 % according to EWGSOP compared to 12.0 % according to EWGSOP2. In females, sarcopenia prevalence was 4.9 % and 6.1 % according to EWGSOP and EWGSOP2 respectively. Lower cut-off points for handgrip strength (27 kg versus 30 kg (males) and 16 kg versus 20 kg (females) for EWGSOP and EWGSOP2 respectively) resulted in the lower sarcopenia prevalence in males. CONCLUSIONS According to the EWGSOP2 definition, the prevalence of sarcopenia in males is significantly lower compared to the EWGSOP definition, whereas the prevalence among women is slightly higher. The lower cut-off points for handgrip strength result in fewer adults being diagnosed with sarcopenia.
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Affiliation(s)
- Jeanine M Van Ancum
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Julian Alcazar
- Geriatric Research Unit, Geriatric Department, Bispebjerg and Frederiksberg University Hospital, Denmark; GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Carel G M Meskers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Barbara Rubæk Nielsen
- Department of Medicine, Geriatric Division, Glostrup Hospital, University of Copenhagen, Denmark
| | - Charlotte Suetta
- Geriatric Research Unit, Geriatric Department, Bispebjerg and Frederiksberg University Hospital, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet Glostrup, University of Copenhagen, Denmark; Geriatric Research Unit, Department of Medicine, Herlev and Gentofte University Hospital, Denmark
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
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13
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Is YouTube a quality source of information on sarcopenia? Eur Geriatr Med 2020; 11:693-697. [PMID: 32385591 DOI: 10.1007/s41999-020-00327-w] [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: 01/14/2020] [Accepted: 04/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND While sarcopenia is a prevalent disorder that affects muscle mass and quality, patients have limited knowledge of it. On the other hand, patients often use social media to obtain health-specific information. Therefore, the aim of this study was to investigate the YouTube videos about sarcopenia in terms of the knowledge value of what they present and to identify which of them can be considered as the quality sources of such information. METHODS The descriptive study included 53 videos retrieved by searching the keywords 'sarcopenia', 'loss of muscle strength', 'sarcopenia treatment,' 'sarcopenia physiotherapy,' and'sarcopenia rehabilitation' on YouTube. The instructive characteristics of the videos were assessed with the Global Quality Scale, by which three quality groups were identified: poor-, moderate-, and high-quality videos. The DISCERN score was utilized to determine reliability. The sources of upload were identified as physicians, non-physician health personnel, health-related websites, universities and academic organizations, patients, and independent users. Finally, the lengths of videos, the number of views, likes, dislikes, and comments, and the DISCERN scores of the videos were compared using group comparisons. RESULTS The results suggested that there were 18 poor-quality, 16 moderate-quality, and 19 high-quality videos. Considering the sources of upload, physicians had the highest ratio in the high-quality group (83.3%). The lengths of videos and the DISCERN scores showed significant differences (p < 0.01). The numbers of views, likes, dislikes, and comments were similar in both quality and source groups. CONCLUSION Most parts of the videos uploaded by physicians and academic organizations were included in the high-quality group. Overall, according to the results of the study, it can be asserted that high quality may be related to reliability. Furthermore, healthcare professionals and academics should consider using YouTube for increasing knowledge and raising awareness of patients about sarcopenia.
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