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Liu L, Huang S, Chen Z, Chen L, Li Z, Lin X, Zhu J, Wang S, Tan Y, Chen X. Effectiveness of sarcopenia screening markers in predicting out-of-hospital death in the oldest (≥80 years) older. Geriatr Nurs 2024; 60:79-84. [PMID: 39232264 DOI: 10.1016/j.gerinurse.2024.08.036] [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: 03/23/2024] [Revised: 07/31/2024] [Accepted: 08/19/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVE The goal of this investigation was to elucidate the correlation between sarcopenia screening indicators (aspartate transaminase/alanine transaminase (AST/ALT) and creatinine/cystatin C*100 (Cr/CysC*100)) and the risk of out-of-hospital (OFH) death among the very advanced age (≥80 years) population. METHODS We conducted a retrospective cohort investigation, involving internal medicine inpatients aged ≥80 years of age, who sought treatment at a teaching hospital in western China. We obtained OFH mortality information from telephonic interviews. Subsequently, we employed Cox proportional hazards models to analyze the links between AST/ALT and Cr/CysC*100 and OFH all-cause mortality among the very advanced age (≥80 years old) population. RESULTS In all, we recruited 398 subjects, among which 51.51% were male. The median age of OFH deceased male patients was 85 years, and the same for female patients was 87 years. The total quantity of OFH deaths was 164 (41.21%). Among the oldest male population, those who died OFH exhibited enhanced AST/ALT, relative to those who survived (death vs. survival: 1.5 vs 1.3, P=0.008). However, among the oldest female, there was no difference in AST/ALT between patients who expired OFH, and those who survived. Among the oldest elders (male and female), Cr/CysC*100 did not significantly differ between surviving and OFH deceased patients. Additional analysis involving the Cox proportional hazards model revealed that among the oldest male population, an enhanced AST/ALT denoted an augmented risk of OFH death (hazard ratios (HRs) =1.797, 95%CI: 1.2-2.691). However, Cr/CysC*100 was not correlated with OFH mortality risk. Among the oldest female population, neither AST/ALT nor Cr/CysC*100 was correlated with OFH mortality risk. CONCLUSIONS Enhanced AST/ALT was correlated with an augmented OFH mortality risk among the oldest male, but not female population. Alternately, Cr/CysC*100 was not linked to OFH mortality risk among any population.
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Affiliation(s)
- Libin Liu
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Sha Huang
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Zecong Chen
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Lanlan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Zhouyu Li
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Xia Lin
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Jiaxiu Zhu
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Shaoqin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Youguo Tan
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China
| | - Xiaoyan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Department of Geriatric, Zigong, Sichuan Province, China.
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Abeywickrama HM, Uchiyama M, Sumiyoshi T, Okuda A, Koyama Y. The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review. Nutr Rev 2024; 82:988-1011. [PMID: 37550266 PMCID: PMC11163457 DOI: 10.1093/nutrit/nuad094] [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] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Zinc (Zn) deficiency, malnutrition, sarcopenia, and frailty are prevalent among older adults and are prominent factors contributing to disability and mortality. OBJECTIVE This scoping review was conducted to aid understanding of the extent and types of research addressing the role of Zn in nutritional status, sarcopenia, and frailty, among older individuals. METHOD A systematic search was performed in August 2022 of 3 electronic databases (PubMed, Web of Science, and ProQuest) using predefined search terms. The review was conducted referring to the Arksey and O'Malley framework and PRISMA-ScR. RESULTS The search retrieved 16 018 records, and a total of 49 studies were included in this review after the screening. Of those, 30 were based on dietary Zn intake, 18 on tissue Zn levels, and 1 on both. Most studies were based on cross-sectional data from community-dwelling older adults. Studies addressing the associations between Zn status and individual anthropometric and sarcopenia-related variables reported inconsistent results. However, most studies reported inverse associations between malnutrition, frailty, and Zn status. CONCLUSION There was more consistent evidence of the relationship of Zn status with malnutrition, sarcopenia, and frailty rather than with individual nutritional parameters. Validated screening and assessment tools and criteria and prospective studies are required to elucidate the relationship of Zn with sarcopenia and frailty in the older population.
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Affiliation(s)
| | - Mieko Uchiyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Tomoko Sumiyoshi
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Akiko Okuda
- Department of Medical Technology, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Yu Koyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
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Gay EL, Coen PM, Harrison S, Garcia RE, Qiao YS, Goodpaster BH, Forman DE, Toledo FGS, Distefano G, Kramer PA, Ramos SV, Molina AJA, Nicklas BJ, Cummings SR, Cawthon PM, Hepple RT, Newman AB, Glynn NW. Sex Differences in the Association between Skeletal Muscle Energetics and Perceived Physical Fatigability: The Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.25.24307934. [PMID: 38853946 PMCID: PMC11160809 DOI: 10.1101/2024.05.25.24307934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Greater perceived physical fatigability and lower skeletal muscle energetics are predictors of mobility decline. Characterizing associations between muscle energetics and perceived fatigability may provide insight into potential targets to prevent mobility decline. We examined associations of in vivo (maximal ATP production, ATPmax) and ex vivo (maximal carbohydrate supported oxidative phosphorylation [max OXPHOS] and maximal fatty acid supported OXPHOS [max FAO OXPHOS]) measures of mitochondrial energetics with two measures of perceived physical fatigability, Pittsburgh Fatigability Scale (PFS, 0-50, higher=greater) and Rating of Perceived Exertion (RPE Fatigability, 6-20, higher=greater) after a slow treadmill walk. Participants from the Study of Muscle, Mobility and Aging (N=873) were 76.3±5.0 years old, 59.2% women, and 85.3% White. Higher muscle energetics (both in vivo and ex vivo ) were associated with lower perceived physical fatigability, all p<0.03. When stratified by sex, higher ATPmax was associated with lower PFS Physical for men only; higher max OXPHOS and max FAO OXPHOS were associated with lower RPE fatigability for both sexes. Higher skeletal muscle energetics were associated with 40-55% lower odds of being in the most (PFS≥25, RPE Fatigability≥12) vs least (PFS 0-4, RPE Fatigability 6-7) severe fatigability strata, all p<0.03. Being a woman was associated with 2-3 times higher odds of being in the most severe fatigability strata when controlling for ATPmax but not the in vivo measures (p<0.05). Better mitochondrial energetics were linked to lower fatigability and less severe fatigability in older adults. Findings imply that improving skeletal muscle energetics may mitigate perceived physical fatigability and prolong healthy aging.
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Glynn NW, Qiao YS. Measuring and Understanding the Health Impact of Greater Fatigability in Older Adults: A Call to Action and Opportunities. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2023; 11:188-201. [PMID: 38074079 PMCID: PMC10707490 DOI: 10.1080/21641846.2023.2252612] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
Different from fatigue, an instantaneous state of tiredness, weakness and lack of energy, fatigability is a trait that contextualizes whole-body fatigue to the level of activity (i.e., intensity and duration) with which the fatigue is associated. Fatigability can be perceived or performance-related. Measuring fatigability improves upon traditional fatigue measures by accounting for self-pacing as older adults likely slow down or limit their daily activity to maintain fatigue in a tolerable range. Anchoring fatigue to activities/tasks improves sensitivity and allows for meaningful comparisons across individuals/between studies, as well as evaluating change over time and treatment effects. Two well-validated approaches are utilized to measure perceived fatigability: 1) a 5-minute slow-paced (1.5 mph/0.67 m/s, 0% grade) treadmill walk immediately followed by Borg rating of perceived exertion; and 2) a self-administered 10-item questionnaire, Pittsburgh Fatigability Scale, with both physical and mental subscales. Many walking-based performance fatigability measures are based on certain lap time or distance, while the Pittsburgh Performance Fatigability Index uses raw accelerometry data to quantify percent of cadence decline over the entire long distance walking tasks. Perceived fatigability prevalence ranges from 20-90% in older adults varying by assessment tool, and is higher with advancing age and in women compared to men. Fatigability is associated with physical and cognitive function, fall risk, mobility decline, and mortality. Unfortunately, the available research lacks representativeness in terms of racial and ethnic diversity. The time is now to incorporate our established sensitive and validated fatigability measures into global research and clinical practice to better understand mechanistic underpinnings and reveal intervention effects to reduce the burden and lessen the consequences of greater fatigability worldwide.
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Affiliation(s)
- Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, PA 15261
| | - Yujia Susanna Qiao
- Department of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, PA 15261
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Azzolino D, Marzetti E, Proietti M, Calvani R, de Souto Barreto P, Rolland Y, Cesari M. Lack of energy is associated with malnutrition in nursing home residents: Results from the INCUR study. J Am Geriatr Soc 2021; 69:3242-3248. [PMID: 34369598 PMCID: PMC9290957 DOI: 10.1111/jgs.17393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/16/2021] [Accepted: 07/10/2021] [Indexed: 01/10/2023]
Abstract
Background Lack of energy is a symptom frequently complained by older people, leading to the inability to continue functioning at the expected level of activity. This study aimed to investigate whether nutritional status was associated with lack of energy in nursing home (NH) residents. Methods This was a cross‐sectional study. A total of 570 NH residents (72.1% women) in 13 French NHs from the Incidence of pNeumonia and related ConseqUences in nursing home Residents study cohort were included in the study. Lack of energy was measured by the question “Did you feel full of energy during the past week?” from the geriatric depression scale. Nutritional status was evaluated according to Mini Nutritional Assessment Short‐Form (MNA‐SF). Unadjusted and adjusted logistic regression models were performed to test the association of nutritional status with lack of energy. Results The mean age of participants was 86.5 (SD 7.5) years. A total of 246 NH residents (43.2%) reported a lack of energy. Overall, 71 (12.5%) residents were malnourished and 323 (56.7%) residents were at risk of malnutrition. Malnutrition was significantly associated with lack of energy (OR = 3.42, 95% CI = 1.92–6.08, P < 0.001), even after adjustment for potential confounders (OR = 2.41, 95% CI = 1.29–4.52, P = 0.006). Among the single items of the MNA‐SF, decrease in food intake, low mobility, and psychological stress or acute disease were individually associated with lack of energy, independently of potential confounders (OR = 1.85, 95% CI = 1.24–2.77, P = 0.003; OR = 1.43, 95% CI = 1.10–1.86, P = 0.008; OR = 1.48, 95% CI = 1.19–1.84, P < 0.001; for each point respectively). Conclusions Lack of energy and malnutrition were closely associated. The reporting of lack of energy should lead to a comprehensive assessment of the aging individual (as happening for malnutrition) in order to preventively/promptly act on potentially reversible causes.
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Affiliation(s)
- Domenico Azzolino
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Marco Proietti
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy.,Liverpool Centre for Cardiovascular Science, Liverpool Heart & Chest Hospital, University of Liverpool, Liverpool, UK
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Philipe de Souto Barreto
- Department of Internal Medicine and Geriatrics, Gerontopole, CHU, Toulouse, France.,UMR INSERM, 1027, University of Toulouse III, Toulouse, France
| | - Yves Rolland
- Department of Internal Medicine and Geriatrics, Gerontopole, CHU, Toulouse, France.,UMR INSERM, 1027, University of Toulouse III, Toulouse, France
| | - Matteo Cesari
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
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