The Relationship between Sarcopenia and Injury Events: A Systematic Review and Meta-Analysis of 98,754 Older Adults

The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB)

BACKGROUND

Fatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife.

METHODS

A total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions).

RESULTS

Overall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015).

CONCLUSIONS

Middle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.

Effect of Resistance Exercise on Body Composition and Functional Capacity in Older Women with Sarcopenic Obesity-A Systematic Review with Narrative Synthesis

BACKGROUND

Resistance exercise has shown effectiveness in reducing various risk factors related to sarcopenic obesity (SO) compared to other types of exercise, e.g., aerobic exercise.

OBJECTIVE

This systematic review evaluates the effect of resistance exercise on body composition, muscular strength, and functional capacity among older women with sarcopenic obesity aged ≥ 60 years.

METHODS

This systematic review is registered on PROSPERO (registration No. CRD42023394603) and follows the PRISMA guidelines. The following electronic databases were used to search the literature: Pedro, Cochrane Central Register of Controlled Trials, Embase, PubMed, and Web of Science. We included only RCTs that investigated the effect of resistance exercise on body composition and functional capacity. Two independent reviewers conducted the process of study selection and data extraction.

RESULTS

The search strategy retrieved 687 results. One hundred and twenty-six records were deleted as duplicates. Consequently, 534 studies were excluded after the title/abstract assessment. After further detailed evaluation of twenty-seven full texts, seven RCTs were included; all the RCTs examined the isolated effect of resistance exercise in women with sarcopenic obesity. The included studies comprised 306 participants, with an average age of 64 to 72 years. We noticed a trend of improvement in the included studies among the intervention groups compared to the control groups among the different outcomes. The study protocol was inconsistent for the intervention settings, duration, and outcomes. Including a modest number of trials made it impossible to perform data meta-analysis.

CONCLUSIONS

Heterogeneity among studies regarding training protocols and the outcome measures reported limited robust conclusions. Still, resistance exercise intervention can improve body composition and functional capacity among elderly women with sarcopenic obesity.

Benefits and side effects of protein supplementation and exercise in sarcopenic obesity: A scoping review

BACKGROUND

Protein supplements have been widely used among those who are struggling with sarcopenic obesity among older adults. However, despite their popularity, there is still a lack of concrete evidence on both the potential benefits and side effects of protein supplementation and exercise on sarcopenic obesity (SO).

OBJECTIVE

Thus, we aimed to determine the impacts of protein supplementation and exercise in older adults with sarcopenic obesity.

METHOD

A systematic database search was conducted for randomised controlled trials, quasi experimental study and pre-post study design addressing the effects of protein supplementation in improving sarcopenic obesity among older adults. This scoping review was conducted based on PRISMA-Scr guidelines across PubMed, Embase, Web of Science and Cochrane Library databases. To assess record eligibility, two independent reviewers performed a rigorous systematic screening process.

RESULTS

Of the 1,811 citations identified, 7 papers met the inclusion criteria. Six studies were randomised controlled trials and one study was a pre-post test study design. The majority of studies discussed the use of both protein supplements and exercise training. The included studies prescribed protein intake ranging from 1.0 to 1.8 g/kg/BW/day for the intervention group, while the duration of exercise performed ranged from 2 to 3 times per week, with each session lasting for 1 hour. Whey protein supplementation has been shown to be effective in improving sarcopenic conditions and weight status in SO individuals. The combination of exercise training especially resistance training and the used of protein supplement provided additional benefits in terms of lean muscle mass as well as biomarkers. The study also revealed a lack of consistency in exercise design among interventions for sarcopenic obesity.

CONCLUSION

Overall, it appears to be a promising option for SO individuals to improve their sarcopenic condition and weight status through the combination of resistance exercise and whey protein supplementation. However, it also highlights the need for caution when it comes to high amounts of protein intake prescription. Future research is warranted to investigate the optimal exercise design for this population, given the limited research conducted in this specific area.