The prevalence of sarcopenia and relationships between muscle and bone in ageing West-African Gambian men and women

Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis

BACKGROUND

Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors.

METHODS

Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis.

RESULTS

Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia.

CONCLUSIONS

Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.

The association of depressive sarcopenia and cognitive decline among the elderly: Evidence from the Survey of Health and Retirement in Europe

OBJECTIVES

The present study aimed to explore the relationship between baseline different sarcopenia statuses combined with different depression statuses and long-term cognitive functions.

METHODS

Finally, a total of 4289 individuals aged 50 years or older from wave 2 to wave 8 of the Survey of Health, Ageing and Retirement in Europe were included in this study. The generalized estimated equation model was used to explore the baseline effect of depression with sarcopenia on long-term cognitive function. Stratified Analyses according to gender, education, region, and family economic level were performed. Sensitivity analyses of wave 5 to wave 8 were conducted to ensure the robustness of the results.

RESULTS

Groups of depression with non-sarcopenia (β = -0.40, 95%CI: -0.59 ~ -0.20, P < 0.001), non-depression with sarcopenia (β = -1.11, 95%CI: -1.91 ~ -0.31, P = 0.007), and depression with sarcopenia (β = -1.19, 95%CI: -1.89 ~ -0.50, P = 0.001) were inversely associated with cognition scores compared with the group of non-depression with non-sarcopenia. Stratified Analysis displayed differences in negative association of depression status with sarcopenia status and cognition. Sensitivity analyses yielded similar results. Other than numeracy, depression with sarcopenia (β = -1.81, 95%CI: -2.45 ~ -1.18, P < 0.001; β = -10.68, 95%CI: -1.05 ~ -0.31, P < 0.001; β = -0.51, 95%CI: -0.65 ~ -0.37, P < 0.001; β = -0.41, 95%CI: -0.55 ~ -0.27, P < 0.001) were inversely associated with cognitive function, orientation, words list learning test and fluency.

CONCLUSIONS

Preliminary depressive sarcopenia appears to increase the risk of cognitive decline. There was a downward trend in total cognitive function. The effect of depression combined with sarcopenia on cognitive function may exist in differences in gender, education, region, and family economic level.

Prevalence of sarcopenia in Africa: a systematic review and meta-analysis of observational studies

BACKGROUND

Existing literature suggests that sarcopenia is a highly prevalent condition in older people. However, most studies to date reporting data on its prevalence have been mainly carried out in Western countries, while data on sarcopenia in Africa is scarce. With this systematic review and meta-analysis, we aimed to determine the prevalence of sarcopenia in African countries and to explore potential factors that could explain higher or lower prevalence of this condition in Africa.

METHODS

Major databases for studies reporting data on sarcopenia in African countries were searched from inception to June 2023. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of sarcopenia in Africa, applying a random effect model. Several sensitivity and meta-regression analyses were run.

RESULTS

Among 147 articles initially screened, six articles (with seven cohorts) including a total of 10,656 participants were included. Mean age of participants was 66.9 years, and the majority were female (58.1%). The weighted prevalence of sarcopenia in the selected countries of Africa was 25.72% (95%CI: 18.90-32.55). This outcome was characterized by a high heterogeneity (I2 = 99%) and by publication bias. Among the factors investigated, sarcopenia was lower when assessed using only one anthropometric measure, or in South Africa.

CONCLUSION

Sarcopenia is a prevalent condition in Africa and thus research regarding this topic is a public health priority. Future studies that cover African countries for which data are not available and using standardized criteria are needed.

A Critical Review of Current Worldwide Definitions of Sarcopenia

With the increasing number of elderly individuals worldwide, the prevalence of age-related loss of muscle mass, referred to as sarcopenia, is expected to increase. Sarcopenia is a relatively new recognized syndrome, which is thought to affect 13% individuals worldwide, and the significant efforts made by different groups have advanced our understanding of the diagnosis, treatment, and natural history of this condition. However, the challenge is now to standardize its measurement and diagnosis to facilitate research in this area and a greater understanding of this condition and its management between clinicians and researchers. The Global Leadership Initiative on Sarcopenia (GLIS) is at the forefront of an international effort to produce standardized definition of sarcopenia. Setting a definition for sarcopenia entails several considerations and trade-offs. In this critical review, we have addressed key challenges driving the process of standardizing the definition, while delving into future avenues in sarcopenia research. Establishing a clear consensus on the working definition of sarcopenia is essential not only for advancing research in this field but also for assessing the prognostic implications of diagnosing sarcopenia and determining the most suitable treatment for affected patients.

Ethical considerations in sarcopenia research

The Article Abstract is not available.

Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: Update 2023

The Journal of Cachexia, Sarcopenia and Muscle (JCSM) aims to publish articles with relevance to wasting disorders and illnesses of the muscle in the broadest sense. In order to avoid publication of inappropriate articles and to avoid protracted disputes, the Editors have established ethical guidelines that detail a number of regulations to be fulfilled prior to submission to the journal. This article updates the principles of ethical authorship and publishing in JCSM and its daughter journal JCSM Rapid Communication. We require the corresponding author, on behalf of all co-authors, to certify adherence to the following principles: All authors listed on a manuscript considered for publication have approved its submission and (if accepted) approve publication in the journal; Each named author has made a material and independent contribution to the work submitted for publication. No person who has a right to be recognized as author has been omitted from the list of authors on the submitted manuscript; The submitted work is original and is neither under consideration elsewhere nor that it has been published previously in whole or in part other than in abstract form; All authors certify that the submitted work is original and does not contain excessive overlap with prior or contemporaneous publication elsewhere, and where the publication reports on cohorts, trials, or data that have been reported on before the facts need to be acknowledged and these other publications must be referenced; All original research work has been approved by the relevant bodies such as institutional review boards or ethics committees; All relevant conflicts of interest, financial or otherwise, that may affect the authors' ability to present data objectively, and relevant sources of funding of the research in question have been duly declared in the manuscript; All authors certify that they will submit the original source data to the editorial office upon request; Authors who have used artificial intelligence, language models, machine learning, or similar technologies need to provide a written statement - as part of the manuscript - that details the use of the respective technology; none of the aforementioned technologies can be listed as an author; The manuscript in its published form will be maintained on the servers of the journal as a valid publication only as long as all statements in these guidelines remain true. If any of the aforementioned statements ceases to be true, the authors have a duty to notify as soon as possible the Editor-in-Chief of the journal, so that the available information regarding the published article can be updated and/or the manuscript can be withdrawn.

Prevalence of Sarcopenia in Africa: A Systematic Review

Objective

The world population gradually getting older, age-related sarcopenia is becoming more frequent. Known to be highly prevalent in high income countries, relative data in Africa are still scarce. This review aims to estimate the prevalence of sarcopenia in Africa and its characteristics.

Study Design and Setting

A literature search in PubMed, Web of Science, Google Scholar, and Scopus was conducted in October 2022. All studies reporting the prevalence of sarcopenia in Africa within 15 years were included, and we did an assessment of bias with Hoy et al's risk bias assessment tool. The estimated prevalence of sarcopenia was the outcome and we performed secondary analyses by age, gender, and diagnostic criteria. The random effect model was used for the prevalence estimation. The prevalence of sarcopenia and 95% confidence interval (95% CI) were calculated using the inverse-variance method.

Results

A total of 17 studies met our eligibility criteria, for a study population of 12,690 participants with 44.3% males and 55.7% females. The overall prevalence of sarcopenia was 25% (95% CI: 19-30%). The prevalence of sarcopenia among 50 years old and older was 23% (95% CI: 17-29%). We had a higher prevalence of sarcopenia among males (30%, %95 IC: 20-39%) than females (29%, %95 IC: 21-36%). The prevalence of sarcopenia was different depending on the diagnosis criteria used.

Conclusion

The prevalence of sarcopenia in Africa was relatively high. However, the fact that the majority of included studies were hospital-based studies shows the necessity of further community-based studies in order to have a more accurate representation of the situation in the general population.

Sex-specific associations between cardiovascular risk factors and physical function: the Gambian Bone and Muscle Ageing Study

BACKGROUND

In Sub-Saharan Africa, the prevalence of obesity, cardiovascular disease (CVD) and impaired physical function are increasing due to rapid urbanization. We investigated sex differences in associations between cardiac workload, arterial stiffness, peripheral vascular calcification (PVC) and physical function in Gambian adults.

METHODS

A total of 488 Gambians aged 40-75+ years were recruited (men: 239; and women: 249). Supine blood pressure and heart rate were measured to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia peripheral quantitative computed tomography scans. Physical function was assessed by chair rise test (CRT), single two-legged jump (s2LJ) and hand grip strength (HGS). Body composition was measured by dual-energy x-ray absorptiometry; body size corrections were used to calculate fat mass index (FMI) and appendicular lean mass index (ALMI). Estimated glomerular filtration rate (eGFR) was measured from fasting blood samples. The relationship between rate pressure product, pulse pressure or presence of PVC (independent variable) with physical function parameters (dependent variable) was tested using linear regression. Sex-interactions were tested (p-int) adjusting for age, eGFR and ALMI/FMI. Results were expressed as mean differences between men and women with 95% confidence intervals. Mediation analyses used ALMI/FMI as mediator.

RESULTS

Women weighed less (54.7 kg ± 10.3 vs. 59.9 kg ± 10.3) and were shorter (157.8 cm ± 6.0 vs. 169.2 cm ± 7.0) compared with men (both P < 0.0001). Women had higher FMI (6.8 kg/m2  ± 2.9 vs. 2.9 kg/m2  ± 2.0, P < 0.0001) and eGFR (263.7 mL/min/1.73 m2  ± 133.1 vs. 237.6 mL/min/1.73 m2  ± 134.6), but lower ALMI (6.2 kg/m2  ± 0.7 vs. 8.02 kg/m2  ± 1.0, P < 0.0001) compared with men. There were significant mean differences between men and women in rate pressure product and s2LJ power (-1.08 [-1.21, -0.95]) and force (-0.57 [-0.63, -0.51]), only after adjusting for age, eGFR and FMI. There were significant mean differences in the associations between pulse pressure and CRT power (-0.28 [-0.31, -0.25]), s2LJ power (-1.07 [-1.20, -0.93]) and HGS (-11.94 [-13.35, -10.54]); these differences were greater after adjusting for age, eGFR and FMI, than ALMI. There were similar differences in the associations between PVC and physical function parameters. In men, FMI mediated the association between rate pressuree product and CRT power (P = 0.002), s2LJ force (P < 0.001) and s2LJ power (P = 0.001). ALMI did not mediate associations for either men or women.

CONCLUSIONS

Multiple risk factors for CVD were associated with poorer physical function in men and were mediated by FMI. There is a need to identify strategies to slow/prevent the rising CVD burden and poor physical function in Sub-Saharan Africa.

Is age-related sarcopenia a real concern for my developing country?

Ageing is a distinctive feature of living organisms. With the modernization of human societies, including the development of science, technology and education, expected life expectancy at birth is being extended. This allows novel health-related conditions to gain particular interest amongst the field experts. Along comes sarcopenia, an age-related condition of global proportions that effects all populations, societies and countries. Several international working groups have been trying to identify the more appropriate and applicable sarcopenia definition and diagnostic criteria to follow. Contrary to the initial muscle mass-related context, the shift of attention to muscle strength by the revised European Working Group in Sarcopenia for Older People (EWGSOP2) was ground-breaking and potentially game-changing. The suggested diagnostic algorithm by the EWGSOP2 for case finding, diagnosing and quantifying the severity of cases further facilitated the applicability on clinical practices. Since being directly related to the ageing process, sarcopenia presents an issue of growing concern particularly within the high-income and developed world regions that are generally characterized with an increased life expectancy. In contrast, the developing world and their generally lower life expectancy do not always have sarcopenia amongst the top targeted health-related concerns. In such cases, the expected life expectancy and the populations' quality of life do not necessarily present an issue of major interest. Other serious medical concerns of acute state often eclipse the need for long-term health-related investments, shifting the interest towards only direct interventions and short-term planning. In conclusion, the emerging of sarcopenia as a serious age-related concern is finding care providers and healthcare systems from lower and middle-income countries (LMICs) unprepared. For the time being, it needs to be introduced and promoted in the developing world as a condition with direct life-threatening implications. Simple and creative forms of approach should be ideated and implemented in both scientific and clinical contexts (by researchers and care providers, respectively). The best practice to address this situation would be by empowering intradisciplinary and interdisciplinary collaborations, as well as facilitating interconnections between researches, healthcare practitioners and clients. This should help establish sarcopenia as a serious age-related condition that needs a multidisciplinary and multidimensional approach.

Identification of Probable sarcopenia based on SARC-F and SARC-CalF in older adults from a low-resource setting

OBJECTIVES

We aimed to investigate the frequency of probable sarcopenia and to compare the performance of SARC-F and SARC-CalF for detecting this condition in outpatient older adults from a low-resource setting.

METHODS

We conducted a retrospective, cross-sectional study in outpatient older adults aged ≥60 years attending a hospital in Peru, between August 2019 and February 2020. Probable sarcopenia was defined as low handgrip strength (<27 kg in men and <16 in women). We used SARC-F and SARC-CalF with their standard cut-off points (≥4 and ≥11, respectively). Low calf circumference was defined as ≤33 cm in women and ≤34 cm in men. We performed sensitivity and specificity analyses.

RESULTS

We included 206 older adults, 102 (49.5%) aged ≥75 years old and 140 (67.9%) females. Probable sarcopenia was present in 36.40% of the participants. SARC-F ≥4 was observed in 29.61% and SARC-CalF ≥11 in 41.26% of the population. SARC-F≥4 showed 41.33% sensitivity and 77.10% specificity, whereas SARC-Calf ≥11 had 50.67% sensitivity and 64.12% specificity.

CONCLUSION

We found that one out of three of the population had probable sarcopenia. SARC-Calf showed superior but still low sensitivity than SARC-F, while both had moderate specificity and thus may be useful for ruling out the disease in clinical practice.

Impact of Using Population-Specific Cut-Points, Self-Reported Health, and Socio-Economic Parameters to Predict Sarcopenia: A Cross-Sectional Study in Community-Dwelling Kosovans Aged 60 Years and Older

The age-related decline of muscle strength, mass, and physical performance (sarcopenia) has been raising concerns among the scientific and healthcare communities. This decline may differ between populations, age groups, and sexes. Therefore, we aimed to explore sarcopenia together with the impact of health and socio-economic parameters in mature Kosovans. A cross-sectional study was conducted on community-dwelling adults aged ≥ 60 years (n = 240, 47.1% female) from the Prishtina region. Sarcopenia was identified using the following criteria: (i) the European Working Group in Sarcopenia for Older People (EWGSOP1), (ii) the revised EWGSOP2 algorithms, and (iii) sex-specific cut-points derived from the Kosovan population. In males, pre-sarcopenia/probable sarcopenia was detected from the EWGSOP1, EWGSOP2 and Kosovan-specific criteria at values of 3.1%, 5.5%, and 28.3%; sarcopenia was detected at 1.6%, 5.5%, and 0.0%, and severe sarcopenia was detected at 4.7%, 2.4%, and 4.7%, respectively. Pre-sarcopenia was lower in females (0.9%, 5.3%, 16.8%), with no cases of sarcopenia or severe sarcopenia detected by either algorithm. Sarcopenic males were older, had a lower weight, BMI, skeletal muscle mass, performance score, nutritional status (p < 0.001), educational level (p = 0.035), and higher malnourishment risk (p = 0.005). It is notable that high overweight and obesity levels were also detected (93.8% of females, 77.1% of males). This study highlights the importance of using population-specific cut-points when diagnosing sarcopenia, as otherwise its occurrence may be underestimated, especially in obese persons. Age, body composition, physical performance, health, and socio-economic conditions can influence the occurrence of sarcopenia.

Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2021

The Journal of Cachexia, Sarcopenia and Muscle (JCSM) aims to publish articles with relevance to wasting disorders and illnesses of the muscle in the broadest sense. In order to avoid publication of inappropriate articles and to avoid protracted disputes, the Editors have established ethical guidelines that detail a number of regulations to be fulfilled prior to submission to the journal. This article updates the principles of ethical authorship and publishing in JCSM and its two daughter journals JCSM Rapid Communication and JCSM Clinical Reports. We require the corresponding author, on behalf of all co-authors, to certify adherence to the following principles: All authors listed on a manuscript considered for publication have approved its submission and (if accepted) approve publication in the journal; Each named author has made a material and independent contribution to the work submitted for publication; No person who has a right to be recognized as author has been omitted from the list of authors on the submitted manuscript; The submitted work is original and is neither under consideration elsewhere nor that it has been published previously in whole or in part other than in abstract form; All authors certify that the submitted work is original and does not contain excessive overlap with prior or contemporaneous publication elsewhere, and where the publication reports on cohorts, trials, or data that have been reported on before the facts need to be acknowledged and these other publications must be referenced; All original research work has been approved by the relevant bodies such as institutional review boards or ethics committees; All relevant conflicts of interest, financial or otherwise, that may affect the authors' ability to present data objectively, and relevant sources of funding of the research in question have been duly declared in the manuscript; All authors certify that they will submit the original source data to the editorial office upon request; The manuscript in its published form will be maintained on the servers of the journal as a valid publication only as long as all statements in these guidelines remain true; If any of the aforementioned statements ceases to be true, the authors have a duty to notify as soon as possible the Editor-in-Chief of the journal, so that the available information regarding the published article can be updated and/or the manuscript can be withdrawn.

Prevalence of Sarcopenia and Relationships Between Muscle and Bone in Indian Men and Women

Both ethnicity and age are important determinants of musculoskeletal health. We aimed to determine the prevalence of sarcopenia, assess the suitability of current diagnostic guidelines, and explore muscle-bone relationships in adults from India. A total of 1009 young (20-35 years) and 1755 older (> 40 years) men and women from existing studies were collated and pooled for the analysis. Dual-energy x-ray absorptiometry measured areal bone mineral density (aBMD) at the hip and spine, and fat and lean mass; hand dynamometer measured hand grip strength (HGS). Indian-specific cut-points for appendicular lean mass (ALM), ALM index (ALMI) and HGS were calculated from young Indian (-2SD mean) populations. Sarcopenia was defined using cut-points from The Foundations for the National Institutes of Health (FNIH), revised European Working Group on Sarcopenia in Older People (EWGSOP2), Asian Working Group for Sarcopenia (AWGS), and Indian-specific cut-points. Low lean mass cut-points were then compared for their predictive ability in identifying low HGS. The relationship between muscle variables (ALM, ALMI, HGS) and aBMD was explored, and sex differences were tested. Indian-specific cut-points (men-HGS:22.93 kg, ALM:15.41 kg, ALMI:6.03 kg/m²; women-HGS:10.76 kg, ALM:9.95 kg, ALMI:4.64 kg/m²) were lower than existing definitions. The Indian-specific definition had the lowest, while EWGSOP2 ALMI had the highest predictive ability in detecting low HGS (men:AUC = 0.686, women:AUC = 0.641). There were sex differences in associations between aBMD and all muscle variables, with greater positive associations in women than in men. The use of appropriate cut-points for diagnosing low lean mass and physical function is necessary in ethnic populations for accurate sarcopenia assessment. Muscle-bone relationships are more tightly coupled during ageing in Indian women than men.

A call to action for osteoporosis research in sub-saharan Africa

Data abounds on osteoporosis in developed countries unlike developing countries, particularly those in sub-Saharan Africa. This review was done to confirm the paucity of data the authors suspected and to encourage studies in this field. AJOL (African Journals Online), MEDLINE and EMBASE databases were searched for studies published from January 1980 to August 2018. The eligibility criteria for inclusion were observational studies evaluating osteoporosis prevalence or incidence rates of fragility fractures. Out of 1,170 articles identified, six met the eligibility criteria. Prevalence of osteoporosis ranged from 18.2% to 65.8% across a heterogenous at-risk population. Bone mineral density assessment was limited by the measurement method, with most studies using quantitative ultrasound instead of standard bone densitometry.

From the available studies, the prevalence of osteoporosis and fragility fracture incidence may not be low in Sub-Saharan Africa; what is, however, evident is the paucity of good quality data from this region. Considering an expected aging population in sub-Saharan Africa, future research should be encouraged and aimed at clarifying the burden of this non-communicable disease. This will guide healthcare policy in this medically underserved part of Africa.

Association between Food Insecurity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

Limited literature has investigated the association between food insecurity and sarcopenia in low- and middle-income countries (LMICs). Therefore, the aim of the present study was to investigate the association between food insecurity and sarcopenia among adults aged ≥65 years in six LMICs. Community-based cross-sectional data of the Study on Global Ageing and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. In the past, 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted. The final sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.5) years; 55.0% females). The prevalence of sarcopenia among those with no food insecurity was 13.0% but this increased to 24.4% among those with severe food insecurity. After adjustment for potential confounders, compared to no food insecurity, severe food insecurity was associated with 2.05 (95%CI = 1.12-3.73) times higher odds for sarcopenia. In this large representative sample of older adults from multiple LMICs, it was found that severe food insecurity is associated with higher odds for sarcopenia. Addressing food insecurity in such settings may be an effective strategy to curb the high prevalence of sarcopenia in LMICs.

Red blood cell distribution width is associated with frailty in older inpatients in China: Sex differences in a cross-sectional study

AIMS

Although some studies have investigated an association between inflammatory marker and frailty, little is known about the relationship of red blood cell volume distribution width (RDW) and frailty. This study aimed to determine whether there were sex-specific associations of RDW and frailty among older hospitalized patients.

METHODS

A cross-sectional study was conducted in a comprehensive tertiary hospital in mainland China between February 2015 and November 2017. Hospitalized patients aged 60 years and above were included. Frailty was defined according to Fried's frailty phenotype. Data on patients' demographics, clinical characteristics, and inflammatory markers were collected. The association was evaluated by using the linear and logistic regression modeling.

RESULTS

The frailty prevalence was 26.65% (89/334) in men and 28.07% (80/285) in women. After adjusting for all covariates, patients in the 4th RDW quartile exhibited an increased risk of frailty compared with those of the 1st RDW quartile [men: odds ratio (OR) = 2.26; 95%CI = 1.01, 5.07; women: OR = 6.29; 95%CI = 2.11, 18.71]. P for trend were < 0.05 for all models.

CONCLUSIONS

An increased RDW among older inpatients was more strongly associated with a corresponding increased risk of frailty in women than in men. Our findings suggest that there were sex differences in the association between elevated RDW levels and frailty among older inpatients. These results may provide support for the intervention decision-making.

Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Importantly, low and middle-income countries (LMICs) across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities. It is anticipated that alongside the increased prevalence of obesity, these countries will further experience an increase in age-related musculoskeletal diseases such as sarcopenia. The developmental origins of health and disease (DOHaD) approach will allow clinicians and researchers to consider developmental trajectories, and the influence of the environment, for targeting high-risk individuals and communities for treatment and/or prevention-based interventions that are implemented throughout all stages of the life course. Once a valid and reliable diagnostic criterion is developed, we can firstly assess the prevalence and burden of sarcopenic obesity in LMICs in Africa, and secondly, develop appropriate and sustainable interventions that target improved dietary and physical activity behaviors throughout the life course.

Understanding factors associated with sarcopenic obesity in older African women from a low-income setting: a cross-sectional analysis

BACKGROUND

High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting.

METHODS

This cross-sectional study recruited black SA women between the ages of 60-85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m² were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored.

RESULTS

The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8-14.7%, including 0.8-9.8% without obesity and 0-4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001).

CONCLUSIONS

The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.

Sarcopenia, Diet, Physical Activity and Obesity in European Middle-Aged and Older Adults: The LifeAge Study

The revised European consensus defined sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. The aim of this study was to determine the prevalence of sarcopenia and analyse the influence of diet, physical activity (PA) and obesity index as risk factors of each criteria of sarcopenia. A total of 629 European middle-aged and older adults were enrolled in this cross-sectional study. Anthropometrics were assessed. Self-reported PA and adherence to the Mediterranean diet were evaluated with the Global Physical Activity Questionnaire (GPAQ) and Prevention with Mediterranean Diet questionnaire (PREDIMED), respectively. The functional assessment included handgrip strength, lower body muscle strength, gait speed and agility/dynamic balance. Of the participants, 4.84% to 7.33% showed probable sarcopenia. Sarcopenia was confirmed in 1.16% to 2.93% of participants. Severe sarcopenia was shown by 0.86% to 1.49% of participants. Male; age group ≤65 years; lower body mass index (BMI); high levels of vigorous PA; and the consumption of more than one portion per day of red meat, hamburgers, sausages or cold cuts and/or preferential consumption of rabbit, chicken or turkey instead of beef, pork, hamburgers or sausages (OR = 0.126-0.454; all p < 0.013) resulted as protective factors, and more time of sedentary time (OR = 1.608-2.368; p = 0.032-0.041) resulted as a risk factor for some criteria of sarcopenia. In conclusion, age, diet, PA, and obesity can affect the risk of having low muscle strength, low muscle mass or low functional performance, factors connected with sarcopenia.

Bipedal hopping as a new measure to detect subtle sensorimotor impairment in people with multiple sclerosis

BACKGROUND

Bipedal hopping has the potential to detect subtle multiple sclerosis (MS)-related impairments, especially among patients who "pass" typical movement tests. In this narrative review, we outline the biomechanics of bipedal hopping and propose its usefulness as a novel outcome measure for people with MS having mild disability.

METHODS

We summarize articles that (1) examined the biomechanics of jumping or hopping and (2) tested the validity and/or reliability of hopping tests. We consolidated consistencies and gaps in research and opportunities for future development of the bipedal hop test.

RESULTS

Bipedal hopping requires immense power, coordination, balance, and ability to reduce co-contraction; movement components typically affected by MS. These impairments can be measured and differentiated by examining specific variables, such as hop length (power), symmetry (coordination), center of pressure (balance), and coefficient of variability (co-contraction/spasticity). Bipedal hopping challenges these aspects of movement and exposes sensorimotor impairments that may not have been apparent during walking.

CONCLUSIONS

Testing of bipedal hopping on an instrumented walkway may detect and monitor sensorimotor control in people with MS who do not currently present with clinical deficits. Early measurement is imperative for precise rehabilitation prescription to slow disability progression prior to onset of measurable gait impairment.Implications for rehabilitationJumping and hopping tests detect lower limb and balance impairments in children, athletes, and older adults.Bipedal hop test measures multiple domains: power, coordination, balance, and muscle timing.Bipedal hop test may expose subtle sensorimotor impairments in people with multiple sclerosis.Multiple variables measured can discern type of sensorimotor impairment to direct personalized rehabilitation programs.

Gender and Exercise in Relation to Obesity in Greek Elderly Population

Purpose: The prevalence of sarcopenic obesity is increasing in older adults (>65 years) and older. Sarcopenic obesity is also related to reduced muscle synthesis, due to low physical activity levels. The purpose of the present study is to investigate possible risk factors, and effects of habitual activity status on different types of obesity in an elderly population. Methods: One hundred and two (n = 102) free living participants, aged >60 years, were randomly selected from Rehabilitation Centers for the Elderly in Thessaloniki and from municipal gymnasiums of Thessaloniki, Greece with a mean age of 68.11 ± 6.40 years. The response rate of the participants was 51%. For the purpose of this study, all the participants selected were healthy and did not receive any medication. Specifically, 46 subjects (19 men and 27 women) were members of Rehabilitation Centers for the Elderly in Thessaloniki, while 56 individuals (31 men and 25 women were members of the municipal gymnasiums of Thessaloniki and exercised 2 to 3 times per week). Anthropometric measurements were taken for all subjects. Body composition was assessed with bioelectrical impedance. Body Mass Index (BMI) was categorized according to the World Health Organization (WHO) (2000) standards. Central obesity was defined as a waist circumference of >102 cm in men and >88 cm in women. All participants completed a specific questionnaire regarding their health status, physical activity and previous weight status. Risk of sarcopenic obesity was diagnosed in the participants with co-existing sarcopenia and obesity resulting in high fat mass concurrent with low lean body mass. Results: Women had more than double risk of developing abdominal obesity (OR:2.133, 95% CI: 0.963–4.725) compared to men. More specifically, 69.6% of the elders who did not exercise regularly had central obesity (men: 52.6% and women: 81.5%), while 38.2% of the exercised elders (men: 36.7% and women: 40%) had central obesity. Sedentary elders demonstrated an increased risk of obesity according to body fat (%BF) (OR: 1.259, 95% CI: 0.576–2.750), double the risk of obesity according to body mass (OR: 2.074, 95% CI: 0.765–5.622), and triple the risk of having central obesity (OR: 3.701, 95% CI: 1.612–8.494) compared to those who exercised. Conclusion Exercise appears to have a protective role against all modes of obesity and thus possibly against obesity-related co-morbidities in the elderly.

Sarcopenia Characteristics Are Associated with Incident Mobility Limitations in African Caribbean Men: The Tobago Longitudinal Study of Aging

BACKGROUND

Sarcopenia varies by ethnicity, and has a major impact on health in older adults. However, little is known about sarcopenia characteristics in African ancestry populations outside the United States. We examined sarcopenia characteristics in 2,142 African Caribbean men aged 59.0 ± 10.4 years (range: 40-92 years) in Tobago, and their association with incident mobility limitations in those aged 55+ (n = 738).

METHODS

Body mass index (BMI), grip strength, dual-x-ray absorptiometry (DXA) appendicular lean mass (ALM), and self-reported mobility limitations were measured at baseline, and 6 years later. Change in sarcopenia characteristics, including grip strength, grip strength/BMI, ALMBMI, and ALM/ht2, were determined. Foundations for the National Institutes of Health Sarcopenia Project (FNIH) and European Working Group for Sarcopenia in Older People 2 (EWGSOP2) cut-points were also examined. Odds ratios (OR) and 95% confidence intervals (CI) for mobility limitation were calculated using multivariable linear regression models adjusted for covariates.

RESULTS

Overall, sarcopenia prevalence was quite low using the FNIH (0.3%) and EWGSOP2 (0.6%) operational cut-points, but was higher in those aged 75+ (2.1% [FNIH] and 3.7% [EWGSOP2]). Prevalence was also higher when based on "weakness", versus "low ALM." When sarcopenia markers were examined separately, baseline levels, but not changes, were associated with incident mobility limitations. Baseline grip strength/BMI was a particularly strong risk factor for incident mobility limitations (OR per SD: 0.50; 95% CI: 0.37-0.68).

CONCLUSIONS

Our findings suggest that grip strength normalized to body mass, measured at one time point, may be a particularly useful phenotype for identifying African Caribbean men at risk for future mobility limitations.

Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: A cross-sectional study

BACKGROUND

Sarcopenia is an age-dependent skeletal muscle disorder that is common in patients with heart failure. The current study aimed to investigate the associations of sarcopenia with carotid atherosclerosis, cardiovascular disease and cardiac arrhythmia in a middle-aged and elderly population without clinical heart failure.

METHODS

A total of 2432 participants (992 men and 1440 women) from Shanghai Changfeng Study were included for analysis. The degree of sarcopenia was measured using height-adjusted appendicular skeletal muscle mass (ASM/height²). Carotid plaques were detected by carotid artery ultrasonography, and myocardial ischemia, infarction and cardiac arrhythmia were diagnosed based on electrocardiogram, past history and clinical manifestations.

RESULTS

Sarcopenia was associated with higher prevalence of carotid atherosclerosis (26.4% vs 20.4%, P = 0.027), myocardial infarction (4.0% vs 1.1%, P = 0.001), and premature ventricular contraction (4.0% vs 2.0%, P = 0.034) in the participants with normal body weight, and higher prevalence of carotid atherosclerosis (45.0% vs 31.2%, P = 0.016), myocardial infarction (10.0% vs 4.3%, P = 0.020) and atrial fibrillation (7.5% vs 1.3%, P < 0.001) in those with overweight/obese status. After adjustment for age, gender, cigarette smoking, alcohol drinking, menopausal status in women and other metabolic and inflammatory confounding factors, sarcopenia was independently associated with the risk of myocardial infarction in the whole population, and the risk of atrial fibrillation in the overweight/obese participants (all P < 0.05). Compared with nonsarcopenic lean participants, the risk of myocardial infarction was gradually increased in sarcopenic lean (OR 3.08 [1.28-7.45], P = 0.012) and sarcopenic overweight/obese participants (OR 4.07 [1.31-12.62], P = 0.015). For the atrial fibrillation, the participants with either sarcopenia or overweight/obesity alone showed no higher risk. However, concomitant sarcopenia and overweight/obesity was associated with approximately 5-fold risk of atrial fibrillation (OR 5.68 [1.34-24.12], P = 0.019) after multiple adjustment.

CONCLUSION

Sarcopenia is associated with myocardial infarction and atrial fibrillation in middle-aged and elderly adults without clinical heart failure.

Sarcopenia: A Contemporary Health Problem among Older Adult Populations

Sarcopenia, a geriatric disease characterized by a progressive loss of skeletal muscle mass and loss of muscle function, constitutes a rising, often undiagnosed health problem. Its prevalence in the elderly population is largely considered variable, as it ranges from 5% to 50% depending on gender, age, pathological conditions as well as diagnostic criteria. There is no one unified approach of treatment or assessment, which makes sarcopenia even harder to assess. There is a pressing need to provide better diagnosis, diagnostics, prevention, and individualized health care. Physical activity and nutrition are the main studied ways to prevent sarcopenia, and they also offer better outcomes. This review aims to report the prevalence of sarcopenia in older adults, its etiology, prevention, and treatment techniques.

Bone in heart failure

There is an increasing interest in osteoporosis and reduced bone mineral density affecting not only post-menopausal women but also men, particularly with coexisting chronic diseases. Bone status in patients with stable chronic heart failure (HF) has been rarely studied so far. HF and osteoporosis are highly prevalent aging-related syndromes that exact a huge impact on society. Both disorders are common causes of loss of function and independence, and of prolonged hospitalizations, presenting a heavy burden on the health care system. The most devastating complication of osteoporosis is hip fracture, which is associated with high mortality risk and among those who survive, leads to a loss of function and independence often necessitating admission to long-term care. Current HF guidelines do not suggest screening methods or patient education in terms of osteoporosis or osteoporotic fracture. This review may serve as a solid base to discuss the need for bone health evaluation in HF patients.

Are jumping mechanography assessed muscle force and power, and traditional physical capability measures associated with falls in older adults? Results from the Hertfordshire Cohort Study

OBJECTIVES

To explore associations between measures of lower limb muscle force, velocity and power from jumping mechanography (JM) and simple physical capability (PC) testing, and falls in community dwelling older adults.

METHODS

Participants performed a two-leg countermovement jump on a ground reaction force platform. Jump force, power and velocity were calculated. PC tests were 6m timed-up-and-go (TUG)(sec), grip strength (kg), gait speed (m/s) and chair rise time (secs). Two-three years after JM and PC testing, self-reported falls in the previous year were recorded, and logistic regression analysis used to determine whether JM and PC measures were associated with falls.

RESULTS

Fall and PC data were available for 258 (169 JM) participants. Mean (SD) age at baseline was 75(2.5) years, 50% (n=129) were women and 27% (n=70) had fallen. As power and velocity increased, the odds of being a faller decreased [(odds ratio (OR)=0.91, 95% confidence interval (CI) 0.85,0.98] and (OR=0.20, 95% CI 0.05 0.72) respectively). Whilst grip strength and TUG were associated with falling; relationships were attenuated after adjustment.

CONCLUSIONS

Jumping mechanography-measured muscle power and velocity were associated with lower risk of falls. In this relatively healthy cohort of older adults JM appears to be more sensitive measure of muscle deficits and falls risk than standard PC measures.

Differences in the Prevalence of Sarcopenia in Community-Dwelling, Nursing Home and Hospitalized Individuals. A Systematic Review and Meta-Analysis

BACKGROUND

Sarcopenia is an age-related disease which leads to a decline in muscle mass and function and is one of the most important health issues in elderly people with a high rate and variety of adverse outcomes.

OBJECTIVE

The current systematic review and meta-analysis study was carried out to estimate the overall prevalence of sarcopenia in both males and females in different regions around the world and to show the major differences in its occurrence among different populations.

DESIGN

A systematic review and meta-analysis of studies published in PubMed (Medline) and Scopus.

PARTICIPANTS

Community dwelling, nursing home and hospitalized older adults aged over 60 years.

MEASUREMENTS

Sarcopenia was defined by the major validated diagnostic criteria, such as the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia (AWGS) and the International Working Group on Sarcopenia (IWGS). The model used was the random effect model for estimating the prevalence of sarcopenia. The sex-specific prevalence of sarcopenia as well as 95% CI (Confidence interval) were calculated using MetaXL (version 5.3). Heterogeneity assessment was carried out by subgroup analysis.

RESULTS

We included 41 studies with a total of 34955 participants. The prevalence of sarcopenia in community-dwelling individuals in the included studies were 11% (95% CI: 8-13%) in men and 9% (95% CI: 7-11%) in women. The prevalence of sarcopenia in nursing-home individuals in the included studies were 51% (95% CI: 37-66%) in men and 31% (95% CI: 22-42%) in women and in hospitalized individuals were 23% (95%, CI: 15-30%) in men and 24% (95% CI: 14-35%) in women.

CONCLUSIONS

Despite the differences encountered between the studies, regarding diagnostic tools used to measure of muscle mass, different regions around the world and different populations and clinical settings, this systematic review revealed that a significant proportion of old people has sarcopenia (major in nursing homes), even in populations healthy in general. However, sarcopenia is caused by the aging progress, early diagnosis and individualized care, including physical activity and nutrition, can prevent some adverse outcomes in all populations.

Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2019

This article details an updated version of the principles of ethical authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle (JCSM) and its two daughter journals JCSM Rapid Communication and JCSM Clinical Reports. We request of all author sending to the journal a paper for consideration that at the time of submission to JCSM, the corresponding author, on behalf of all co-authors, needs to certify adherence to these principles. The principles are as follows: all authors listed on a manuscript considered for publication have approved its submission and (if accepted) approve publication in JCSM as provided; each named author has made a material and independent contribution to the work submitted for publication; no person who has a right to be recognized as author has been omitted from the list of authors on the submitted manuscript; the submitted work is original and is neither under consideration elsewhere nor that it has been published previously in whole or in part other than in abstract form; all authors certify that the submitted work is original and does not contain excessive overlap with prior or contemporaneous publication elsewhere, and where the publication reports on cohorts, trials, or data that have been reported on before the facts need to be acknowledged and these other publications must be referenced; all original research work has been approved by the relevant bodies such as institutional review boards or ethics committees; all relevant conflicts of interest, financial or otherwise, that may affect the authors' ability to present data objectively, and relevant sources of funding of the research in question have been duly declared in the manuscript; the manuscript in its published form will be maintained on the servers of JCSM as a valid publication only as long as all statements in the guidelines on ethical publishing remain true. If any of the aforementioned statements ceases to be true, the authors have a duty to notify as soon as possible the Editors of JCSM, JCSM Rapid Communication, and JCSM Clinical Reports, respectively, so that the available information regarding the published article can be updated and/or the manuscript can be withdrawn.

Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer

BACKGROUND

Treatment-related toxicities and decreased levels of patient performance during cancer therapy might contribute to body composition changes and thereby impact outcomes. However, the effect of longitudinal body composition changes on outcomes in patients with advanced endometrial cancer is unknown. This study investigated the association between body composition changes during staging surgery and adjuvant chemoradiotherapy and outcomes in patients with stage III endometrial cancer.

METHODS

Pretreatment and post-treatment computed tomography (CT) images of 131 patients with stage III endometrial cancer who were treated between 2008 and 2016 were analysed. All CT images were contrast enhanced and acquired according to the standardized protocol. The skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), and total adipose tissue index were measured from two sets of CT images obtained at the level of the third lumbar vertebra. The skeletal muscle gauge was calculated by multiplying SMI by SMD (SMI × SMD). Predictors of overall survival and progression-free survival were identified using Cox regression models.

RESULTS

The median follow-up was 50.6 (range 12.1-117.0) months. Overall, body mass index (BMI) changes during treatment were 0.4% per 210 days (95% confidence interval: -0.6 to 1.4; P = 0.41), and patients experienced an average SMD loss of 2.1% per 210 days (95% confidence interval: -4.0 to -0.2; P = 0.03). Weight loss and SMD loss ≥5% were observed in 23 (17.6%) and 54 (41.2%) patients, respectively. The changes in SMD did not correlate with those in BMI (Spearman's ρ for SMD, -0.13; P = 0.13). SMD change (per 1 Hounsfield unit/210 days decrease) was independently associated with poorer overall survival (hazard ratio: 1.32, 95% confidence interval: 1.14-1.52; P < 0.001) and progression-free survival (hazard ratio: 1.28, 95% confidence interval: 1.12-1.43; P < 0.001). Our results did not show association between survival and pretreatment myosteatosis and sarcopenia or changes in SMI and total adipose tissue index during treatment. The pretreatment skeletal muscle gauge was associated with treatment modifications such as delays, dose reductions, and discontinuation of chemotherapy.

CONCLUSIONS

Skeletal muscle radiodensity decreased significantly during treatment and was independently associated with poorer survival in patients with stage III endometrial cancer who underwent staging surgery and adjuvant chemoradiotherapy. SMD loss was occult and occurred independently of BMI change.

Association of Diet Quality with Low Muscle Mass-Function in Korean Elderly

There is a growing body of evidence that links nutrition to muscle mass and function in the elderly, suggesting that it has an important role to play both in the prevention and management of age-related sarcopenia. Some nutrients have been studied, but less is known about the influence of overall diet quality on the loss of skeletal muscle mass and function. This study investigated the interrelationship between the recommended food score (RFS), as an indicator of overall diet quality, and muscle mass function among the Korean elderly. The sample consisted of 521 participants (263 men and 258 women), aged >65 years, who participated in the 2014–2015 National Fitness Award project. Appendicular skeletal muscle mass (ASM) was assessed by bioelectrical impedance analysis. Low muscle mass was defined as having an ASM corrected for height lower than the cutoff value established by the European Working Group on Sarcopenia in Older People. Muscle function, assessed by handgrip strength (HGS), was defined as low if it was below the 20th percentile of elderly men and women. Low muscle mass-function, defined as low muscle mass with low muscle strength (HGS), was found in 29 men (11.0%) and 22 women (8.5%). In elderly men, the low muscle mass-function group had significantly lower RFS values than the normal group after adjustments for age, body fat percentage, drinking, smoking, education, and physical activity (p = 0.019). However, there was no association between RFS and muscle mass-function in elderly women. Our findings suggest that better diet quality may be associated with higher muscle mass in elderly Korean men.

The prevalence of sarcopenia and relationships between muscle and bone in ageing West-African Gambian men and women

BACKGROUND

The rapidly rising ageing population in low and middle-income countries (LMIC) will lead to a concurrent increase in musculoskeletal diseases. Sarcopenia is a disease caused by progressive loss of skeletal muscle mass and strength, leading to adverse outcomes including frailty, falls, fractures, and premature mortality. We investigated the prevalence of sarcopenia, assessed the suitability of current diagnostic guidelines and explored muscle-bone relationships in ageing men and women from rural Gambia.

METHODS

A total of 249 women and 239 men aged 40-75+ years were recruited. Body composition was measured using dual energy X-ray absorptiometry. Comparisons of the Foundations for the National Institutes of Health (FNIH) and European Working Group On Sarcopenia (EWGSOP) definitions of sarcopenia to define prevalence and to identify poor physical capability were determined. Functional ability was assessed by jumping mechanography to calculate lower limb muscle force and power; grip strength was assessed by a hand dynamometer. Peripheral quantitative computed tomography was used to assess muscle-bone relationships.

RESULTS

The prevalence of sarcopenia in Gambian men and women significantly varied depending on the definition used; in men 20% and 19% and in women 45% and 10% for FNIH and EWGSOP, respectively. The FNIH appendicular lean mass cut-off had greatest sensitivity and specificity in identifying low functional ability in Gambian adults. Muscle force was positively associated with measures of tibial bone size, strength, and mineral content.

CONCLUSIONS

The variation in the prevalence of sarcopenia depends on the definition used and highlights the importance of measuring functional capability across ethnic populations.