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Joaquín C, Bretón I, Ocón-Bretón MJ, Zabalegui A, Bellido D, Matía Martín P, Martínez-Olmos MÁ, Zugasti A, Riestra M, Botella F, García-Almeida JM, NutriEcoMuscle Study Team. Nutritional and Physical Rehabilitation in Post-Critical Coronavirus Disease 2019 (COVID-19) Ambulatory Patients: The NutriEcoMuscle Study. Nutrients 2025; 17:1722. [PMID: 40431462 DOI: 10.3390/nu17101722] [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: 04/11/2025] [Revised: 05/09/2025] [Accepted: 05/10/2025] [Indexed: 05/29/2025] Open
Abstract
Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m2, 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R2 = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0-120) min/week of strength exercise and 60 (0-120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence.
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Affiliation(s)
- Clara Joaquín
- Department of Endocrinology and Nutrition, Hospital Germans Trias i Pujol, Carretera Canyet, s/n, 08916 Badalona, Spain
| | - Irene Bretón
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, C/Dr. Esquerdo, 46, 28007 Madrid, Spain
| | - María Julia Ocón-Bretón
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario Lozano Blesa, C/San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - Alba Zabalegui
- Nutritional Support Unit, Hospital Universitario Vall d'Hebron, Pg. de la Vall d'Hebron, 119 Horta-Guinardó, 08035 Barcelona, Spain
| | - Diego Bellido
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Ferrol (A Coruña), Av. da Residencia, s/n, 15405 Ferrol, Spain
| | - Pilar Matía Martín
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Miguel Ángel Martínez-Olmos
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
- Molecular Endocrinology Group, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), 28029 Madrid, Spain
| | - Ana Zugasti
- Section of Clinical Nutrition and Dietetics, Complejo Hospitalario Universitario de Navarra, C/de Irunlarrea, 3, 31008 Pamplona, Spain
| | - María Riestra
- Department of Endocrinology and Nutrition, Hospital Universitario de Cabueñes, Los Prados, 395, 33394 Gijón, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Francisco Botella
- Nutrition Area coordinator, Spanish Society of Endocrinology and Nutrition, C/Villalar, 7, 28001 Madrid, Spain
| | - José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Hospital Virgen de la Victoria, H. Quironsalud. UMA, IBIMA Málaga, 29010 Málaga, Spain
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Navas Moreno V, Sebastián-Valles F, Carrillo López E, Justel Enríquez A, Sager La Ganga C, Sampedro-Núñez MA, Rodríguez Laval V, Sánchez de la Blanca N, Montes Muñiz Á, Alfonso Manterola F, Jiménez-Borreguero LJ, Marazuela M. Impact of Sarcopenia on Mortality in Patients Undergoing TAVI: A Follow-Up Study. J Clin Med 2025; 14:3182. [PMID: 40364213 PMCID: PMC12072693 DOI: 10.3390/jcm14093182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Revised: 04/24/2025] [Accepted: 05/02/2025] [Indexed: 05/15/2025] Open
Abstract
Objective: The use of transcatheter aortic valve implantation (TAVI) has expanded in patients with severe aortic stenosis who are deemed inoperable. However, sarcopenia may be a determining factor in their survival. The aim of our study is to assess the impact of sarcopenia, evaluated by computed tomography (CT), on mortality in this patient population. Methods: Patients with severe aortic stenosis undergoing follow-up after TAVI at Hospital Universitario de la Princesa were recruited. Body composition was analyzed using routine CT scans and open-source software. Survival analysis was performed, and correlations between body composition parameters at the T12 and L3 vertebral levels were assessed. Results: Our sample comprised 97 subjects. Time to mortality was associated with diabetes mellitus (p = 0.050), atrial fibrillation (p = 0.02), and respiratory disease (p = 0.03). Interestingly, sarcopenia (p = 0.039) and normal-density muscle area (p = 0.025) were also associated with time to mortality, with the association between sarcopenia and time to mortality becoming stronger after adjusting for covariates (p < 0.001). The correlation between different body composition parameters at the T12 and L3 vertebral levels was substantial and statistically significant. Conclusions: The use of CT to assess sarcopenia in patients with severe aortic stenosis undergoing TAVI is highly valuable and can predict time to mortality. Sarcopenia should be considered as a relevant parameter in the comprehensive evaluation of these patients.
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Affiliation(s)
- Víctor Navas Moreno
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
| | - Fernando Sebastián-Valles
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
| | - Elena Carrillo López
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
| | - Alicia Justel Enríquez
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
| | - Carolina Sager La Ganga
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
| | - Miguel Antonio Sampedro-Núñez
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
| | | | - Nuria Sánchez de la Blanca
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
| | - Álvaro Montes Muñiz
- Department of Cardiology, Hospital Universitario de la Princesa, 28028 Madrid, Spain (L.J.J.-B.)
| | | | | | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28028 Madrid, Spain; (V.N.M.); (F.S.-V.); (N.S.d.l.B.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28028 Madrid, Spain
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Wilandh E, Skinnars Josefsson M, Persson Osowski C, Mattsson Sydner Y. Improving hospital food and meal provision: a qualitative exploration of nutrition leaders' experiences in implementing change. BMC Health Serv Res 2025; 25:410. [PMID: 40108558 PMCID: PMC11924658 DOI: 10.1186/s12913-025-12499-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Accepted: 02/28/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND Recently, numerous initiatives have been taken to improve food and meals for hospital inpatients. Research providing in-depth knowledge on leading such improvement initiatives and implementing changes, specifically through facilitation within this multilevel context, is essential. This study aims to explore nutrition leaders' experiences in implementing changes to improve food and meal provision for hospital inpatients, focusing on facilitation activities. METHOD This is a qualitative interview study within the social constructivist paradigm. Participants were recruited through professional networks, advertisements, and snowballing. Eighteen semi-structured interviews were conducted individually with participants in leadership roles of food and meal improvement initiatives at Swedish hospitals. The interviews were transcribed verbatim and analysed thematically through an i-PARIHS lens. RESULTS Three themes of facilitation activities were identified: 'Building Relationships', 'Placing Food and Meals on the Agenda', and 'Cultivating Skills'. Building relationships involved establishing connections between the service and clinical divisions. Creating common structures and multidisciplinary teamwork enabled collaboration across organisational boundaries. Placing food and meals on the agenda involved both initial and ongoing communication activities, as food and meal tasks were often considered low priority. Cultivating skills encompassed creating learning opportunities for implementing lasting changes, tailored to specific contexts and adopted within everyday practices. CONCLUSIONS Collaboration between foodservice and clinical professionals, along with the dissemination of knowledge, appears to be important for implementing changes. Active leadership supports successful implementations by providing structured approaches, including feedback systems, and by contributing to the recognition of improvement initiatives, according to experiences shared during interviews.
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Affiliation(s)
- Emma Wilandh
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, Uppsala, 751 22, Sweden.
| | - Malin Skinnars Josefsson
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, Uppsala, 751 22, Sweden
| | - Christine Persson Osowski
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, 721 23, Sweden
| | - Ylva Mattsson Sydner
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, Uppsala, 751 22, Sweden
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Carey MR, Ladanyi A, Nishikawa M, Bordon A, Leb JS, Pinsino A, Driggin E, Latif F, Sayer GT, Clerkin KJ, Takeda K, Uriel N, Colombo PC, Yuzefpolskaya M. Pre-operative pectoralis muscle area index is associated with biomarkers of inflammation and endotoxemia and predicts clinical outcomes after left ventricular assist device implantation: A cohort study. Artif Organs 2024; 48:1494-1501. [PMID: 39096053 DOI: 10.1111/aor.14836] [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: 04/05/2024] [Revised: 06/21/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Pre-left ventricular assist device (LVAD) pectoralis muscle assessment, an estimate of sarcopenia, has been associated with postoperative mortality and gastrointestinal bleeding, though its association with inflammation, endotoxemia, length-of-stay (LOS), and readmissions remains underexplored. METHODS This was a single-center cohort study of LVAD patients implanted 1/2015-10/2018. Preoperative pectoralis muscle area was measured on chest computed tomography (CT), adjusted for height squared to derive pectoralis muscle area index (PMI). Those with PMI in the lowest quintile were defined as low-PMI cohort; all others constituted the reference cohort. Biomarkers of inflammation (interleukin-6, adiponectin, tumor necrosis factor-α [TNFα]) and endotoxemia (soluble (s)CD14) were measured in a subset of patients. RESULTS Of the 254 LVAD patients, 95 had a preoperative chest CT (median days pre-LVAD: 7 [IQR 3-13]), of whom 19 (20.0%) were in the low-PMI cohort and the remainder were in the reference cohort. Compared with the reference cohort, the low-PMI cohort had higher levels of sCD14 (2594 vs. 1850 ng/mL; p = 0.04) and TNFα (2.9 vs. 1.9 pg/mL; p = 0.03). In adjusted analyses, the low-PMI cohort had longer LOS (incidence rate ratio 1.56 [95% confidence interval 1.16-2.10], p = 0.004) and higher risk of 90-day and 1-year readmissions (subhazard ratio 5.48 [1.88-16.0], p = 0.002; hazard ratio 1.73 [1.02-2.94]; p = 0.04, respectively). CONCLUSIONS Pre-LVAD PMI is associated with inflammation, endotoxemia, and increased LOS and readmissions.
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Affiliation(s)
- Matthew R Carey
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Annamaria Ladanyi
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Mia Nishikawa
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Abraham Bordon
- Department of Radiology, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Jay S Leb
- Department of Radiology, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Alberto Pinsino
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Elissa Driggin
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Farhana Latif
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Gabriel T Sayer
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Kevin J Clerkin
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Koji Takeda
- Division of Cardiac, Thoracic & Vascular Surgery, Department of Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Nir Uriel
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Paolo C Colombo
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
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Abe T, Yoshimura Y, Sato Y, Nagano F, Matsumoto A. Sarcopenia as a Robust Predictor of Readmission within 6 Months among Individuals Experiencing Acute Stroke. Ann Geriatr Med Res 2024; 28:307-314. [PMID: 38600867 PMCID: PMC11467510 DOI: 10.4235/agmr.24.0017] [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: 01/22/2024] [Revised: 02/29/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Sarcopenia negatively affects the short-term prognosis of hospitalized older adults. However, no evidence currently supports a direct relationship between sarcopenia and readmission among individuals who have experienced an acute stroke. Therefore, we investigated whether sarcopenia is associated with readmission after discharge. METHODS This retrospective cohort study included patients who had experienced acute stroke. Sarcopenia was defined as the coexistence of low skeletal muscle mass index (SMI) and grip strength. We applied the log-rank test and Cox proportional hazards regression analysis to analyze whether sarcopenia, low SMI, and low grip strength were associated with readmission within 6 months. RESULTS Among 228 included patients (mean age, 72.8 years; 146 males), the prevalence of sarcopenia was 24.6% (n=56; male 17.8%; female 36.6%). Cox proportional hazards regression analysis using the propensity score as a covariate revealed that sarcopenia (hazard ratio [HR]=7.21; 95% confidence interval [CI] 1.45-35.8; p=0.016) and low skeletal muscle mass (HR=7.40; 95% CI 1.14-48.1; p=0.036), but not low grip strength (HR=1.42; 95% CI 0.281-7.21; p=0.670), were significantly associated with readmission for stroke within 6 months. CONCLUSIONS Sarcopenia was negatively associated with readmission within 6 months of stroke onset in patients in Japan who had experienced an acute stroke. These findings suggest that the identification of sarcopenia may facilitate prognostic prediction from the acute stage and intervention(s) to prevent rehospitalization.
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Affiliation(s)
- Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, Minami Uonuma-city, Niigata, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, Minami Uonuma-city, Niigata, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Rodríguez-Lumbreras L, Ruiz-Cárdenas JD, Murcia-González MA. Risk of secondary sarcopenia in Europeans with fibromyalgia according to the EWGSOP2 guidelines: systematic review and meta-analysis. Eur J Phys Rehabil Med 2024; 60:703-715. [PMID: 38860694 PMCID: PMC11403634 DOI: 10.23736/s1973-9087.24.08348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Fibromyalgia is characterized by chronic widespread pain accompanied by reduced levels of physical activity and associated comorbidities such as overweight and obesity which have been associated to sarcopenia development. The aim of this systematic review is to ascertain whether Europeans with fibromyalgia show a reduction in sarcopenia determinants compared to apparently-healthy controls and to determine the risk of sarcopenia and its possible risk factors (PROSPERO: CRD42023439839). EVIDENCE ACQUISITION Systematic searches were conducted on six databases (Academic-Search-Ultimate, CENTRAL, PubMed, SciELO, WOS-Core Collection, and ClinicalTrials.gov last-search February-2024) looking for original studies developed in European countries which assessed any of the sarcopenia determinants proposed by the EWGSOP2-guidelines (handgrip strength, five sit-to-stand, appendicular skeletal mass [ASM], skeletal muscle index [SMI]) and included fibromyalgia and healthy-control individuals. Studies mixing fibromyalgia with other diagnoses were excluded. Random-effects meta-analyses and meta-regressions were used to analyze possible differences and associated risk factors. The risk of bias was assessed using the Cochrane-Rob tool and the Quality Assessment Tool for Observational Studies, and the certainty of the evidence using GRADE-approach. EVIDENCE SYNTHESIS A total of 25 studies (6393 individuals; 97% women; 20-65 years) were included. Fibromyalgia individuals showed reduced muscle strength ([handgrip] SMD: -1.16 [-1.29, -1.03]; high-certainty; [five sit-to-stand] not-assessed) and muscle quantity ([ASM] mean-difference: -0.83 kg [-1.41, -0.37]; [SMI] mean-difference: -0.26 kg/m2 [-0.41, -0.10]; both low-certainty) compared to healthy-controls. Fibromyalgia individuals had nine-times greater risk for probable sarcopenia (OR: 9.23 [6.85, 12.45]; high-certainty), but not for confirmed sarcopenia ([ASM] OR: 0.91 [0.49, 1.67]; [SMI] OR: 0.67 [0.19, 2.33]; both low-certainty) according to the EWGSOP2 cut-off points. Reduced muscle strength was strongly associated to fibromyalgia-severity (β=-0.953 [-0.069, -0.038]). Studies were rated as high-risk of bias overall because did not account for some potential confounders (physical activity, sedentary time, Body Mass Index) which could influence the estimated effect. CONCLUSIONS Europeans with fibromyalgia have a large reduction in muscle strength and may have a reduction in muscle quantity. The risk of probable sarcopenia according to the EWGSOP2 cut-off points was nine-times higher, but may have no difference in risk of reduced muscle quantity relative to healthy-controls. Muscle strength was strongly associated to disease severity.
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Affiliation(s)
- Laura Rodríguez-Lumbreras
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
| | - Juan D Ruiz-Cárdenas
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain -
| | - María A Murcia-González
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
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Gay-As MU, Lee SC, Lai FC. Sarcopenia Among Older People in the Philippines: A Scoping Review. Creat Nurs 2024; 30:133-144. [PMID: 38533549 DOI: 10.1177/10784535241239684] [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] [Indexed: 03/28/2024]
Abstract
Aims: This review aimed to identify and map the evidence about sarcopenia among older Filipinos. Methods: Studies about sarcopenia among Filipinos aged 60 and above were included. All studies regardless of type, setting, language, and timeframe were reviewed. The Cochrane Library, Cumulative Index of Nursing and Allied Health, Embase, PubMed, and Health Research and Development Information Network were searched. The study was conducted per an a priori protocol and utilized the Joanna Briggs Institute guidance for scoping reviews. Results: From the 87 records identified, 20 studies published from 2013 to 2023 were eligible (≥ 5424 participants). The studies were varied; 11 cross-sectional, 2 conference lectures, 2 consensus reports, 1 meta-analysis, cohort study, case series, posthoc analysis, and continuing education. As to setting, 11 studies were conducted in the hospital and 4 in the community. On the level of prevention, 5 studies addressed the primary level, 10 studies secondary, and 2 studies both tertiary and secondary. The studies focused on: sarcopenia in a specific group (13 studies), consensus (4 studies), and education (3 studies). Conclusions: Sarcopenia studies among older Filipinos were limited. Most were hospital-based and involved patients with comorbidities. Some studies used sarcopenia assessment guidelines with Filipino normative references. Sarcopenia impacts the overall well-being of older Filipinos; hence more studies and health promotion programs are necessary.
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Affiliation(s)
- Mark U Gay-As
- School of Nursing, Taipei Medical University, Taipei City
- College of Nursing, Benguet State University in La Trinidad, Benguet, Philippines
| | - Shu-Chun Lee
- School of Gerontology and Long-term Care, Taipei Medical University, Taipei City
| | - Fu-Chih Lai
- School of Nursing, Taipei Medical University, Taipei City
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De Spiegeleer A, Descamps A, Wynendaele E, Naumovski P, Crombez L, Planas M, Feliu L, Knappe D, Mouly V, Bigot A, Bielza R, Hoffmann R, Van Den Noortgate N, Elewaut D, De Spiegeleer B. Streptococcal quorum sensing peptide CSP-7 contributes to muscle inflammation and wasting. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167094. [PMID: 38428683 DOI: 10.1016/j.bbadis.2024.167094] [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: 11/29/2023] [Revised: 02/04/2024] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
Muscle wasting diseases, such as cancer cachexia and age-associated sarcopenia, have a profound and detrimental impact on functional independence, quality of life, and survival. Our understanding of the underlying mechanisms is currently limited, which has significantly hindered the development of targeted therapies. In this study, we explored the possibility that the streptococcal quorum sensing peptide Competence Stimulating Peptide 7 (CSP-7) might be a previously unidentified contributor to clinical muscle wasting. We found that CSP-7 selectively triggers muscle cell inflammation in vitro, specifically the release of IL-6. Furthermore, we demonstrated that CSP-7 can traverse the gastrointestinal barrier in vitro and is present in the systemic circulation in humans in vivo. Importantly, CSP-7 was associated with a muscle wasting phenotype in mice in vivo. Overall, our findings provide new mechanistic insights into the pathophysiology of muscle inflammation and wasting.
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Affiliation(s)
- Anton De Spiegeleer
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Amélie Descamps
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Evelien Wynendaele
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Petar Naumovski
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Liesbeth Crombez
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Marta Planas
- LIPPSO, Department of Chemistry, Universitat de Girona, Maria Aurèlia Capmany 69, Girona, Spain
| | - Lidia Feliu
- LIPPSO, Department of Chemistry, Universitat de Girona, Maria Aurèlia Capmany 69, Girona, Spain
| | - Daniel Knappe
- Center for Biotechnology and Biomedicine, University of Leipzig, Leipzig, Germany; Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, University of Leipzig, Leipzig, Germany
| | - Vincent Mouly
- Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | - Anne Bigot
- Centre de Recherche en Myologie, Sorbonne Université, Paris, France
| | - Rafael Bielza
- Department of Geriatric Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Ralf Hoffmann
- Center for Biotechnology and Biomedicine, University of Leipzig, Leipzig, Germany; Institute of Bioanalytical Chemistry, Faculty of Chemistry and Mineralogy, University of Leipzig, Leipzig, Germany
| | - Nele Van Den Noortgate
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Dirk Elewaut
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; VIB Inflammation Research Center, Unit for Molecular Immunology and Inflammation, Ghent University, Ghent, Belgium; Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Bart De Spiegeleer
- Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University Hospital, Ghent, Belgium; Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
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9
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Shadmand Foumani Moghadam MR, Vaezi A, Jandari S, Araste A, Rezvani R. Navigating sarcopenia in COVID-19 patients and survivors: Understanding the long-term consequences, transitioning from hospital to community with mechanisms and interventions for future preparedness. Aging Med (Milton) 2024; 7:103-114. [PMID: 38571679 PMCID: PMC10985777 DOI: 10.1002/agm2.12287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 04/05/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused widespread devastation, with millions of confirmed cases and deaths worldwide. Although there were efforts made to develop treatments and vaccines for COVID-19, the coexistence of sarcopenia, a muscle disorder, has been largely overlooked. It is while new variants of this disease (eg, BA.2.86) are challenging the current protocols. Sarcopenia is associated with increased mortality and disability, and shares common mechanisms with COVID-19, such as inflammation, hormonal changes, and malnutrition. This can worsen the effects of both conditions. Furthermore, survived patients with COVID-19 who have elevated risk, as well as aging, which increases the process of sarcopenia. Therefore, addressing sarcopenia in patients with COVID-19 and surviving individuals can be crucial for improving outcomes and preventing long-term disability. During hospital stays, assessing sarcopenia through indicators like muscle wasting and malnutrition is important. Nutritional interventions, such as malnutrition screening and enteral feeding, play a critical role in preventing sarcopenia in hospitals. Mental health and physical activity evaluations and interventions are also necessary. Even after recovering from COVID-19, there is a risk of developing sarcopenia, requiring continued monitoring. Nutrition and physical activity considerations are vital for prevention and management, necessitating tailored training programs and diet therapy. Mental health should not be overlooked, with regular screening, and community-based interventions. Infrastructure should support physical activity, and mental health services must become more accessible. Community engagement through support groups and peer networks can foster resilience and social connection. Efforts are needed to promote healthy diets and ensure access to nutritious foods.
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Affiliation(s)
| | | | - Sajedeh Jandari
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Asie Araste
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Reza Rezvani
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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10
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Chen S, Xu X, Gong H, Chen R, Guan L, Yan X, Zhou L, Yang Y, Wang J, Zhou J, Zou C, Huang P. Global epidemiological features and impact of osteosarcopenia: A comprehensive meta-analysis and systematic review. J Cachexia Sarcopenia Muscle 2024; 15:8-20. [PMID: 38086772 PMCID: PMC10834350 DOI: 10.1002/jcsm.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/04/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta-analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population-based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55 158 studies, and 66 studies (64 404 participants, mean age from 46.6 to 93 years) were analysed in the final analysis, including 48 cross-sectional studies, 17 cohort studies and 1 case-control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7-20.3, I2 = 98.7%), including 15.3% (95% CI: 13.2-17.4, I2 = 97.6%) in men and 19.4% (95% CI: 16.9-21.9, I2 = 98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1-24.4, I2 = 98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3-18.9, I2 = 98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P = 0.001). Frailty (OR = 4.72, 95% CI: 2.71-8.23, I2 = 61.1%), malnutrition (OR = 2.35, 95% CI: 1.62-3.40, I2 = 50.0%), female sex (OR = 5.07, 95% CI: 2.96-8.69, I2 = 73.0%) and higher age (OR = 1.10, 95% CI: 1.06-1.15, I2 ==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta-analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR = 1.54, 95% CI: 1.20-1.97; I2 = 1.0%, three studies), fracture (HR = 2.13, 95% CI: 1.61-2.81; I2 = 67.8%, seven studies) and mortality (HR = 1.75, 95% CI: 1.34-2.28; I2 = 0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.
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Affiliation(s)
- Shanping Chen
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Xiao Xu
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Huping Gong
- College of Nursing, Gannan Medical University, Ganzhou, China
| | - Ruzhao Chen
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Lijuan Guan
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Xuedan Yan
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Lihua Zhou
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Yongxue Yang
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Jiang Wang
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Jianghua Zhou
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chuan Zou
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
- Department of General Practice, Chengdu Fifth People's Hospital, Chengdu, China
| | - Pan Huang
- College of Nursing, Wenzhou Medical University, Wenzhou, China
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11
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Beretta MV, de Paula TP, da Costa Rodrigues T, Steemburgo T. Prolonged hospitalization and 1-year mortality are associated with sarcopenia and malnutrition in older patients with type 2 diabetes: A prospective cohort study. Diabetes Res Clin Pract 2024; 207:111063. [PMID: 38110120 DOI: 10.1016/j.diabres.2023.111063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023]
Abstract
AIM To assess the relationship of the presence of sarcopenia and malnutrition with unfavorable clinical outcomes: prolonged length of hospital stay (LOS), readmission, and one-year mortality in older patients with type 2 diabetes (T2D). METHODS Were included 319 patients with ≥ 60 years of age with T2D hospitalized at a university hospital in Southern Brazil. Sarcopenia was diagnosed according to handgrip strength (HGS), calf circumference (CC), and the timed up and go (TUG) walking test, and malnutrition according to the subjective global assessment (SGA) and the mini nutritional assessment long form (MNA-LF). Multivariate analyses, adjusted for confounders, were performed to assess the association of sarcopenia and malnutrition with clinical outcomes. One-year survival was compared using Kaplan-Meier analysis. RESULTS The association between sarcopenia and malnutrition increased by 2.42 times (95 %CI 1.35-4.36) the probability of LOS ≥ 14 days and by 2.01 times (95 %CI 1.09-3.72) the risk of one-year mortality. Older patients with malnutrition and sarcopenia have a higher risk of one-year mortality (log-rank p < 0.05) compared with well-nourished patients without sarcopenia. CONCLUSION In older patients with type 2 diabetes, those with sarcopenia, and malnutrition have higher odds of prolonged hospitalization and risk of mortality within one year after hospital discharge.
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Affiliation(s)
- Mileni Vanti Beretta
- Graduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Tatiana Pedroso de Paula
- Graduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ticiana da Costa Rodrigues
- Graduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Thais Steemburgo
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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12
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López Jiménez E, Neira Álvarez M, Menéndez Colino R, Checa López M, Grau Jiménez C, Pérez Rodríguez P, Vasquez Brolen B, Arias Muñana E, Ramírez Martín R, Alonso Bouzón C, Amor Andrés MS, Bermejo Boixareu C, Brañas F, Alcantud Ibáñez M, Alcantud Córcoles R, Cortés Zamora EB, Gómez Jiménez E, Romero Rizos L, Avendaño Céspedes A, Hernández Socorro CR, Abizanda P. Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study. J Nutr Health Aging 2024; 28:100010. [PMID: 38267149 DOI: 10.1016/j.jnha.2023.100010] [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: 10/28/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES The main objective was to analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs). DESIGN Prospective multicentric observational cohort study. SETTING Seven AGUs from University Hospitals in Spain. PARTICIPANTS Hospitalized adults ≥ 70 years old, able to ambulate and without severe dementia. MEASUREMENTS Ultrasound measurements of QRF were acquired at 2/3 distal between anterior-superior iliac spine and patella in both legs by trained Geriatricians. Ultrasound Chison model ECO2 was used. QRF area, thickness, edema, echogenicity, and fasciculations were measured. RESULTS From the complete sample (n = 143), in 45 (31.5%) participants, ultrasound images were classified as non-valid by an expert radiologist. Mean age was 87.8 (SD 5.4). Mean hospital stay 7.6 days (SD 4.3). From those with valid images, 36 (49.3%), 2 (2.7%), and 35 (47.9%) presented a decrease, equal values, or an increase in QRF area from baseline to discharge, respectively, and 37 (50.0%), 2 (2.7%), and 35 (47.3%) presented a decrease, equal values, or an increase in QRF thickness, respectively. 26 (35.6%) presented a decrease in more than 0.2 cm2 of QRF area, and 23 (31.1%) a decrease in more than 0.1 cm of QRF thickness. Only 4 (5.4%) patients presented new edema, while 13 (17.6%) worsened echogenicity. CONCLUSION One third of older adults develop significant muscle loss during a hospitalization for acute medical diseases. TRIAL REGISTRATION NUMBER NCT05113758.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Fátima Brañas
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Rubén Alcantud Córcoles
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa Belén Cortés Zamora
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Gómez Jiménez
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Luis Romero Rizos
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain
| | - Almudena Avendaño Céspedes
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | - Pedro Abizanda
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain.
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13
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Ruiz-Cárdenas JD, Montemurro A, Martínez-García MDM, Rodríguez-Juan JJ. Sit-to-Stand Video Analysis-Based App for Diagnosing Sarcopenia and Its Relationship With Health-Related Risk Factors and Frailty in Community-Dwelling Older Adults: Diagnostic Accuracy Study. J Med Internet Res 2023; 25:e47873. [PMID: 38064268 PMCID: PMC10746979 DOI: 10.2196/47873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/29/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Probable sarcopenia is determined by a reduction in muscle strength assessed with the handgrip strength test or 5 times sit-to-stand test, and it is confirmed with a reduction in muscle quantity determined by dual-energy X-ray absorptiometry or bioelectrical impedance analysis. However, these parameters are not implemented in clinical practice mainly due to a lack of equipment and time constraints. Nowadays, the technical innovations incorporated in most smartphone devices, such as high-speed video cameras, provide the opportunity to develop specific smartphone apps for measuring kinematic parameters related with sarcopenia during a simple sit-to-stand transition. OBJECTIVE We aimed to create and validate a sit-to-stand video analysis-based app for diagnosing sarcopenia in community-dwelling older adults and to analyze its construct validity with health-related risk factors and frailty. METHODS A total of 686 community-dwelling older adults (median age: 72 years; 59.2% [406/686] female) were recruited from elderly social centers. The index test was a sit-to-stand video analysis-based app using muscle power and calf circumference as proxies of muscle strength and muscle quantity, respectively. The reference standard was obtained by different combinations of muscle strength (handgrip strength or 5 times sit-to-stand test result) and muscle quantity (appendicular skeletal mass or skeletal muscle index) as recommended by the European Working Group on Sarcopenia in Older People-2 (EWGSOP2). Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) of the receiver operating characteristic curve were calculated to determine the diagnostic accuracy of the app. Construct validity was evaluated using logistic regression to identify the risks associated with health-related outcomes and frailty (Fried phenotype) among those individuals who were classified as having sarcopenia by the index test. RESULTS Sarcopenia prevalence varied from 2% to 11% according to the different combinations proposed by the EWGSOP2 guideline. Sensitivity, specificity, and AUC were 70%-83.3%, 77%-94.9%, and 80.5%-87.1%, respectively, depending on the diagnostic criteria used. Likewise, positive and negative predictive values were 10.6%-43.6% and 92.2%-99.4%, respectively. These results proved that the app was reliable to rule out the disease. Moreover, those individuals who were diagnosed with sarcopenia according to the index test showed more odds of having health-related adverse outcomes and frailty compared to their respective counterparts, regardless of the definition proposed by the EWGSOP2. CONCLUSIONS The app showed good diagnostic performance for detecting sarcopenia in well-functioning Spanish community-dwelling older adults. Individuals with sarcopenia diagnosed by the app showed more odds of having health-related risk factors and frailty compared to their respective counterparts. These results highlight the potential use of this app in clinical settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05148351; https://clinicaltrials.gov/study/NCT05148351. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3390/s22166010.
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Affiliation(s)
- Juan D Ruiz-Cárdenas
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
| | - Alessio Montemurro
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
| | - María Del Mar Martínez-García
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
- Cystic Fibrosis Association of Murcia, Murcia, Spain
| | - Juan J Rodríguez-Juan
- Physiotherapy Department, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
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14
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Qu Q, Guo Q, Sun J, Lu X, Cheang I, Zhu X, Yao W, Li X, Zhang H, Zhou Y, Liao S, Gao R. Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate. BMC Geriatr 2023; 23:619. [PMID: 37789259 PMCID: PMC10546679 DOI: 10.1186/s12877-023-04326-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999-2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14-2.49, P = 0.008; HR 1.48, 95% CI 1.04-2.10, P = 0.028; HR 1.30, 95% CI 1.02-1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.
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Affiliation(s)
- Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qixin Guo
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jinyu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Haifeng Zhang
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Street, Suzhou, 215002, China
- Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Rongrong Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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15
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Beaudart C, Reginster JY, Amuthavalli Thiyagarajan J, Bautmans I, Bauer J, Burlet N, Cesari M, Cherubini A, Cooper C, Cruz-Jentoft AJ, Dawson-Hughes B, Fielding RA, Harvey NC, Landi F, Laslop A, Maggi S, Montero-Errasquin B, Concepción PYM, Rolland Y, Rizzoli R, Visser M, Bruyère O. Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties. Aging Clin Exp Res 2023; 35:1581-1593. [PMID: 37219755 PMCID: PMC10363087 DOI: 10.1007/s40520-023-02438-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.
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Affiliation(s)
- Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jürgen Bauer
- Center for Geriatric Medicine and Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | | | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | | | | | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, CERPOP UMR 1295, University of Toulouse III, Inserm, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
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16
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Darvishi A, Shafiee G, Balajam NZ, Hemami MR, Ostovar N, Heshmat R. Cost-effectiveness analysis of sarcopenia management interventions in Iran. BMC Public Health 2023; 23:819. [PMID: 37143011 PMCID: PMC10157910 DOI: 10.1186/s12889-023-15693-w] [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: 01/18/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVES Identification the optimal management intervention of sarcopenia is a concern of health systems. We aimed to analyze the cost-effectiveness of sarcopenia management strategies in Iran. METHODS We constructed a lifetime Markov model based on natural history. The strategies comparedincluded exercise training, nutritional supplements, whole body vibration (WBV), and various exercise interventions and nutritional supplement combinations. A total of 7 strategies was evaluated in addition to the non-intervention strategy. Parameter values were extracted from primary data and the literature, and the costs and Quality-adjusted life years (QALYs) were calculated for each strategy. Deterministic and probabilistic sensitivity analysis, including the expected value of perfect information (EVPI), was also performed to determine the robustness of the model. Analyses were performed using the 2020 version of TreeAge Pro software. RESULTS All seven strategies increased lifetime effectiveness (QALYs). The protein and Vitamin D3 (P + D) strategy had the highest effectiveness values among all strategies. After removing the dominated strategies, the estimated ICER for the P + D compared to Vitamin D3 alone (D) strategy was calculated as $131,229. Considering the cost-effectiveness threshold ($25,249), base-case results indicated that the D strategy was the most cost-effective strategy in this evaluation. Sensitivity analysis of model parameters also demonstrated the robustness of results. Also, EVPI was estimated at $273. CONCLUSIONS Study results, as the first economic evaluation of sarcopenia management interventions, showed that despite the higher effectiveness of D + P, the D strategy was the most cost-effective. Completing clinical evidence of various intervention options can lead to more accurate results in the future.
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Affiliation(s)
- Ali Darvishi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran
| | - Narges Zargar Balajam
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Navid Ostovar
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Beaudart C, Demonceau C, Reginster JY, Locquet M, Cesari M, Cruz Jentoft AJ, Bruyère O. Sarcopenia and health-related quality of life: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023. [PMID: 37139947 DOI: 10.1002/jcsm.13243] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/08/2023] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
The decrease of physical abilities and functional decline that can be caused by musculoskeletal conditions such as sarcopenia, can lead to higher levels of dependency and disability. Therefore, it may influence patient reported outcome measures (PROM), such as the health-related quality of life (HRQoL). The purpose of this systematic review and meta-analysis is to provide a comprehensive overview of the relationship between sarcopenia and HRQoL. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed throughout the whole process of this work. A protocol was previously published on PROSPERO. The electronic databases MEDLINE, Scopus, Allied and Complementary Medicine (AMED), EMB Review - ACP Journal Club, EBM Review - Cochrane Central of Register of Controlled Trials and APA PsychInfo were searched until October 2022 for observational studies reporting a HRQoL assessment in both sarcopenic and non-sarcopenic individuals. Study selection and data extraction were carried out by two independent researchers. Meta-analysis was performed using a random effect model, reporting an overall standardized mean difference (SMD) and its 95% confidence interval (CI) between sarcopenic and non-sarcopenic individuals. Study quality was measured using the Newcastle-Ottawa Scale and the strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The search strategy identified 3725 references from which 43 observational studies were eligible and included in this meta-synthesis study. A significantly lower HRQoL was observed for sarcopenic individuals compared with non-sarcopenic ones (SMD -0.76; 95% CI -0.95; -0.57). Significant heterogeneity was associated with the model (I2 = 93%, Q test P-value <0.01). Subgroup analysis showed a higher effect size when using the specific questionnaire SarQoL compared with generic questionnaires (SMD -1.09; 95% CI -1.44; -0.74 with the SarQoL versus -0.49; 95% CI -0.63; -0.36 with generic tools; P-value for interaction <0.01). A greater difference of HRQoL between sarcopenic and non-sarcopenic was found for individuals residing in care homes compared with community-dwelling individuals (P-value for interaction <0.001). No differences were found between age groups, diagnostic techniques, and continents/regions. The level of evidence was rated as moderate using the GRADE assessment. This systematic review and meta-analysis combining 43 observational studies shows that HRQoL is significantly reduced in sarcopenic patients. The use of disease-specific HRQoL instruments may better discriminate sarcopenic patients with respect to their quality of life.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Céline Demonceau
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Médéa Locquet
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | | | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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18
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Stuck AK, Basile G, Freystaetter G, de Godoi Rezende Costa Molino C, Lang W, Bischoff‐Ferrari HA. Predictive validity of current sarcopenia definitions (EWGSOP2, SDOC, and AWGS2) for clinical outcomes: A scoping review. J Cachexia Sarcopenia Muscle 2023; 14:71-83. [PMID: 36564353 PMCID: PMC9891988 DOI: 10.1002/jcsm.13161] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/25/2022] [Indexed: 12/25/2022] Open
Abstract
Over the last 3 years new definitions of sarcopenia by the Sarcopenia Definition and Outcome Consortium (2020, SDOC), European Working Group on Sarcopenia in Older People (2019, EWGSOP2) and Asian Working Group on Sarcopenia (2019, AWGS2) have been proposed. The objective of this scoping review was to explore predictive validity of these current sarcopenia definitions for clinical outcomes. We followed the PRISMA checklist for scoping reviews. Based on a systematic search performed by two independent reviewers of databases (Pubmed and Embase) articles comparing predictive validity of two or more sarcopenia definitions on prospective clinical outcomes published since January 2019 (the year these definitions were introduced) were included. Data were extracted and results collated by clinical outcomes and by sarcopenia definitions, respectively. Of 4493 articles screened, 11 studies (mean age of participants 77.6 (SD 5.7) years and 50.0% female) comprising 82 validity tests were included. Overall, validity tests on the following categories of clinical outcomes were performed: fracture (n = 40, assessed in one study), mortality (n = 18), function (n = 11), institutionalization (n = 7), falls (n = 4), and hospitalization (n = 2). Thereby, EWGSOP2 was investigated in 15 validity tests (18.3%) on all categories of clinical outcomes, whereas SDOC was investigated in four validity tests (4.9%) in one study on fractures in men only, and none of the validity tests investigated predictive validity by the AWGS2. However, we were not able to pool the data using a meta-analytic approach due to important methodological heterogeneity between the studies. We identified various definitions of clinical outcomes that were used to test predictive validity of sarcopenia definitions suggesting that an agreement on an operational definition of a clinical outcome is key to advance in the field of sarcopenia. Moreover, data on predictive validity using the sarcopenia definitions by the SDOC and AWGS2 are still scarce and lacking, respectively. In a next step, prospective studies including both women and men are needed to compare predictive validity of current sarcopenia definitions on defined key clinical outcomes.
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Affiliation(s)
- Anna K. Stuck
- Centre on Aging and MobilityUniversity Hospital Zurich and University of ZurichZurichSwitzerland
| | - Giacomo Basile
- Centre on Aging and MobilityUniversity Hospital Zurich and University of ZurichZurichSwitzerland
| | - Gregor Freystaetter
- Centre on Aging and MobilityUniversity Hospital Zurich and University of ZurichZurichSwitzerland
- Department of Aging MedicineUniversity Hospital ZurichZurichSwitzerland
| | | | - Wei Lang
- Centre on Aging and MobilityUniversity Hospital Zurich and University of ZurichZurichSwitzerland
| | - Heike A. Bischoff‐Ferrari
- Centre on Aging and MobilityUniversity Hospital Zurich and University of ZurichZurichSwitzerland
- Department of Aging MedicineUniversity Hospital ZurichZurichSwitzerland
- University Clinic for Aging Medicine, City Hospital Zurich – WaidZurichSwitzerland
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19
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Mahmoodi M, Hejazi N, Bagheri Z, Nasimi N, Clark CCT, Moosavi M, Dabbaghmanesh MH, Mazloom Z. Validation of the Persian version of the sarcopenia-specific quality of life questionnaire (SarQoL ®-IR). Aging Clin Exp Res 2023; 35:137-145. [PMID: 36289155 DOI: 10.1007/s40520-022-02255-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/11/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND The sarcopenia quality of life (SarQoL)® questionnaire is a specific tool to measure QoL in sarcopenia. The aim of this study was to validate the SarQoL® questionnaire for evaluation of sarcopenia-related quality of life in Iranian community-dwelling older adults. METHODS Validity (discriminative power, construct validity), reliability (internal consistency, test-retest reliability), and floor/ceiling effects of SarQoL® questionnaire were evaluated in the current study. Moreover, the SarQoL® questionnaire was compared with the Short-Form 36-item (SF-36) and the EuroQoL 5-Dimensions (EQ-5D) questionnaires. RESULTS Among 501 community-dwelling older adults, 128 elderly participants (including 88 sarcopenic individuals) were recruited for validation. Participants with sarcopenia had lower quality of life than non-sarcopenic individuals (Total Score: 39.37 ± 7.45 vs. 65.09 ± 7.85, p < 0.001). Also, the findings demonstrated a high internal consistency (Cronbach's alpha of 0.881), excellent test-retest reliability (ICC = 0.995, 95% CI 0.990-0.998), and no floor/ceiling effect of SarQoL® questionnaire. CONCLUSION This is the first study to confirm the reliability and validity of the Persian version of the SarQoL® for the measurement of quality of life among Iranian sarcopenic older adults.
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Affiliation(s)
- Marzieh Mahmoodi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Science, Shiraz, Iran
| | - Najmeh Hejazi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Science, Shiraz, Iran.
| | - Zahra Bagheri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Nasimi
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Science, Shiraz, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Mahsa Moosavi
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Shiraz Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zohreh Mazloom
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Science, Shiraz, Iran.
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20
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and sarcopenia]. NUTR HOSP 2022; 39:15-22. [PMID: 36546336 DOI: 10.20960/nh.04507] [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: 12/24/2022] Open
Abstract
Introduction Sarcopenia is a multidimensional condition that negatively affects muscle mass, muscle strength, and physical performance. The prevalence of sarcopenia in people with diabetes is much higher than that of the general population, especially in individuals with poor nutritional status. Both sarcopenia and malnutrition are conditions amenable to intervention to improve clinical prognosis. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with sarcopenia.
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21
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Verstraeten LMG, de Haan NJ, Verbeet E, van Wijngaarden JP, Meskers CGM, Maier AB. Handgrip strength rather than chair stand test should be used to diagnose sarcopenia in geriatric rehabilitation inpatients: REStORing health of acutely unwell adulTs (RESORT). Age Ageing 2022; 51:6834150. [PMID: 36413590 PMCID: PMC9681126 DOI: 10.1093/ageing/afac242] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND according to the revised sarcopenia definition proposed by the European Working Group on Sarcopenia in Older People (EWGSOP2) and revised definition of the Asian Working Group for Sarcopenia (AWGS2019), handgrip strength (HGS) and chair stand test (CST) can be used interchangeably as initial diagnostic measures. OBJECTIVE to assess the agreement between sarcopenia prevalence, using either HGS or CST, and their association with adverse outcomes in geriatric rehabilitation inpatients. METHODS REStORing health of acutely unwell adulTs is an observational, longitudinal cohort of geriatric rehabilitation inpatients. Cohen's kappa (κ) was used to assess the agreement between sarcopenia prevalence (no, probable and confirmed and severe sarcopenia) according to EWGSOP2 and AWGS2019 using either HGS or CST. Associations between HGS and CST and readmission, institutionalisation and mortality were assessed by binomial regression. RESULTS patients (n = 1,250, 57% females) had a median age of 83.1 years (interquartile range: [77.5-88.3]). There was no agreement between probable sarcopenia prevalence using HGS or CST for EWGSOP2 and AWGS2019, respectively (HGS: 70.9% and 76.2%; CST: 95.5% and 98.4%; κ = 0.08 and 0.02). Agreement between confirmed and severe sarcopenia prevalence using either HGS or CST was strong to almost perfect. HGS was associated with 3-month institutionalisation and 3-month and 1-year mortality, whereas CST was not associated. CONCLUSIONS HGS and CST cannot be used interchangeably as diagnostic measures for probable sarcopenia in geriatric rehabilitation inpatients. CST is not useful to predict adverse outcomes 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 Sciences, Amsterdam 1081BT, The Netherlands
| | - Nina J de Haan
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081BT, The Netherlands
| | - Eline Verbeet
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081BT, The Netherlands
| | | | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam 1081HZ, The Netherlands
| | - Andrea B Maier
- Address correspondence to: Andrea B. Maier, Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands. Tel: +31629444246.
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22
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Casey P, Alasmar M, McLaughlin J, Ang Y, McPhee J, Heire P, Sultan J. The current use of ultrasound to measure skeletal muscle and its ability to predict clinical outcomes: a systematic review. J Cachexia Sarcopenia Muscle 2022; 13:2298-2309. [PMID: 35851996 PMCID: PMC9530572 DOI: 10.1002/jcsm.13041] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/21/2022] [Accepted: 06/25/2022] [Indexed: 11/06/2022] Open
Abstract
Quantification and monitoring of lean body mass is an important component of nutrition assessment to determine nutrition status and muscle loss. The negative impact of reduced muscle mass and muscle function is increasingly evident across acute and chronic disease states but is particularly pronounced in patients with cancer. Ultrasound is emerging as a promising tool to directly measure skeletal muscle mass and quality. Unlike other ionizing imaging techniques, ultrasound can be used repeatedly at the bedside and may compliment nutritional risk assessment. This review aims to describe the current use of skeletal muscle ultrasound (SMUS) to measure muscle mass and quality in patients with acute and chronic clinical conditions and its ability to predict functional capacity, severity of malnutrition, hospital admission, and survival. Databases were searched from their inception to August 2021 for full-text articles in English. Relevant articles were included if SMUS was investigated in acute or chronic clinical contexts and correlated with a defined clinical outcome measure. Data were synthesized for narrative review due to heterogeneity between studies. This review analysed 37 studies (3100 patients), which met the inclusion criteria. Most studies (n = 22) were conducted in critical care. The clinical outcomes investigated included functional status at discharge (intensive care unit-acquired weakness), nutritional status, and length of stay. SMUS was also utilized in chronic conditions such as chronic obstructive pulmonary disease, chronic heart failure, and chronic renal failure to predict hospital readmission and disease severity. Only two studies investigated the use of SMUS in patients with cancer. Of the 37 studies, 28 (76%) found that SMUS (cross-sectional area, muscle thickness, and echointensity) showed significant associations with functional capacity, length of stay, readmission, and survival. There was significant heterogeneity in terms of ultrasound technique and outcome measurement across the included studies. This review highlights that SMUS continues to gain momentum as a potential tool for skeletal muscle assessment and predicting clinically important outcomes. Further work is required to standardize the technique in nutritionally vulnerable patients, such as those with cancer, before SMUS can be widely adopted as a bedside prognostic tool.
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Affiliation(s)
- Patrick Casey
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Mohamed Alasmar
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - John McLaughlin
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Department of GastroenterologySalford Royal NHS Foundation TrustSalfordUK
| | - Yeng Ang
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Department of GastroenterologySalford Royal NHS Foundation TrustSalfordUK
| | - Jamie McPhee
- Manchester Metropolitan University Institute of SportManchesterUK
- Department of Musculoskeletal RadiologySalford Royal NHS Foundation TrustSalfordUK
| | - Priam Heire
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - Javed Sultan
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
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23
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Darroch P, O’Brien WJ, Mazahery H, Wham C. Sarcopenia Prevalence and Risk Factors among Residents in Aged Care. Nutrients 2022; 14:nu14091837. [PMID: 35565805 PMCID: PMC9105949 DOI: 10.3390/nu14091837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate the prevalence of sarcopenia and associated risk factors among older adults living in three residential aged care (RAC) facilities within Auckland, New Zealand. A total of 91 older adults (63% women, mean age ± SD; 86.0 ± 8.3 years) were recruited. Using the European Working Group on Sarcopenia in Older People criteria, sarcopenia was diagnosed from the assessment of: appendicular skeletal muscle mass/height2, using an InBody S10 body composition analyser and a SECA portable stadiometer or ulna length to estimate standing height; grip strength using a JAMAR handheld dynamometer; and physical performance with a 2.4-m gait speed test. Malnutrition risk was assessed using the Mini Nutrition Assessment–Short Form (MNA-SF). Most (83%) of residents were malnourished or at risk of malnutrition, and 41% were sarcopenic. Multivariate regression analysis showed lower body mass index (Odds Ratio (OR) = 1.4, 95% CI: 1.1, 1.7, p = 0.003) and lower MNA-SF score (OR = 1.6, 95% CI: 1.0, 2.4, p = 0.047) were predictive of sarcopenia after controlling for age, level of care, depression, and number of medications. Findings highlight the need for regular malnutrition screening in RAC to prevent the development of sarcopenia, where low weight or unintentional weight loss should prompt sarcopenia screening and assessment.
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Association of Frailty with Perioperative Outcomes Following Hepatic Resection: A National Study. J Am Med Dir Assoc 2022; 23:684-689.e1. [PMID: 35304129 DOI: 10.1016/j.jamda.2022.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Risk of mortality and major comorbidity remains high following hepatic resection. Given recent advancements in nonsurgical techniques to control hepatic malignancy, accurate assessment of surgical candidates, especially those considered frail, has become imperative. The present study aimed to characterize the impact of frailty on clinical and financial outcomes following hepatic resection in older individuals. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS All older adults (≥65 years) undergoing elective hepatic resection were identified from the 2012 to 2019 National Inpatient Sample. METHODS Frailty was defined by using the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnosis indicator. Multivariable regression models were developed to assess the independent association of frailty with mortality, perioperative complications, and resource utilization. Marginal effects were tabulated to assess the impact of hospital volume on frailty-associated mortality. RESULTS Of an estimated 40,735 patients undergoing major hepatic resection, 9.0% were considered frail. After multivariable adjustment, frailty was associated with increased odds of mortality (adjusted odds ratio [AOR] 2.9; 95% confidence interval [CI] 2.0-4.3; P < .001) and perioperative complication (AOR 2.9; 95% CI 2.4-3.4; P < .001). Furthermore, frail patients incurred longer risk-adjusted length of stay (14.2 vs 6.7 days, P < .001) and greater hospitalization costs ($55,100 vs $29,300, P < .001). In assessing the impact of institutional expertise on perioperative outcomes, the marginal effect of frailty on mortality became less pronounced with increasing operative volume. CONCLUSIONS AND IMPLICATIONS As the population of the United States continues to age, surgeons are increasingly likely to encounter candidates for major hepatic resection who are frail. The present study associated frailty with inferior clinical and financial outcomes; however, frailty-associated mortality became less pronounced at centers with high hepatic resection operative volume. Coding-based instruments, such as the Johns Hopkins Adjusted Clinical Groups, may identify patients from electronic medical records who may benefit from further geriatric assessment and targeted treatments.
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Hullick C, Conway J, Hall A, Murdoch W, Cole J, Hewitt J, Oldmeadow C, Attia J. Video-telehealth to support clinical assessment and management of acutely unwell older people in Residential Aged Care: a pre-post intervention study. BMC Geriatr 2022; 22:40. [PMID: 35012480 PMCID: PMC8744579 DOI: 10.1186/s12877-021-02703-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older people living in Residential Aged Care (RAC) are at high risk of clinical deterioration. Telehealth has the potential to provide timely, patient-centred care where transfer to hospital can be a burden and avoided. The extent to which video telehealth is superior to other forms of telecommunication and its impact on management of acutely unwell residents in aged care facilities has not been explored previously. METHODS In this study, video-telehealth consultation was added to an existing program, the Aged Care Emergency (ACE) program, aiming at further reducing Emergency Department (ED) visits and hospital admissions. This controlled pre-post study introduced video-telehealth consultation as an additional component to the ACE program for acutely unwell residents in RACs. Usual practice is for RACs and ACE to liaise via telephone. During the study, when the intervention RACs called the ED advanced practice nurse, video-telehealth supported clinical assessment and management. Five intervention RACs were compared with eight control RACs, all of whom refer to one community hospital in regional New South Wales, Australia. Fourteen months pre-video-telehealth was compared with 14 months post-video-telehealth using generalized linear mixed models for hospital admissions after an ED visit and ED visits. One thousand two hundred seventy-one ED visits occurred over the 28-month study period with 739 subsequent hospital admissions. RESULTS There were no significant differences in hospital admission or ED visits after the introduction of video-telehealth; adjusted incident rate ratios (IRR) were 0.98 (confidence interval (CI) 0.55 to 1.77) and 0.89 (95% CI 0.53 to 1.47) respectively. CONCLUSIONS Video-telehealth did not show any incremental benefit when added to a structured hospital avoidance program with nursing telephone support. TRIAL REGISTRATION The larger Aged Care Emergency evaluation is registered with ANZ Clinical Trials Registry, ACTRN12616000588493.
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Affiliation(s)
- Carolyn Hullick
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia. .,Belmont Hospital, Hunter New England Local Health District, Belmont, Australia. .,Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Jane Conway
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Alix Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Wendy Murdoch
- Belmont Hospital, Hunter New England Local Health District, Belmont, Australia
| | | | - Jacqueline Hewitt
- Hunter New England Central Coast Primary Health Network, Newcastle West, Australia
| | | | - John Attia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,John Hunter Hospital, Hunter New England Health, Locked Bag 1, HRMC, New Lambton Heights, NSW, 2310, Australia
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Chatzipetrou V, Bégin MJ, Hars M, Trombetti A. Sarcopenia in Chronic Kidney Disease: A Scoping Review of Prevalence, Risk Factors, Association with Outcomes, and Treatment. Calcif Tissue Int 2022; 110:1-31. [PMID: 34383112 PMCID: PMC8732833 DOI: 10.1007/s00223-021-00898-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022]
Abstract
Sarcopenia, a condition characterized by loss of skeletal muscle mass and function, has important clinical ramifications. We aimed to map the existing literature about prevalence, risk factors, associated adverse outcomes, and treatment of sarcopenia in individuals with chronic kidney disease (CKD). A scoping review of the literature was conducted to identify relevant articles published from databases' inception to September 2019. Individuals with CKD, regardless of their disease stage and their comorbidities, were included. Only studies with sarcopenia diagnosed using both muscle mass and function, based on published consensus definitions, were included. For studies on treatment, only randomized controlled trials with at least one sarcopenia parameter as an outcome were included. Our search yielded 1318 articles, of which 60 from were eligible for this review. The prevalence of sarcopenia ranged from 4 to 42% according to the definition used, population studied, and the disease stage. Several risk factors for sarcopenia were identified including age, male gender, low BMI, malnutrition, and high inflammatory status. Sarcopenia was found to be associated with several adverse outcomes, including disabilities, hospitalizations, and mortality. In CKD subjects, several therapeutic interventions have been assessed in randomized controlled trial with a muscle mass, strength, or function endpoint, however, studies focusing on sarcopenic CKD individuals are lacking. The key interventions in the prevention and treatment of sarcopenia in CKD seem to be aerobic and resistance exercises along with nutritional interventions. Whether these interventions are effective to treat sarcopenia and prevent clinical consequences in this population remains to be fully determined.
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Affiliation(s)
- Varvara Chatzipetrou
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Marie-Josée Bégin
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Mélany Hars
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
- Division of Geriatrics, Department of Readaptation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
- Division of Geriatrics, Department of Readaptation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
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Sundar VV, Ong SH, Easaw MEPM, Chee WSS. Sarcopenia with co-existent type 2 diabetes mellitus is associated with worse clinical outcomes among hospitalised cardiac patients. Clin Nutr ESPEN 2021; 46:380-385. [PMID: 34857224 DOI: 10.1016/j.clnesp.2021.08.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS Sarcopenia has been shown associated with functional decline, disability, poorer quality of life and mortality. However, there are limited studies among hospitalised cardiac patients in Malaysia. This study aimed to identify the association of sarcopenia and type 2 diabetes mellitus (T2DM) with clinical outcomes among hospitalised cardiac patients. METHODS This prospective observational study assessed 100 patients who were admitted to the general wards at the National Heart Institute. We measured handgrip strength, body composition using bioelectrical impedance analysis (BIA) and recorded the length of stay (LOS), unplanned readmission and incidence of infection within 90 days after discharge. Logistic regression analysis at a significant level p < 0.05 was used to identify the association between sarcopenia and clinical outcomes. RESULTS The prevalence of sarcopenia was 63%, and this was similar in patients with or without T2DM. After adjustment, sarcopenia was significantly associated with 90-day unplanned readmission (adjusted OR 3.5; 95%CI 1.40-8.77; p = 0.007) and LOS (AOR 0.4; 95%CI 0.16-0.88; p = 0.026). After adjustment, the co-existent of T2DM and sarcopenia was significantly associated with 90-day unplanned readmission (AOR 7.3; 95%CI 1.82-29.66; p = 0.005) and 90-day incidence of infection (AOR 4.4; 95%CI 1.12-17.52; p = 0.033). CONCLUSION Sarcopenia with co-existent T2DM was associated with increased risk for readmission and infection among hospitalised cardiac patients. Early identification of sarcopenia is important for timely intervention to improve prognosis in hospitalised cardiac patients with T2DM.
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Affiliation(s)
- Vatana V Sundar
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia; Dietetics and Food Services, National Heart Institute, 145, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia.
| | - Shu Hwa Ong
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Mary Easaw P M Easaw
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Winnie Siew Swee Chee
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Ai Y, Xu R, Liu L. The prevalence and risk factors of sarcopenia in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr 2021; 13:93. [PMID: 34479652 PMCID: PMC8414692 DOI: 10.1186/s13098-021-00707-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/10/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sarcopenia was a frequent chronic complication in patients with type 2 diabetes mellitus (T2DM), and previous evidence showed conflicting results regarding the prevalence and risk factors of sarcopenia in T2DM. In the current study, we aimed at systematically exploring the prevalence and risk factors of sarcopenia in patients with T2DM. METHODS PubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched to identify observational studies which investigated the prevalence and risk factors of sarcopenia in patients with T2DM. The quality of individual included studies was evaluated using The Newcastle-Ottawa scale. Pooled effects regarding prevalence and associated factors were calculated using random-effects models. The potential publication bias was assessed via funnel plot and Egger test. RESULTS Twenty-eight studies involving 16,800 patients were included in our meta-analysis. The pooled prevalence of sarcopenia in patients with T2DM was 18% (95% CI 0.15-0.22; I2 = 97.4%). The pooled results showed that elder age (OR 4.73; 95% CI 4.30-5.19; I2 = 85.6%), male gender, chronic hyperglycemia (higher HbA1c) (OR 1.16; 95% CI 1.05-2.47; I2 = 99.2%) and osteoporosis (OR 1.16; 95% CI 1.05-2.47; I2 = 99.2%) was predictors for sarcopenia, whereas patients with lower BMI (OR 1.16; 95% CI 1.05-2.47; I2 = 99.2%) and metformin administrations (OR 1.16; 95% CI 1.05-2.47; I2 = 99.2%) were not prone to get sarcopenia. The funnel plot and statistical tests showed no obvious publication bias. CONCLUSIONS Sarcopenia was frequent in T2DM patients. Elder age, male gender and chronic hyperglycemia, Osteoporosis were significant risk factors for Sarcopenia. Lower BMI and metformin administrations were associated with lower risk of sarcopenia.
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Affiliation(s)
- Yaqin Ai
- Medical Department, The Fourth Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi, China
| | - Ruoxin Xu
- Jiangxi Medical College, Nanchang University, No. 461 Bayi Road, Donghu District, Nanchang, 330006, Jiangxi, China
| | - Lingping Liu
- Department of Endocrinology, Zhuhai people's hospital (Zhuhai hospital affiliated of Jinan University), Zhuhai, 519000, Guangdong, China.
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Rossi AP, Urbani S, Gattazzo S, Nori N, Fantin F, Zoico E, Mazzali G, Muollo V, Ghoch ME, Zamboni M. The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire score as a predictor of skeletal muscle mass loss. Aging Clin Exp Res 2021; 33:2593-2597. [PMID: 33389711 DOI: 10.1007/s40520-020-01763-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/24/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous studies showed a strong relationship between reduction of appendicular muscle mass and worsening disability; hence, accuracy in assessing muscle mass is considered a key feature for a sarcopenia screening tool. AIM The aim of the study was to evaluate if the 7 items of Mini Sarcopenia Risk Assessment (MSRA) questionnaire predict muscle mass loss in a population of community-dwelling elderly subjects over a 5.5-y follow-up. METHODS The study included 159 subjects, 92 women and 67 men aged 71.5 ± 2.2 years and with mean body mass index of 26.7 ± 4.0 kg/m2. Appendicular skeletal muscle mass (ASMM) as measured with Dual-Energy X-ray absorptiometry (DXA), was obtained at baseline and after 2 and 5.5 years of follow-up where the skeletal muscle index (SMI) was calculated. RESULTS A significant reduction of ASMM and SMI was observed at two and 5.5 years of follow-up, in both, men and women. Repeated-measures analysis of variance (ANOVA) found a significant time effect on ASMM for both subjects with MSRA > 30 and ≤ 30 (P < 0.01 and P < 0.001). The group × time interaction was significant (P < 0.001), after even considering separately subjects with normal muscle mass and low muscle mass at baseline (P < 0.05 and P = 0.005). Similar results were obtained for SMI. Considering only the subjects with normal SMI at baseline, subjects with MSRA questionnaire ≤ 30 showed 5.7 (95% CI 1.73-19.03) higher risk of exceeding the low muscle mass threshold. CONCLUSION In a population of community-dwelling elderly men and women, MSRA score of 30 is predictive of a steeper decline in ASMM and SMI and of a higher risk of exceeding the low muscle mass EWGSOP threshold.
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Affiliation(s)
- Andrea P Rossi
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy.
| | - Silvia Urbani
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | - Stefano Gattazzo
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | - Nicole Nori
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | - Francesco Fantin
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | - Elena Zoico
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | - Gloria Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
| | | | - Marwan El Ghoch
- Department Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Mauro Zamboni
- Department of Medicine, Geriatrics Division, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126, Verona, Italy
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Geerinck A, Beaudart C, Reginster JY, Locquet M, Monseur C, Gillain S, Bruyère O. Development and validation of a short version of the Sarcopenia Quality of Life questionnaire: the SF-SarQoL. Qual Life Res 2021; 30:2349-2362. [PMID: 33782793 PMCID: PMC8298237 DOI: 10.1007/s11136-021-02823-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form. METHODS The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test-retest reliability, structural validity and examined item parameters with a graded response model (IRT). RESULTS The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59-43.45) vs. 42.86 (26.56-63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847-0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094-0.123; SRMR = 0.055) with no misfitting items and good response category separation. CONCLUSIONS A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.
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Affiliation(s)
- A Geerinck
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - C Beaudart
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - J-Y Reginster
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Locquet
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - C Monseur
- Department of Education Sciences, University of Liège, Liège, Belgium
| | - S Gillain
- Geriatrics Department, University Hospital of Liège, Liège, Belgium
| | - O Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
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Cordwell A, McClure R, Villani A. Adherence to a Mediterranean diet and health-related quality of life: a cross-sectional analysis of overweight and obese middle-aged and older adults with and without type 2 diabetes mellitus. Br J Nutr 2021; 128:1-7. [PMID: 34167600 DOI: 10.1017/s0007114521002324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The relationship between adherence to a Mediterranean diet (MedDiet) and health-related quality of life (HRQoL) is unclear, particularly in vulnerable older adults. This cross-sectional analysis explored the association between adherence to a MedDiet and subscales of HRQoL in two independent cohorts of overweight and obese middle-aged to older adults with and without type 2 diabetes mellitus (T2DM). Both cohorts were community-dwelling (T2DM aged ≥ 50 years; non-T2DM aged ≥ 60 years) with a BMI ≥ 25 kg/m2. Adherence to a MedDiet was assessed using the Mediterranean Diet Adherence Screener, and HRQoL was determined using the 36-item short-form health survey. Multiple regression analysis was used to examine the association between adherence to a MedDiet and HRQoL subscales. A total of 152 middle-aged to older adults were included (T2DM: n 87, 71·2 (sd 8·2) years, BMI: 29·5 (sd 5·9) kg/m2; non-T2DM: n 65, 68·7 (sd 5·6) years, BMI: 33·7 (sd 4·9) kg/m2). Mean adherence scores for the entire cohort were 5·3 (sd 2·2) (T2DM cohort: 5·6(sd 2·3); non-T2DM cohort: 4·9 (sd 2·0)). In the adjusted model, using pooled data from both study cohorts, adherence to a MedDiet was significantly associated with the general health subscale of HRQoL (β = 0·223; 95 % CI 0·006, 0·044; P = 0·001). Similar findings were also observed in the T2DM cohort (β = 0·280; 95 % CI 0·007, 0·054; P = 0·001). However, no additional significant associations between adherence to a MedDiet and HRQoL subscales were observed. We showed that adherence to a MedDiet was positively associated with the general health subscale of HRQoL in middle-aged to older adults with T2DM. However, larger longitudinal data in older adults with a wider range of adherence scores, particularly higher adherence, are required to better understand the direction of this relationship.
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Affiliation(s)
- Amy Cordwell
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Rebecca McClure
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Anthony Villani
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
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Ross E, Wright H, Villani A. Lower body extremity function is associated with health-related quality of life: a cross-sectional analysis of overweight and obese older adults with and without type 2 diabetes mellitus. Qual Life Res 2021; 30:2265-2273. [PMID: 33745064 DOI: 10.1007/s11136-021-02821-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE We aimed to explore the relationship between characteristics of the sarcopenic phenotype and health-related quality of life (HRQoL) in community-dwelling overweight and obese older adults with and without type 2 diabetes mellitus (T2DM). METHODS Appendicular lean mass (ALM), corrected for height (ALM/m2) was assessed by dual-energy X-ray absorptiometry. Muscle strength was assessed using handgrip strength (HGS), and lower extremity physical function was assessed using the Short Performance Physical Battery (SPPB) and gait speed. HRQoL was determined using the short-form 36 (SF-36) survey. Multiple regression analysis was used to examine the association between characteristics of the sarcopenic phenotype and domains of HRQoL. RESULTS A total of n = 152 community-dwelling older adults were included (T2DM cohort: n = 87, 71.2 ± 8.2 years, BMI: 29.5 ± 5.9 kg/m2; Obese cohort: n = 65, 68.7 ± 5.6 years, BMI: 33.7 ± 4.9 kg/m2). After adjusting for potential confounders, gait speed and SPPB were positively associated with the physical function subscale of HRQoL (Gait speed: ß = 0.658; P < 0.001; SPPB: ß = 0.478; P < 0.001). This relationship was also maintained for gait speed when assessed independently by cohort (T2DM cohort: ß = 0.637; P < 0.001; Obese cohort: ß = 0.507; P = 0.003). CONCLUSIONS Our results further contribute to the literature suggesting that lower body extremity function is associated with the physical function subscale of HRQoL. However, larger longitudinal data are required to assess whether lower body extremity function is independently associated with HRQoL, which includes the potential impact of nutrition and physical activity status.
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Affiliation(s)
- Emily Ross
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia
| | - Hattie Wright
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia
| | - Anthony Villani
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4558, Australia.
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Prevalence, associated factors, and prognostic value of sarcopenia in patients with acute exacerbated chronic obstructive pulmonary disease: A cohort study. Clin Nutr ESPEN 2021; 42:188-194. [PMID: 33745576 DOI: 10.1016/j.clnesp.2021.01.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Besides pulmonary dysfunctions, patients with chronic obstructive pulmonary disease (COPD) also frequently have systemic comorbidities. Among these, sarcopenia is associated with worse pulmonary function and clinical outcomes. Patients with acute exacerbated COPD (AECOPD) have increased systemic inflammation, which can intensify muscle dysfunction. Therefore, the present study aimed to evaluate the prevalence of sarcopenia in AECOPD patients and assess the associated factors and their prognostic value. As a secondary aim, we also assessed the performance of calf circumference (CC) to diagnose this condition. METHODS Prospective cohort study in a Brazilian public hospital with AECOPD patients. Sarcopenia was assessed according to the recommendations from the European Working Group of Sarcopenia in Older People Consensus 2 (EWGSOP2); namely, reduced handgrip strength (HGS) combined with low fat-free mass index (FFMI) or CC. Data on clinical, nutritional, and sociodemographic features were collected. The evaluated clinical outcomes were the length of hospital stay (LOS), admission in intensive care units (ICUs), and in-hospital death. RESULTS Among 208 patients (54.8% females, 67.6 ± 10.1 years) evaluated, 16.3% presented sarcopenia. Malnutrition (odds ratio [OR] = 16.50, 95% confidence interval [CI] 3.58-76.08), and disease stages III-IV (OR = 4.05 95%CI 1.20-13.76) were associated with the presence of sarcopenia. The CC showed satisfactory performance in diagnosing sarcopenia as compared to FFMI as a marker of reduced muscle mass (kappa = 0.703; area under the receiver operating characteristic [AUC ROC] curve = 0.886; 95%CI 0.811-0.961). Sarcopenia was not associated with clinical outcomes. CONCLUSION Almost 20% of patients in this study presented sarcopenia. Malnutrition and advanced Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage were associated with increased chances of this condition in AECOPD patients. Reduced HSG combined with low CC may be an alternative when FFMI not be obtained for sarcopenia diagnosis.
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Scheerman K, Meskers CGM, Verlaan S, Maier AB. Sarcopenia, Low Handgrip Strength, and Low Absolute Muscle Mass Predict Long-Term Mortality in Older Hospitalized Patients: An Observational Inception Cohort Study. J Am Med Dir Assoc 2021; 22:816-820.e2. [PMID: 33453174 DOI: 10.1016/j.jamda.2020.12.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Sarcopenia is highly prevalent in hospitalized older patients and associated with short-term mortality. This study aimed to investigate whether sarcopenia and its measures handgrip strength (HGS) and muscle mass at hospital admission were associated with long-term mortality in a cohort of hospitalized older patients. DESIGN Observational, prospective, longitudinal inception cohort study. SETTING AND PARTICIPANTS Academic teaching hospital; patients age ≥70 years admitted to the internal medicine, acute admission, trauma, or orthopedic wards. METHODS HGS and muscle mass were measured at admission using a hand dynamometer and bioelectrical impedance analysis. Sarcopenia was determined based on the European Working Group on Sarcopenia in Older People definition. HGS and muscle mass (skeletal muscle mass index, appendicular lean mass, relative skeletal muscle mass) were expressed as sex-specific tertiles. The associations of sarcopenia, HGS, and muscle mass with mortality (during a follow-up of 3.4-4.1 years) were analyzed using Cox regression, adjusted for age, sex, comorbidity, and weight or height. Associations of HGS and muscle mass were stratified by sex. RESULTS Out of 363 patients [mean age: 79.6 years (standard deviation: 6.4), 49.9% female] 49% died. Probable sarcopenia (prevalence of 53.7%) and sarcopenia (prevalence of 20.8%) were significantly associated with long-term mortality [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.08‒2.17 and 1.71 95% CI 1.12‒2.61, respectively]. Low HGS, skeletal muscle mass index, and appendicular lean mass were associated with a higher mortality risk (lowest tertile vs highest tertile: HR 2.660, 95% CI 1.40‒5.05; HR 1.95, 95% CI 1.06‒3.58 and HR 1.99 (95% CI 1.12‒3.53) in male patients. No statistically significant associations of relative muscle mass with mortality were found. CONCLUSIONS AND IMPLICATIONS Sarcopenia and its measures (low HGS and low absolute muscle mass at admission) predict long-term mortality in older hospitalized patients.
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Affiliation(s)
- Kira Scheerman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Section of Gerontology and Geriatrics, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Carel G M Meskers
- Amsterdam Movement Sciences, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, the Netherlands
| | - Sjors Verlaan
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Victoria, Melbourne, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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Lu JL, Ding LY, Xu Q, Zhu SQ, Xu XY, Hua HX, Chen L, Xu H. Screening Accuracy of SARC-F for Sarcopenia in the Elderly: A Diagnostic Meta-Analysis. J Nutr Health Aging 2021; 25:172-182. [PMID: 33491031 DOI: 10.1007/s12603-020-1471-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sarcopenia is an age-related disease, which is characterized by a decline in muscle mass and function. It is one of the most important health issues in the elderly and often leads to a high rate and variety of adverse outcomes. OBJECTIVES To evaluate the screening accuracy of SARC-F for sarcopenia in the elderly. DESIGN We conducted a meta-analysis using articles available in 6 databases including PubMed (Medline), Web of Science, Embase, Cochrane Controlled Register of Trials (CENTRAL), China Knowledge Resource Integrated Database (CNKI), and Wanfang databases from inception to May 2020. PARTICIPANTS Adults aged 60 years and older. MEASUREMENTS Sarcopenia was defined by EWGSOP2, EWGSOP, AWGS, FNIH and IWGS. Two authors independently extracted data based on predefined criteria. Where data were available we calculated pooled summary estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence interval (CI) based on different criteria using the hierarchical logistic regression modeling including bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) modeling. RESULTS We included 20 studies, with the prevalence of sarcopenia ranging from 6.42% to 21.56%. The number of the literatures using EWGSOP, EWGSOP2, AWGS, IWGS and FNIH as diagnostic criteria was 13, 4, 13, 8, 7, respectively. Bivariate analysis yielded a pooled sensitivity of 32% (95%CI:19%-47%), 77% (95%CI: 49%-92%), 27% (95%CI: 16%-42%), 39% (95%CI: 27%-52%), 35% (95%CI: 23%-49%) and a pooled specificity of 86% (95%CI:77%-92%), 63% (95%CI: 43%-79%), 91% (95%CI: 85%-95%), 86% (95%CI: 76%-92%), 89% (95%CI: 81%-93%), respectively. The area under the HSROC curve were 0.68 (95%CI: 0.64-0.72), 0.75 (95%CI: 0.71-0.78), 0.73 (95%CI: 0.69-0.77), 0.67 (95%CI: 0.62-0.71), 0.70 (95%CI: 0.65-0.73), respectively. CONCLUSIONS The screening accuracy of SARC-F was various based on different diagnostic criteria. There were some limitations for SARC-F, however, considering the higher practicability and specificity for screening sarcopenia in practice, SARC-F was still an effective screening tool for sarcopenia in the elderly. And the screening accuracy of SARC-F needs further exploration when EWGSOP2 is applied as diagnostic criteria and geriatric inpatients are the target participants.
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Affiliation(s)
- J-L Lu
- Qin Xu, Professor of Nursing, School of Nursing, Nanjing Medical University, 140 Hanzhong Road, Gulou District, Nanjing, China (211166), E-mail:
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Veronese N, Barbagallo M. Consequences of Sarcopenia in Older People: The Epidemiological Evidence. PRACTICAL ISSUES IN GERIATRICS 2021:27-31. [DOI: 10.1007/978-3-030-80038-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Xia L, Zhao R, Wan Q, Wu Y, Zhou Y, Wang Y, Cui Y, Shen X, Wu X. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies. Cancer Med 2020; 9:7964-7978. [PMID: 32924316 PMCID: PMC7643685 DOI: 10.1002/cam4.3428] [Citation(s) in RCA: 188] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/08/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health-related outcomes. DESIGN An umbrella review of meta-analyses of observational studies. SETTING AND PARTICIPANTS Patients with sarcopenia and controls without sarcopenia were included. MEASURES The PubMed, Web of Science and Embase were searched for relevant systematic review and meta-analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. RESULTS Totally 54 outcomes extracted from 30 meta-analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age-related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all-cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. CONCLUSIONS AND IMPLICATIONS Sarcopenia significantly affected a wide range of adverse health-related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as "low" and "very low," more prospective cohort studies are required in the future.
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Affiliation(s)
- Lin Xia
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Rui Zhao
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Qianyi Wan
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yutao Wu
- Department of Oral and Maxillofacial SurgeryWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Yong Zhou
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yong Wang
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yaping Cui
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Xiaoding Shen
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Xiaoting Wu
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
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Brennan-Olsen SL, Vogrin S, Balogun S, Wu F, Scott D, Jones G, Hayes A, Phu S, Duque G, Beauchamp A, Talevski J, Naureen G, Winzenberg TM. Education, occupation and operational measures of sarcopenia: Six years of Australian data. Australas J Ageing 2020; 39:e498-e505. [PMID: 32969133 DOI: 10.1111/ajag.12816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To examine associations of education and occupation with handgrip strength (HGS), lower limb strength (LLS) and appendicular lean mass (ALM). METHODS Measures of HGS, LLS and ALM (dual-energy X-ray absorptiometry) were ascertained at baseline in 1090 adults (50-80 years, 51% women), ~3 and 5 years. Education and occupation were self-reported, the latter categorised as high-skilled white collar (HSWC), low-skilled white collar (LSWC) or blue collar. Separate general estimating equations were performed. RESULTS The highest education group had greater HGS than the middle (0.33 psi) and lowest (0.48 psi) education groups, and 0.34 kg greater ALM than the lowest education group. HGS was 0.46 psi greater for HSWC than LSWC groups. Compared to LSWC groups, LLS was 5.38 and 7.08 kg greater in HSWC and blue-collar groups. Blue-collar and HSWC groups each had ~ 0.60-0.80kg greater ALM than LSWC. CONCLUSION Progressive muscle loss can be prevented by targeted intervention; thus, we suggest clinical attention be directed towards specific social groups.
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Affiliation(s)
- Sharon L Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Sara Vogrin
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia
| | - Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia
| | - David Scott
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas., Australia
| | - Alan Hayes
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia.,Institute of Health and Sport, Victoria University, Footscray, Vic., Australia
| | - Steven Phu
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia
| | - Alison Beauchamp
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia.,School of Rural Health, Monash University, Warragul, Vic., Australia
| | - Jason Talevski
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia
| | - Ghazala Naureen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Vic., Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Vic., Australia
| | - Tania M Winzenberg
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Vic., Australia
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Wu S, Ning HT, Xiao SM, Hu MY, Wu XY, Deng HW, Feng H. Effects of vibration therapy on muscle mass, muscle strength and physical function in older adults with sarcopenia: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2020; 17:14. [PMID: 32963629 PMCID: PMC7499918 DOI: 10.1186/s11556-020-00247-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background Sarcopenia, a progressive loss of muscle mass and function with advancing age, is a prevalent condition among older adults. As most older people are too frail to do intensive exercise and vibration therapy has low risk and ease of participation, it may be more readily accepted by elderly individuals. However, it remains unclear whether vibration therapy would be effective among older adults with sarcopenia. This systematic review and meta-analysis examined the effect of vibration therapy including local vibration therapy and whole-body vibration therapy, for enhancing muscle mass, muscle strength and physical function in older people with sarcopenia. Methods A systematic literature search was conducted in March 2019 in the following 5 electronic databases: PubMed, CINAHL, Embase, PEDro, and the Cochrane Central Register of Controlled Trials, with no restriction of language or the year of publication. Randomized controlled trials and quasi-experimental studies examining effects of vibration therapy on muscle mass, muscle strength or physical function in older adults with sarcopenia were included in this systematic review. Two reviewers independently assessed the methodological quality of the selected studies. Results Of the 1972 identified studies, seven publications from six studies involving 223 participants were included in this systematic review. Five of them conducted whole-body vibration therapy, while two conducted local vibration therapy. A meta-analysis of randomized controlled studies indicated that muscle strength significantly increased after whole-body vibration therapy (SMD 0.69, 95% CI 0.28 to 1.11, I2 = 0%, P = 0.001) and local vibration therapy (SMD 3.78, 95% CI 2.29 to 5.28, P < 0.001). Physical performance measured by the sit-to-stand test and the timed-up-and-go test were significantly improved after the intervention (SMD -0.79, 95% CI − 1.21 to − 0.37, I2 = 0%, P < 0.001) and SMD -0.83, 95% CI − 1.56 to − 0.11, I2 = 64%, P = 0.02, respectively). Conclusion Vibration therapy could be a prospective strategy for improving muscle strength and physical performance in older adults with sarcopenia. However, due to the limited number of the included studies, caution is needed when interpreting these results. More well-designed, large sample size studies should be conducted to further explore and validate the benefits of vibration therapy for this population.
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Affiliation(s)
- Shuang Wu
- Xiangya school of nursing, Central South University, Changsha, Hunan province China
| | - Hong-Ting Ning
- Xiangya school of nursing, Central South University, Changsha, Hunan province China
| | - Su-Mei Xiao
- Department of Public health, Sun Yat-Sen University, Guangzhou, Guangdong province China
| | - Ming-Yue Hu
- Xiangya school of nursing, Central South University, Changsha, Hunan province China
| | - Xin-Yin Wu
- Department of Epidemiology and Biostatistics, Xiangya school of Public health, Central South University, Changsha, Hunan province China
| | - Hong-Wen Deng
- School of basic medical science, Central South University, Changsha, Hunan province China
| | - Hui Feng
- Xiangya school of nursing, Central South University, Changsha, Hunan province China.,Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, China
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Villani A, McClure R, Barrett M, Scott D. Diagnostic differences and agreement between the original and revised European Working Group (EWGSOP) consensus definition for sarcopenia in community-dwelling older adults with type 2 diabetes mellitus. Arch Gerontol Geriatr 2020; 89:104081. [PMID: 32485520 DOI: 10.1016/j.archger.2020.104081] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
Abstract
AIM We aimed to compare diagnostic differences for identification of sarcopenia using the original operational definition developed by the European Working Group on Sarcopenia in Older People (EWGSOP1) and the most recently revised EWGSOP2 definition in community dwelling older adults with type 2 diabetes mellitus (T2DM). METHODS Appendicular Lean Mass (ALM) corrected for height (ALM/m2) was assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength (HGS) or chair stands, and the Short Physical Performance Battery (SPPB) and gait speed were used to evaluate lower extremity physical function. Cohen's kappa (κ) statistic was applied to determine the degree of agreement between the two definitions. Chi-square analysis with Bonferroni post hoc corrections were applied to determine differences in the prevalence of sarcopenic case-findings. RESULTS A total of n = 87 older adults (71.2 ± 8.2 years; 66.7% males; BMI: 29.5 ± 5.8 kg/m2) were included. Agreement between the two definitions was low and non-significant (κ value = 0.118; P = 0.144). Significantly more cases of sarcopenia were identified when applying the EWGSOP1 definition (EWGSOP1: n = 6 (7%); EWGSOP2: n = 2 (2%); P = 0.004). No sex specific differences were observed. Only 2 of the 6 (33.3%) cases of sarcopenia identified by EWGSOP1 were also identified as sarcopenic when applying the EWGSOP2 diagnostic criteria. CONCLUSIONS We showed significant discordance and limited overlap in the number of sarcopenic case-findings when applying both EWGSOP definitions. It is unknown as to whether the new diagnostic criteria are better at identifying adverse clinical outcomes in patients with T2DM. Future investigation is therefore warranted.
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Affiliation(s)
- Anthony Villani
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
| | - Rebecca McClure
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - Michelle Barrett
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, 3021, Australia
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Zhang Y, Chen X, Hou L, Lin X, Qin D, Wang H, Hai S, Cao L, Dong B. Prevalence and Risk Factors Governing the Loss of Muscle Function in Elderly Sarcopenia Patients: A longitudinal Study in China with 4 Years of Follow-Up. J Nutr Health Aging 2020; 24:518-524. [PMID: 32346691 DOI: 10.1007/s12603-020-1361-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Data regarding the occurrence of risk factors that promote the loss of muscle mass, strength and function in sarcopenia patients in elderly Chinese patients are sparse. Here, we investigated the alterations in muscle mass, function and strength in those with sarcopenia over a 4-year period. We further evaluated the risk factors leading to a loss of grip strength, gait speed and skeletal muscle mass index in sarcopenia patients. DESIGN A face-to-face cross-sectional survey. SETTING AND PARTICIPANTS The study population consisted of 560 Chinese aged over 59 years. MEASUREMENTS Study recordings took places over a four-year period from 2014. Muscle mass was assessed through bioelectrical impedance analysis (BIA) performed on an Inbody720, Biospace. Hand-grip strength and 6 m walking speed were used as measurements of muscle strength and function. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria (AWGS). RESULTS In total, 474 of the elderly residents completed the follow-up. The rates of decreased ASMI, grip strength, and gait speed in the sarcopenia patients increased over the 4-year period. Following multivariate analysis, age was identified as the main risk factor for all the observed decrease, gender was specifically related to the loss of ASMI, stroke was a risk factor for gait speed and sarcopenia. A high BMI was a risk factor for a low gait speed but was protective for a loss of skeletal muscle mass and sarcopenia. CONCLUSIONS Age leads to a decline in muscle strength and function. In elderly Chinese patients with sarcopenia, the rates of reduced grip strength, gait-speed and sarcopenia increased. A high BMI was protective against the decline in muscle mass and sarcopenia, but represented a risk factor for low gait speed. Stoke was identified to cause a loss of gait speed in sarcopenia patients.
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Affiliation(s)
- Y Zhang
- Professor Birong Dong, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang, Chengdu, Sichuan, China, 610041. E-mail address: , Fax: +86-028-85421550, Tel: +86-028-85421550
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Hershkovitz A, Yichayaou B, Ronen A, Maydan G, Kornyukov N, Burstin A, Brill S. The association between hand grip strength and rehabilitation outcome in post-acute hip fractured patients. Aging Clin Exp Res 2019; 31:1509-1516. [PMID: 30993662 DOI: 10.1007/s40520-019-01200-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/09/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE Various factors have been shown to affect the rehabilitation outcome of hip fractured patients. Considering the decrease in muscle mass with aging and its impact on mobility, we hypothesized that a relationship exists between hand grip strength and rehabilitation outcome. METHODS We retrospectively studied 373 post-hip fracture patients, admitted for rehabilitation. Muscle strength was measured by hand grip dynamometer. MAIN OUTCOME MEASURES functional independence measure motor functional independence measure, motor functional independence measure effectiveness and length of stay). A favorable functional gain was defined as a motor Functional Independence Measure effectiveness score > 0.5. The Spearman correlation assessed the associations between hand grip strength and outcome measures. A multiple linear regression model tested whether hand grip strength was an independent predictor of discharge motor Functional Independence Measure scores and length of stay RESULTS: Significant correlations were found between hand grip strength and functional outcomes. A significant independent association was found between hand grip strength and discharge motor Functional Independence Measure score after adjustment for confounding demographic and clinical variables. High hand grip strength on admission was significantly associated with a greater chance of achieving a favorable functional gain (OR 1.064, 95% CI, 1.01-1.13; p = 0.032). Hand grip strength was not found to be associated with length of stay. CONCLUSION Hand grip strength is independently associated with rehabilitation outcome in post-acute frail hip fractured patients. Initial screening for hand grip strength on admission may help identify patients who require an intensive resistance exercise program.
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Affiliation(s)
- Avital Hershkovitz
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel.
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Beloosesky Yichayaou
- Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ayelet Ronen
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel
| | - Gal Maydan
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel
| | - Natalia Kornyukov
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel
| | - Arie Burstin
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel
| | - Shai Brill
- Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, 49245, Petach Tikva, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Veronese N, Demurtas J, Soysal P, Smith L, Torbahn G, Schoene D, Schwingshackl L, Sieber C, Bauer J, Cesari M, Bruyere O, Reginster JY, Beaudart C, Cruz-Jentoft AJ, Cooper C, Petrovic M, Maggi S. Sarcopenia and health-related outcomes: an umbrella review of observational studies. Eur Geriatr Med 2019; 10:853-862. [DOI: 10.1007/s41999-019-00233-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/23/2019] [Indexed: 12/11/2022]
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Veronese N, Pizzol D, Demurtas J, Soysal P, Smith L, Sieber C, Strandberg T, Bourdel-Marchasson I, Sinclair A, Petrovic M, Maggi S. Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies. Eur Geriatr Med 2019; 10:685-696. [PMID: 34652699 DOI: 10.1007/s41999-019-00216-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/28/2019] [Indexed: 12/25/2022]
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Beaudart C, Locquet M, Touvier M, Reginster JY, Bruyère O. Association between dietary nutrient intake and sarcopenia in the SarcoPhAge study. Aging Clin Exp Res 2019; 31:815-824. [PMID: 30955158 DOI: 10.1007/s40520-019-01186-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/28/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND It has been suggested that a balanced nutritional intake may be useful in preventing or even reversing sarcopenia. AIM To describe cross-sectional associations between dietary nutrient intake and sarcopenia. METHODS Subjects recruited from the SarcoPhAge study population completed a food frequency questionnaire. The micronutrient and macronutrient intake was evaluated in both sarcopenic and non-sarcopenic participants. The Nutritional Belgian Recommendations of 2016 were used, i.e., adequate intake and estimated average requirement (EAR). For micronutrients, the prevalence of insufficient intake was estimated as the proportion of subjects whose intake was below the EAR. RESULTS A total of 331 subjects (mean age of 74.8 ± 5.9 years, 58.9% women) had complete data and were included in this study. Among them, 51 were diagnosed with sarcopenia (15.4%). In the fully adjusted model, analyses revealed that sarcopenic subjects consumed significantly lower amounts of two macronutrients (proteins, lipids) and five micronutrients (potassium, magnesium, phosphorus, iron, and vitamin K) than non-sarcopenic subjects (all p values < 0.005). A significantly increased prevalence of insufficiency was found for sarcopenic subjects compared to non-sarcopenic subjects for potassium, magnesium, iron, calcium and vitamins E and C (all p values < 0.005). The prevalence of sarcopenic subjects who were also below the Nutritional Belgian Recommendations for protein and lipids was significantly higher than that of non-sarcopenic subjects. DISCUSSION AND CONCLUSIONS Sarcopenic subjects seem to consume significantly reduced amounts of many micronutrients and macronutrients compared to non-sarcopenic subjects. These results suggest that a poorly balanced diet may be associated with sarcopenia and poor musculoskeletal health, although prospective studies are needed to confirm these findings.
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Affiliation(s)
- Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium.
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium.
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN, UMR U1153 Inserm/U1125 Inra/Cnam/Universités Paris 5, 7 et 13, Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité (CRESS), Paris, France
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
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Kim GR, Sun J, Han M, Nam CM, Park S. Evaluation of the directional relationship between handgrip strength and cognitive function: the Korean Longitudinal Study of Ageing. Age Ageing 2019; 48:426-432. [PMID: 30794286 DOI: 10.1093/ageing/afz013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/29/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND recent studies suggest that handgrip strength is linked with cognitive impairment at older ages. However, it remains unclear as to whether muscular strength influences subsequent cognitive performance, or whether lower levels of cognitive function increase the likelihood of muscle strength decline. OBJECTIVE to investigate the directional relationship between handgrip strength and cognitive impairment using longitudinal data among older adults. METHODS repeated measures of handgrip strength and cognitive function were collected in a sample of 5,995 participants of the Korean Longitudinal Study of Aging (KLoSA) over a period of 8 years. Time-lagged general estimating equations, while accounting for correlation among repeated measures, was used to assess the temporal effect of handgrip strength on cognitive impairment and vice versa with adjustment for other confounding factors. RESULTS after adjustment, greater handgrip strength was related to subsequent reduction in the risk of cognitive impairment, such that participants in the highest quartile presented approximately 50% decrease in their risk of cognitive impairment [adjusted odds ratio (OR) = 0.499 (95% CI 0.422 to 0.589] compared to the lowest quartile after controlling for potential confounding factors. Conversely, cognitive impairment was a significant predictor of reduced muscular strength [β regression coefficient -0.804, 95% CI, -1.168 to -0.439, for participants with dementia compared with those with normal cognitive function]. CONCLUSIONS in conclusion, a significant bi-directional relationship was found between muscular strength and cognitive function, suggesting that these may have shared common pathways that are worthy of being further elucidated in future studies.
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Affiliation(s)
- Gyu Ri Kim
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Jiyu Sun
- Department of Biostatistics, College of Medicine, Yonsei University, Seoul, Korea
| | - Minkyung Han
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Biostatistics, College of Medicine, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Sohee Park
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Korea
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Abstract
PURPOSE OF REVIEW To discuss recent progress in sarcopenia research and to highlight controversies in the field particularly around reaching consensus on a definition of sarcopenia. RECENT FINDINGS Accordingly, this review begins with a discussion of the increasing awareness of this condition; briefly describes evolving definitions of sarcopenia; suggests a framework for consistent terminology for sarcopenia; discusses outstanding issues in the definition of sarcopenia; and reviews the association between sarcopenia and adverse outcome in older adults. In addition, the role of sarcopenia in other diseases is discussed. The field of sarcopenia continues to hold considerable promise and work continues to resolve outstanding concerns in this field with a unifying consensus definition on the horizon.
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Affiliation(s)
- Peggy M Cawthon
- San Francisco Coordinating Center, 550 16th Street, 2nd Floor, Box #0560, San Francisco, CA, 94143, USA.
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