Nutritional status and body fat mass: Determinants of sarcopenia in community-dwelling older adults

Relationship between myostatin, musclin, nutritional status, and functionality in older Colombian community-dwelling adults: A cross-sectional study

OBJECTIVES

Aging-associated body composition changes lead to a decrease in muscle mass and strength, affecting the functionality of older adults. Myostatin and musclin are myokines that regulate muscle metabolism and may modulate muscle changes during aging. Our objective was to determine the relationship between myostatin, musclin, and nutritional status with physical functionality in older adults.

METHODS

This was a cross-sectional study of a subsample of a stratified random sampling population survey in community-dwelling 60-90-year-old adults of both sexes. Serum myostatin and musclin concentrations were measured using MILLIPLEX technology (Merck Millipore, USA). Trained personnel recorded body mass index (BMI), and waist (WC), calf (CC), and arm (AC) circumferences as indicators of nutritional status. Functionality tests included handgrip strength (GS), walking speed (WS), and Advanced Activities of Daily Living.

RESULTS

Of 101 participants, 55.4% were women, 56.4% were between 60 and 69 years old, 53.5% had abdominal obesity, 23.8% had dynapenia, and 33.7% had low WS. Neither myostatin nor musclin showed significant changes from 60 to 90 years. In a multiple lineal regression model, myostatin showed an inverse correlation with BMI, CC, and AC in men (P < 0.05) but did not explain GS or WS. In a similar analysis, musclin and WC showed an inverse correlation with GS (P < 0.05). Moreover, myostatin was lower in the more physically active men (P < 0.05) but musclin did not show any relationship with the Advanced Activities of Daily Living scale.

CONCLUSIONS

Myostatin and musclin do not decrease with aging and are associated with nutritional and metabolic status. Musclin is associated with dynapenic obesity in older adults.

Abdominal obesity as a risk factor for sarcopenia among the community-dwelling older adults: data from baseline phase of Birjand longitudinal aging study

Objectives

Sarcopenia could be linked to abdominal obesity through various mechanisms. The aim of the current study was to evaluate the association between sarcopenia and abdominal obesity among community-dwelling aged population.

Methods

Data were collected from 1356 eligible older adults (≥ 60 years) who participated in the baseline phase of Birjand Longitudinal Aging Study (BLAS) in 2019. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), a body shape index (ABSI), body roundness index (BRI), and body adiposity index (BAI) were measured. Sarcopenia was assessed based on hand grip strength, appendicular skeletal muscle mass (ASMM) and gait speed.

Results

In the studied population, 834 individuals were sarcopenic. The best predictors of sarcopenia and low gait speed were BAI and WHtR (AUC = 0.61 to 0.65). All abdominal obesity indices were risk factors for sarcopenia, except for WHR. ABSI was significantly and directly associated with sarcopenia, only in the crude model (OR (95%CI): 1.14 (1.02; 1.28), P = 0.02). WHR, WHtR, BMI, and WC increased and ABSI decreased the odds of low handgrip strength.

Conclusions

Most abdominal obesity indices were identified as risk factors for sarcopenia except for WHR. Anthropometric indices can be considered for evaluating the risk of sarcopenia in the elderly.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-025-01616-6.

Clinical significance of serum irisin, 25(OH)D3 and albumin in older adults with chronic disease and sarcopenia

BACKGROUND

Sarcopenia, characterized by progressive muscle mass and strength decline, poses a significant health challenge among older adults, especially those with chronic diseases. Our study aims to evaluate the combined diagnostic potential of irisin, 25(OH)D3, and albumin for sarcopenia in older patients with chronic conditions.

METHODS

A cohort of 393 older patients with chronic diseases, including 117 diagnosed with sarcopenia were included. Fasting blood samples were collected, and serum biomarkers (25(OH)D3, albumin, and irisin) were measured using automated biochemical analyzers and enzyme-linked immunosorbent assay to evaluate nutritional and muscle-related parameters.

RESULTS

The prevalence of sarcopenia was higher among patients aged 80 or older compared to younger age groups in our study population. Strong associations were observed between sarcopenia and osteoporosis, tumors, and risk of malnutrition. Serum irisin, 25(OH)D3, and albumin levels were significantly lower in sarcopenic patients. Individual biomarkers displayed diagnostic potential, and a combined biomarker test showed superior accuracy. Multivariate logistic regression identified age, osteoporosis, malnutrition, and fatigue as independent risk factors, while higher serum biomarker levels correlated with reduced sarcopenia risk. Positive correlations were observed between serum biomarkers and sarcopenia severity indicators.

CONCLUSIONS

This study highlights the potential of irisin, 25(OH)D3, and albumin as diagnostic and prognostic tools for sarcopenia in older patients with chronic diseases, contributing to early detection and intervention strategies to enhance their quality of life.

A graded personalized exercise program's effect on muscle and body fat: randomized controlled trial

OBJECTIVES

With population aging, personalized exercise programs considering clinical and demographic factors like sex, age, and physical activity level are essential; however, research on their effects remains limited. We aimed to evaluate the effectiveness of a Global Physical Activity Questionnaire-based graded personalized exercise program tailored for middle-aged adults aged 40-69 years.

PARTICIPANTS

We enrolled 71 middle-aged adults in their 40s, 50s, and 60s (approximately 20 participants per age group) in a parallel-group randomized controlled trial.

INTERVENTION

Participants were assigned using age-stratified randomization to a treatment or control group. Participants were categorized into three levels according to weekly physical activity measured by the Global Physical Activity Questionnaire and physical activity guidelines for adults. Each participant's grade was determined by applying equal weight adjustments for sex, age, and physical activity level, and the participants were assigned an exercise program corresponding to their grade. The exercise intervention consisted of a circuit training program alternating between aerobic and anaerobic exercises. The control group was instructed to maintain their usual physical activity levels.

MAIN OUTCOME MEASURES

Changes from before to after exercise in clinical results (body composition, physical fitness, ultrasound-measured muscle/fat thickness, and biochemical data) were recorded during the 8-week exercise program and differences between pre- and post-exercise values of the groups were analyzed using the t-test and Wilcoxon rank-sum test.

RESULTS

Among 64 participants who had completed the program, 33 (51.5%) participated in the exercise program. The exercise program significantly increased abdominal muscle thickness (p < 0.01), reduced body fat percentage (p = 0.02) and waist circumference (p = 0.01), and positively affected various physical fitness indicators.

CONCLUSIONS

This study demonstrated the beneficial effects of a graded personalized exercise program on muscle thickness, body fat, and physical fitness and offers key data to support early preventive exercise programs in middle-aged adults to mitigate the risk of sarcopenia in later life.

TRIAL REGISTRATION

Registered on November, 29, 2024 at cris.nih.go.kr identifier KCT0009970.

Serum albumin as a biomarker of (nutritional status in) sarcopenia

INTRODUCTION

To explore the possible associations between blood markers including albumin, hemoglobulin, creatinine and 25 OH vitamin D with sarcopenia using the ISarcoPRM algorithm.

MATERIALS AND METHODS

A total of 2094 community-dwelling males and postmenopausal females (495 males, 1599 females)aged ≥ 50 years were recruited and their demographic data along with all comorbidities and laboratory evaluations were noted. Functional measurements were also quantified and the ISarcoPRM algorithm was used for the diagnosis/confirmation of the participants into sarcopenic and non-sarcopenic categories.

RESULTS

Sarcopenia was detected in 434 (20.7%) participants and low albumin level in 578 (27.6%) of them. While sarcopenia was detected in 193 (33.4%) of 578 subjects with low albumin levels, and in 241 (15.9%) of 1516 subjects with normal albumin levels (p < 0.001). In the binary logistic regression analysis, among the blood parameters; only albumin levels [OR: 0.932 (95% CI 0.876-0.992) in males (p = 0.026), OR: 0.901 (95% CI 0.862-0.941) in females (p < 0.001)were found to be independently associated with sarcopenia in each gender. After adjusting for sociodemographic and other clinical factors, having low albumin levels(≤ 4.0 g/dL) were independently associated with sarcopenia i.e. 2.368 times (95% CI 1.424-3.939) in males and 2.026 times (95% CI 1.520-2.699) in females (both p < 0.001).

CONCLUSION

Independent of other factors, low albumin level is associated with sarcopenia i.e. at least two times in both genders. Older and obese adults at risk of malnutrition should be screened/diagnosed and treated early for sarcopenia. Prospective studies are needed for better/prompt management of relevant patients who are prone to significant morbidity and mortality.

Association between metabolic score for visceral fat index and BMI-adjusted skeletal muscle mass index in American adults

BACKGROUND

The metabolic score for visceral fat (METS-VF) is a recently identified index for evaluating visceral fat, also referred to as abdominal obesity. The skeletal muscle mass index (SMI) serves as a critical measure for assessing muscle mass and sarcopenia. Both obesity and the reduction of muscle mass can significantly affect human health. However, research exploring the relationship between METS-VF and SMI remains limited. This study aims to investigate whether a association exists between these two indices, and if so, to elucidate the nature of their interactions.

METHODS

We conducted a cross-sectional study using data from the NHANES database, focusing on U.S. adults aged 20 years and older from 2013 to 2018. Controlling for relevant covariables, we primarily investigated the association between METS-VF and SMI values utilizing weighted multivariable linear regression models. Additionally, we assessed the diagnostic efficacy of METS-VF for sarcopenia.

RESULTS

A total of 3,594 participants were included in this study for analysis. The final adjusted model from the weighted multivariable linear regression indicated that METS-VF was negatively associated with SMI, with a coefficient of β = -0.13 (95% CI: -0.14, -0.12; P < 0.001). Subgroup analyses further demonstrated that this negative association was consistent across different populations. Notably, the negative association varied significantly between diabetic and nondiabetic population, as well as among populations classified by different BMI categories. Additionally, threshold effect analysis identified a significant inflection knot at 6.33. The characteristic curves of the subjects' work illustrated that, compared to other indicators, METS-VF exhibited excellent diagnostic efficacy for sarcopenia, with an area under the curve (AUC) of 0.825.

CONCLUSION

Our results indicate that METS-VF is negatively correlated with SMI among adults in the United States, suggesting that visceral obesity exerts a detrimental effect on muscle mass. Furthermore, METS-VF shows potential as a valuable indicator for assessing SMI and sarcopenia. These findings underscore the importance of considering lipid metabolism disorders in the context of muscle health and highlight the potential for developing prevention strategies for sarcopenia.

Association between sarcopenia and weight-adjusted waist index in male patients with type 2 diabetes

BACKGROUND

The Weight-adjusted-waist index (WWI) has emerged as a predictive factor for a range of metabolic disorders. To date, the predictive value of the WWI in relation to sarcopenia in individuals with diabetics has not been extensively explored. This study aims to investigate the impact of the WWI on the prevalence of sarcopenia among patients with type 2 diabetes mellitus (T2DM).

METHOD

In this study, we enrolled 417 patients with T2DM from the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between Dec. 2023 and Apr. 2024. The relationship between the WWI and the prevalence of sarcopenia in T2DM patients was evaluated using multivariate logistic regression, subgroup analysis, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis.

RESULTS

Among the 417 patients with T2DM, 76 (18.22%) were identified as having sarcopenia. The prevalence of sarcopenia across the WWI quartile categories, from the first to the fourth quartile, was 8.65%, 8.57%, 20.19% and 8.65% respectively. Multivariate logistic regression analysis revealed that, after adjusting for covariates, a higher WWI was an independent risk factor for sarcopenia in male T2DM patients (OR = 1.836, 95% CI: 1.216-2.772, P = 0.004). This association was not observed in female patients. Subgroup analysis further revealed a stronger correlation between WWI and sarcopenia among male patients with higher HbA1c levels. In males, RCS regression demonstrated a non-linear positive correlation, with an inflection point at a WWI of 10.42 cm/√kg. Finally, the area under the ROC curve (AUC) for the WWI was 0.612.

CONCLUSIONS

WWI emerges as a robust and independent risk factor for sarcopenia in male patients with T2DM. WWI may serve as an accessible and cost-effective tool for identify sarcopenia in patients with diabetes.

Elevated risk of possible sarcopenia and weak muscle strength with higher dietary inflammatory index in Iranian breast cancer survivors: a cross-sectional study

BACKGROUND

Increased levels of inflammation in cancer patients and survivors can make them more prone to muscle wasting and sarcopenia. Diet can be an appropriate treatment for alleviating patient complications. Therefore, this study was performed to determine the association between sarcopenia and its components with the dietary inflammatory index (DII) among breast cancer survivors.

METHODS

A total of 223 female breast cancer survivors were included in this research at the Cancer Prevention Research Center of Seyyed Al-Shohada Hospital and the Iranian Cancer Control Charity Institute (MACSA). Forty-three items of dietary inflammatory index (DII) were extracted from the Food Frequency Questionnaire. Sarcopenia detection was performed according to the Asian criteria. The linear and binary logistic regression was used to assess the association between sarcopenia and its components with DII.

RESULTS

Participants in the highest DII quartile had significantly elevated risk of impaired hand grip strength and calf circumference in both crude and adjusted models. Moreover, individuals consuming a more pro-inflammatory diet displayed a greater risk of abnormal appendicular skeletal muscle index in the crude model. After controlling for potential confounders, participants in the top quartile of DII had a 2.992-fold greater risk of possible sarcopenia than those in the bottom quartile (P value = 0.035). In addition, a decreasing linear trend was observed between higher DII score and 0.059 and 0.349- units lower in appendicular skeletal muscle mass index and hand grip strength variables in the crude Model (P-value < 0.05).

CONCLUSION

Diets with more pro-inflammatory features might be associated with increased risk of possible sarcopenia, as well as its components especially muscle mass and strength in women recovering from breast cancer.

Prevalence of, and factors associated with, sarcopenia in Iran: a systematic review and meta-analysis

Background

Several studies have assessed the epidemiology of sarcopenia in Iran with conflicting results, but comprehensive information has remained limited. Therefore, we aimed to perform a systematic review and meta-analysis of the prevalence of sarcopenia and its associated factors among Iranian population.

Methods

We searched in Embase, PubMed, Scopus, and Google Scholar, as well as Persian databases including the Scientific Information Database and Magiran, from inception to 31 May 2024. We included cross-sectional observational studies reporting the prevalence rate of, and/or factors associated with, sarcopenia in Iranian population. The pooled prevalence of sarcopenia was estimated using a random-effects model.

Results

Totally, 14 eligible studies were included. The overall pooled prevalence of sarcopenia in Iran was 22.1% (95% confidence interval [CI]: 18.7-25.6). This rate in older adult population (≥60 years) was 23.5% (95% CI: 17.9-29.0). Sarcopenia was more prevalent in men (23.2% [95% CI: 21.3-25.1]) than in women (15.5% [95% CI: 9.2-21.9]). The prevalence of severe sarcopenia was 24.5% (95% CI: 16.9-32.0). Factors associated with an increased risk of sarcopenia included older age, male gender, higher body fat, lower socioeconomic status, lower education, insufficient physical activity, diabetes, smoking, and malnutrition; conversely, dietary patterns rich in anti-inflammatory nutrients, Mediterranean diet adherence, and higher mineral and vitamin intake were associated with a lower likelihood of sarcopenia.

Conclusion

The prevalence of sarcopenia is notably high in Iran, particularly among men and older ages. These findings emphasize the need for targeted interventions in nutrition and lifestyle to reduce sarcopenia risk and improve quality of life among Iranians.

Pilot study on the relationship between oral function or subjective symptoms and appetite

OBJECTIVE

This pilot study evaluated the relationships between appetite and oral function, and between appetite and the subjective symptoms of decreased oral function.

METHODS

Seventy-one adult dental clinic patients (22 males, 66.0 ± 14.0 years) participated in this study. A Council on Nutrition Appetite Questionnaire score of ≤28 indicated anorexia, and the Mini Nutritional Assessment Short-form, body mass index and skeletal muscle mass index were used to define subject characteristics. Seven oral function tests and seven subjective symptoms related to oral function were evaluated. The relationship between subject characteristics, oral function tests, subjective symptoms and anorexia was analysed using the chi-square test and univariate and multivariate logistic regression.

RESULT

There were significant differences between the normal appetite group and the anorexia group for the 10-item Eating Assessment Tool (EAT-10) survey and the question 'Food remains in the oral cavity after eating' (p < .05). Univariate logistic regression found significant differences in the items of masticatory function, the EAT-10 survey and the question 'Food remains in the oral cavity after eating'. Multivariate logistic regression revealed significant differences in masticatory function (AOR 4.35; 95% CI: 1.03-18.35; p = .045) and EAT-10 (AOR 6.27; 95% CI: 1.40-24.02; p = .016).

CONCLUSION

This pilot study investigated the influence of factors related to oral function on appetite. Relationships were found among poor masticatory function, poor swallowing function and anorexia.

The characteristics of the body mass frequency index in dysmobility syndrome: A pilot study

BACKGROUND

With the advancement of global aging, there has been an increase in patients with dysmobility syndrome (DS), often accompanied by osteoporosis, sarcopenia, and sarcopenic obesity. The objective of this study was to evaluate the application value of the body mass frequency index (BMFI) in older patients with DS by comprehensively analyzing the differences in BMFI between community-dwelling older subjects using medical and engineering methods.

METHODS

A cross-sectional study was conducted to recruit community-dwelling older subjects aged 60-90 years. Various assessments and measurements were performed, including basic information collection, gait analysis, bone mineral density (BMD) and body composition measurement, fall and fracture risk et al. Gait analysis and body mass index (BMI) are in the established model to calculate BMFI. Analysis of BMFI was performed in community-dwelling older subjects, and the specificity and threshold of BMFI in predicting dysmobility syndrome (DS) were further analyzed.

RESULTS

Significant differences in BMFI were observed between older adults with DS and those without DS. BMFI in older people was associated with bone quality, fracture risk, body fat percentage, appendicular skeletal muscle mass index (ASMI), grip strength, and speed. The odds ratio (OR) and 95 % confidence interval (CI) for BMFI in the non-DS and DS groups were 0.823 (0.743-0.901), respectively. Receiver operating characteristic (ROC) analysis demonstrated that BMFI had predictive value in distinguishing non-DS from DS (AUC = 0.669) (P < 0.05). The optimal threshold for predicting non-DS and DS was found to be 16.04 (sensitivities = 0.483, specificities = 0.774).

CONCLUSION

The measurement of BMFI has demonstrated disparities in musculoskeletal status among older adults with and without DS. Notably, BMFI exhibits a unique predictive capacity for DS among the elderly population.

Body composition characteristics and influencing factors of different parts of sarcopenia in elderly people: A community-based cross-sectional survey

Objectives

This study aims to describe the differences in body composition among different body parts of the elderly in the community and its relationship with sarcopenia.

Methods

Elderly people aged ≥65 underwent bioelectric impedance analysis testing and were categorized into a sarcopenia group, possible sarcopenia group, and control group. The characteristics of body composition indicators in different parts and their relationship with different stages of sarcopenia were analyzed.

Results

The sarcopenia group illustrated the lowest values of FFM, FFM%, BFM, BFM%, ICW, and limb PhA, along with higher ECW/TBW in the trunk and left leg compared to the control group. The possible sarcopenia group showed lower FFM% in limbs and trunk, and higher BFM% compared to the control group. Gender differences in elderly body composition were observed, with an increase in BFM% in various body parts posing a risk factor for possible sarcopenia in elderly males, whereas an increase in BFM% except in the left arm was a protective factor for sarcopenia in elderly females.

Conclusion

The body composition of the elderly in the community varied significantly in different stages of sarcopenia and genders, which correlated with sarcopenia.

The association between weight-adjusted-waist index and sarcopenia in adults: a population-based study

This study aims to investigate the relationship between weight-adjusted-waist index (WWI), a new body index, and sarcopenia, while also assessing the potential of WWI as a tool for screening sarcopenic patients. The cross-sectional study involved adults who possessed complete data on WWI and appendicular skeletal muscle mass from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Surveys. Weighted multivariate regression and logistic regression analyses were employed to explore the independent relationship between WWI and sarcopenia. The study included 26,782 participants. The results showed that WWI demonstrated a positive correlation with sarcopenia risk. In the fully adjusted model, with each 1 unit increase in WWI, the risk of developing sarcopenia rose 14.55 times higher among males (OR: 14.55, 95% CI 12.33, 17.15) and 2.86 times higher among females (OR: 2.86, 95% CI 2.59, 3.15). The optimal cutoff values of WWI for sarcopenia were 11.26 cm/√kg for males and 11.39 cm/√kg for females. Individuals with a higher WWI have an increased risk of developing sarcopenia, and a high WWI functions as a risk factor for sarcopenia. Assessing WWI could assist in identifying individuals at risk of sarcopenia.

The association between healthy beverage index and sarcopenia in Iranian older adults: a case-control study

BACKGROUND

Sarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults.

METHODS

In the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia.

RESULTS

In the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2- odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01-0.25 and T3- OR = 0.10, 95% CI: 0.01-0.60).

CONCLUSIONS

Our findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.

Association between oxidative balance score and sarcopenia in older adults

Sarcopenia is a progressive skeletal muscle disease in which oxidative stress has been proposed as one of the primary markers. The oxidative balance score (OBS) represents the oxidative balance of a person's dietary pattern using the merged intake of anti-oxidants and pro-oxidants. Therefore, the present study assessed the association between OBS and sarcopenia in Iranian older adults. In the current study, 80 people with sarcopenia and 80 without it were considered the case and control groups, respectively. All controls were matched by sex with cases. To confirm sarcopenia, skeletal muscle mass index (SMI), handgrip strength (HGS) measurement, and gait speed were used. Also, body composition was measured by bioelectrical impedance analysis (BIA). A valid and reliable food frequency questionnaire (FFQ) was used to assess all participants' dietary intake of pro-oxidants and anti-oxidants. Conditional logistic regression was applied to assess the association between OBS and sarcopenia. In the bivariate model, we observed lower odds of sarcopenia in the second and last tertile of OBS in comparison to the first tertile (T) (T2 - odds ratio (OR) = 0.414, 95% confidence interval (CI) : 0.186-0.918 and T3 - OR = 0.101, 95% CI: 0.041-0.248). After adjusting for potential confounders, the association was not significant in second and last tertile of OBS in comparision to the first one. The present study's findings demonstrated that overcoming exposure to anti-oxidants over pro-oxidants, as illustrated by a higher OBS, is not related to lower odds of sarcopenia in older adults.

The prevalence and factors associated with sarcopenia in Thai older adults: A systematic review and meta-analysis

Objective

This systematic review and meta-analysis aimed to assess the prevalence and identify factors associated with sarcopenia in older Thais.

Methods

Research studies were searched in online databases, including PubMed, Embase, Scopus, and Thai-Journal Citation Index. The articles included in this review were limited to being published between January 1, 2013 and January 31, 2023 and observational study designs. The research quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. A meta-analysis was performed using the JBI SUMARI software. The review protocol has been registered on PROSPERO with the assigned ID CRD42023420514.

Results

A total of 265 research articles were initially identified, out of which 17 articles were included in this study, including a total of 4,668 participants aged 60 years and over, consisting of 1,380 (29.6%) men and 3,288 (70.4%) women. The overall prevalence of sarcopenia in Thai older adults was 20.7% (95% CI 14.4%-27.8%). Subgroup analysis of the sarcopenia prevalence based on the study areas revealed that the prevalence was 33.4% (95% CI 28.7%-38.3%) in hospitalized individuals, 23.2% (95% CI 12.5%-35.9%) in outpatient clinic settings, and 17.3% (95% CI 9.4%-26.8%) in community-living older adults. Advanced age (OR = 4.60, 95% CI 3.07-6.91), being male (OR = 2.30, 95% CI 1.37-3.85), low body mass index (BMI) (OR = 8.95, 95% CI 6.05-13.25), and malnutrition (OR = 2.78, 95% CI 2.09-3.70) are strong predictors of sarcopenia in older adults in Thailand.

Conclusions

This systematic review represents the first assessment of the overall prevalence and factors associated with sarcopenia in Thai older adults, indicating its significant concern within this population. These findings are of importance for public health management aimed at preventing and managing sarcopenia in the country.

Development of multiple biomarker panels for prediction of sarcopenia in community-dwelling older adults

BACKGROUND

It is required to consider multiple biomarkers simultaneously to predict sarcopenia and to understand its complex pathological mechanisms. This study aimed to develop multiple biomarker panels for predicting sarcopenia in older adults and to further examine its association with the incidence of sarcopenia.

METHODS

A total of 1,021 older adults were selected from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019 criteria. Among the 14 biomarker candidates at baseline, eight biomarkers that could optimally detect individuals with sarcopenia were selected to develop a multi-biomarker risk score (range from 0 to 10). The utility of developed multi-biomarker risk score in discriminating sarcopenia was investigated using receiver operating characteristic (ROC) analysis.

RESULTS

The multi-biomarker risk score had an area under the ROC curve (AUC) of 0.71 with an optimal cut-off of 1.76 score, which was significantly higher than all single biomarkers with AUC of <0.7 (all, p<0.01). During the two-year follow-up, the incidence of sarcopenia was 11.1%. Continuous multi-biomarker risk score was positively associated with incidence of sarcopenia after adjusting confounders (odds ratio [OR]=1.63; 95% confidence interval [CI]=1.23-2.17). Participants with a high risk score had higher odds of sarcopenia than those with a low risk score (OR=1.82; 95% CI=1.04-3.19).

CONCLUSIONS

Multi-biomarker risk score, which was a combination of eight biomarkers with different pathophysiologies, better discriminated the presence of sarcopenia than a single biomarker, and it could further predict the incidence of sarcopenia over two years in older adults.

Factors Associated with Sarcopenia among Elderly Individuals Residing in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis

To investigate the factors associated with sarcopenia in elderly individuals residing in nursing homes and community settings, we conducted a systematic search of databases, including MEDLINE, EMBASE, PubMed, Web of Science and Cochrane, up to May 2023. We incorporated a total of 70 studies into our analysis. Our findings revealed that the prevalence of sarcopenia in nursing homes ranged from 25% to 73.7%, while in community settings, it varied from 5.2% to 62.7%. The factors associated with sarcopenia in both nursing homes and community settings included male gender, BMI, malnutrition, and osteoarthritis. In community settings, these factors comprised age, poor nutrition status, small calf circumference, smoking, physical inactivity, cognitive impairment, diabetes, depression and heart disease. Currently, both the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGS) standards are widely utilized in nursing homes and community settings, with the EWGSOP standard being more applicable to nursing homes. Identifying factors associated with sarcopenia is of paramount significance, particularly considering that some of them can be modified and managed. Further research is warranted to investigate the impact of preventive measures on these factors in the management of sarcopenia among elderly individuals residing in nursing homes and community settings.

Association of the amount of alcohol consumption with change in skeletal muscle and fat mass among Korean adults

The association between changes in alcohol consumption and body composition remains unclear. We investigated the association between changes in drinking habits and muscle mass and fat mass in adults. From the Health Examinees in Korea, the study population (N = 62 094) was categorized according to alcohol consumption (g of ethanol/day) and the changes in drinking habits between the baseline and follow-up periods were determined. Predicted muscle mass index (pMM), lean mass index, and fat mass index (pFM) were also calculated using age, sex, weight, height, and waist circumference. The β coefficient and adjusted means were then calculated using multiple linear regression analysis after adjusting for covariates, including follow-up duration, calorie intake, and protein intake. Compared to the almost-unchanged drinking group (reference; adjusted mean: -0.030 [95% confidence intervals: -0.048, -0.011]), there was no statistical difference or tendency of change in the pMMs of the most-decreased (-0.024 [-0.048, 0.000]) and the most-increased (-0.027 [-0.059, -0.013]) alcohol-consumed groups. The pFM decreased at those with less alcohol consumption (0.053 [-0.011, 0.119]) and increased with increased alcohol consumption (0.125 [0.063, 0.187]), compared to the no-change group (reference; 0.088 [0.036, 0.140]). Thus, changes in alcohol consumption were not significantly associated with changes in muscle mass. Increased alcohol consumption was associated with increased fat mass. Reducing the amount of alcohol consumption may improve body composition in terms of fat mass.

Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis

The effects of supplementation with whey protein alone or with vitamin D on sarcopenia-related outcomes in older adults are unclear. We aimed to assess the effect of whey protein supplementation alone or with vitamin D on lean mass (LM), strength, and function in older adults with or without sarcopenia or frailty. We searched PubMed, Web of Science, and SCOPUS databases. Randomized controlled trials (RCT) that investigated the effect of whey protein supplementation with or without vitamin D on sarcopenia outcomes in healthy and sarcopenic or frail older adults were included. Standardized mean differences (SMDs) were calculated for LM, muscle strength, and physical function data. The analysis showed that whey protein supplementation had no effect on LM and muscle strength; nevertheless, a significant improvement was found in physical function (SMD = 0.561; 95% confidence interval [CIs]: 0.256, 0.865, n = 33), particularly gait speed (GS). On the contrary, whey protein supplementation significantly improved LM (SMD = 0.982; 95% CI: 0.228, 1.736; n = 11), appendicular lean mass and physical function (SMD = 1.211; 95% CI: 0.588, 1.834; n = 16), and GS in sarcopenic/frail older adults. By contrast, co-supplementation with vitamin D enhanced LM gains (SMD =0.993; 95% CI: 0.112, 1.874; n = 11), muscle strength (SMD =2.005; 95% CI: 0.975, 3.035; n = 11), and physical function (SMD = 3.038; 95% CI: 2.196, 3.879; n = 18) significantly. Muscle strength and physical function improvements after whey protein supplementation plus vitamin D were observed without resistance exercise (RE) and short study duration subgroups. Moreover, the combination of whey protein and vitamin D with RE did not enhance the effect of RE. Whey protein supplementation improved LM and function in sarcopenic/frail older adults but had no positive effect in healthy older persons. By contrast, our meta-analysis showed that co-supplementation with whey protein and vitamin D is effective, particularly in healthy older adults, which is likely owing, we propose, to the correction of vitamin D insufficiency or deficiency. The trial was registered at https://inplasy.com as INPLASY202240167.

Association between upper limb movements during drumming and cognition in older adults with cognitive impairment and dementia at a nursing home: a pilot study

Background

Despite the association between motor dysfunction and dementia, quantitative assessment of dementia-related specific motor dysfunction in patients with severe dementia is difficult. Thus, this study aimed to develop a new method to measure upper limb motor function in people with dementia.

Methods

We examined the relationship between dementia severity and dementia-related specific motor dysfunction using the Mini-Mental State Examination (MMSE), a dementia screening test. Participants comprised 16 nursing home residents with a mean age of 86 years and MMSE score of 14.56 (range, 1-23) Points. Participants were seated in a circle and instructed to play a drum that was placed in their lap using mallets (drumsticks) in their dominant hand. Acceleration and gyroscopic sensors were attached to their wrists to collect data on arm movements while drumming. Upper limb motor characteristics were confirmed by recording acceleration and arm movement during drumming and analyzing the correlation with handgrip strength.

Results

Handgrip strength was correlated with arm elevation angle during drumming. The arm elevation angle displayed a significant regression equation with the MMSE score and showed the best regression equation along with handgrip strength (adjusted R² = 0.6035, p = 0.0009).

Conclusion

We developed a new method using drums to measure upper limb motor function in people with dementia. We also verified that the average arm elevation angle during drumming could predict cognitive dysfunction. This system may be used to monitor people with dementia in a simple and safe way.

Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007

Objectives

Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality.

Method

The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified.

Results

In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)].

Conclusion

Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.

Relationship between the 25-question Geriatric Locomotive Function Scale and physical function in the elderly people

INTRODUCTION

Locomotive syndrome (LS) is a condition of reduced mobility. The LS stage can be determined by the stand-up test, two-step test, and 25-question geriatric locomotive function scale (GLFS-25). This study aimed to establish whether the LS stage can be reliably determined using the GLFS-25, and to clarify the correlation between the GLFS-25's six subcategories and physical functions.

MATERIALS AND METHODS

We administered the GLFS-25 and evaluated physical functions using the stand-up test, the two-step test, handgrip strength, the five-times sit-to-stand test, the 4 m walking test, and the duration of single leg standing. We assessed 103 participants over 65 years of age. We analyzed the correlation between LS stage and GLFS-25 score, as well as the correlations between physical functions and the GLFS-25's six subcategories.

RESULTS

There was a discrepancy between the LS stage determined using the GLFS-25 alone and the LS stage determined using all three tools. ROC analysis revealed a cut-off value of 6 for the discrimination of LS stages 0/1 and 14 for stages 1/2. The analysis revealed an AUC of 0.78 and 0.81, respectively. Among the six subcategories of the GLFS-25, movement-related difficulty, usual care, ADL, and social activities were correlated with mobility functions. In contrast, body pain and cognitive showed no correlation.

CONCLUSION

The GLFS-25 is useful for screening those with severe LS stages; however, evaluation of actual physical function is recommended for precise staging of LS in those with low GFLS-25 scores. Among the six subcategories of the GLFS-25, body pain and cognitive were independent of the other four subcategories.

Associations between Body Mass Index and Probable Sarcopenia in Community-Dwelling Older Adults

(1) Background/Objectives: The relationship between body mass index (BMI) and probable sarcopenia, a precursor to sarcopenia diagnosis, is unclear. While low BMI has been associated with sarcopenia risk, some evidence suggests that obesity may confer protection. We aimed to investigate the association between probable sarcopenia and BMI and, furthermore, to explore associations with waist circumference (WC). (2) Methods: This cross-sectional study included 5783 community-dwelling adults (mean age 70.4 ± 7.5 years) from Wave 6 of the English Longitudinal Study of Ageing (ELSA). Probable sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria for low hand grip strength and/or slow chair rise. Associations between BMI and probable sarcopenia were examined using multivariable regression analysis and were similarly performed for WC. (3) Results: Our overall findings show that an underweight BMI was significantly associated with an increased likelihood of probable sarcopenia [OR (CI) 2.25 (1.17, 4.33), p = 0.015]. For higher BMI categories, the findings were conflicting. Overweight and obesity were associated with an increased likelihood of probable sarcopenia when defined by lower limb strength alone, [OR (CI), 2.32 (1.15, 4.70), p = 0.019; 1.23 (1.02, 1.49), p = 0.35, and 1.49 (1.21, 1.83), p < 0.001, respectively]. In contrast, overweight and obesity appeared protective when probable sarcopenia was assessed by low hand grip strength alone [OR (CI) 0.72 (0.60, 0.88), p = 0.001, and 0.64 (0.52, 0.79), p < 0.001, respectively]. WC was not significantly associated with probable sarcopenia on multivariable regression analysis. (4) Conclusion: This study supports the evidence that low BMI is associated with an increased likelihood of probable sarcopenia, highlighting an important at-risk group. The findings for overweight and obesity were inconsistent and may be measurement dependent. It seems prudent that all older adults at risk of probable sarcopenia, including those with overweight/obesity, are assessed to prevent underdetection of probable sarcopenia alone or with the double burden of obesity.

A Nomogram for Optimizing Sarcopenia Screening in Community-dwelling Older Adults: AB3C Model

OBJECTIVES

Sarcopenia is associated with significantly higher mortality risk, and earlier detection of sarcopenia has remarkable public health benefits. However, the model that predicts sarcopenia in the community has yet to be well identified. The study aimed to develop a nomogram for predicting the risk of sarcopenia and compare the performance with 3 sarcopenia screen models in community-dwelling older adults in China.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

A total of 966 community-dwelling older adults.

METHODS

A total of 966 community-dwelling older adults were enrolled in the study, with 678 participants grouped into the Training Set and 288 participants grouped into the Validation Set according to a 7:3 randomization. Predictors were identified in the Training Set by univariate and multivariate logistic regression and then combined into a nomogram to predict the risk of sarcopenia. The performance of this nomogram was assessed by calibration, discrimination, and clinical utility.

RESULTS

Age, body mass index, calf circumference, congestive heart failure, and chronic obstructive pulmonary disease were demonstrated to be predictors for sarcopenia. The nomogram (named as AB3C model) that was constructed based on these predictors showed excellent calibration and discrimination in the Training Set with an area under the receiver operating characteristic curve (AUC) of 0.930. The nomogram also showed perfect calibration and discrimination in the Validation Set with an AUC of 0.897. The clinical utility of the nomogram was supported by decision curve analysis. Comparing the performance with 3 sarcopenia screen models (SARC-F, Ishii, and Calf circumference), the AB3C model outperformed the other models regarding sensitivity and AUC.

CONCLUSIONS AND IMPLICATIONS

AB3C model, an easy-to-apply and cost-effective nomogram, was developed to predict the risk of sarcopenia, which may contribute to optimizing sarcopenia screening in community settings.

Indicators predicting the development and improvement of sarcopenia in older adults requiring long-term care

[Purpose] This study aimed to identify factors associated with sarcopenia development and improvement among older adults requiring long-term care. [Participants and Methods] This prospective observational study included 118 older adults requiring long-term care in a single facility. Sarcopenia was assessed according to the 2019 diagnostic criteria of the Asian Working Group for Sarcopenia at baseline and after 6 months. Nutritional status was measured using calf circumference and the Mini Nutritional Assessment-Short Form to examine the association between sarcopenia onset and improvement. [Results] Risk of malnutrition and lower calf circumference at baseline were significantly associated with sarcopenia development. The study also showed that a non-risk of malnutrition, higher calf circumference, and higher skeletal muscle mass index were significantly associated with improved sarcopenia. [Conclusion] The Mini Nutritional Assessment-Short Form and calf circumference were able to predict sarcopenia development and improvement in older adults requiring long-term care.

Identification of SNPs and expression patterns of ALB, AHSG and GC genes and their association with growth traits in Hu sheep

Growth traits are economically important traits in sheep breeding. This study was conducted to evaluate the polymorphisms of ALB, AHSG and GC genes and their association with growth traits in Hu sheep. We measured and recorded the body weight (BW), body height (BH), body length (BL) and feed conversion ratio (FCR) of 1418 male Hu sheep raised in the same environment from 80 to 180 days of age. The total of four SNPs in the ALB, AHSG and GC genes were identified by direct sequencing technology. The results of association analysis showed that two loci (g.8699 A>T and g.13458 T>C) of ALB gene significantly affect average daily gain (ADG; P < 0.05). The genotypes of SNP g.2454 T>C in AHSG gene were significantly associated with ADG and FCR (P < 0.05). There were significant associations between GC g.19484 A>C and BW, BH and BL (P < 0.05). The results of qRT-PCR showed that ALB, AHSG, and GC genes were extremely significantly higher in H_BW sheep compared with those in the L_BW sheep (P < 0.01). These results revealed that ALB-1 g.8699 A>T, ALB-2 g.13458 T>C, AHSG g.2454 T>C and GC g.19484 A>C loci are potential molecular markers for Hu sheep breeding.

Validation of the Persian version of the sarcopenia-specific quality of life questionnaire (SarQoL®-IR)

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.

Association between body fat and sarcopenia in older adults with type 2 diabetes mellitus: A cross-sectional study

OBJECTIVES

To investigate the association between body fat (BF%) and sarcopenia in older adults with type 2 diabetes mellitus (T2DM) and potential link with increased levels of inflammatory indicators and insulin resistance.

METHODS

A total of 543 older adults with T2DM were included in this cross-sectional study. Appendicular skeletal muscle (ASM), handgrip strength and gait speed were measured to diagnose sarcopenia according to the updated Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Body composition data were tested using dual-energy X-ray absorptiometry (DEXA). Levels of serum high-sensitive C-reactive protein (hs-CRP), interleukin-6, fasting blood insulin (FINS), hemoglobin A1c (HbA1c), 25-hydroxyvitamin D₃ [25(OH) D₃] were also determined.

RESULTS

The prevalence of sarcopenia in all participants was 8.84%, of which 11.90% were male and 5.84% females. The Pearson's correlation analysis revealed that BF% was negatively correlated with gait speed in men and women (R =-0.195, P=0.001; R = -0.136, P =0.025, respectively). After adjusting for all potential confounders, sarcopenia was positive associated with BF% (male, OR: 1.38, 95% CI: 1.15-1.65, P< 0.001; female, OR: 1.30, 95% CI: 1.07-1.56, P=0.007), and negatively associated with body mass index (BMI) (male, OR: 0.57, 95% CI: 0.44-0.73, P<0.001; female, OR: 0.48, 95% CI: 0.33-0.70, P<0.001). No significant differences were found in hs-CRP, interleukin-6, and insulin resistance between older T2DM adults with and without sarcopenia.

CONCLUSION

Higher BF% was linked to an increased risk of sarcopenia in older adults with T2DM, suggesting the importance of assessing BF% rather than BMI alone to manage sarcopenia.

Sarcopenia in the Cirrhotic Patient: Current Knowledge and Future Directions

Cirrhosis predisposes to abnormalities in energy, hormonal, and immunological homeostasis. Disturbances in these metabolic processes create susceptibility to sarcopenia or pathological muscle wasting. Sarcopenia is prevalent in cirrhosis and its presence portends significant adverse outcomes including the length of hospital stay, infectious complications, and mortality. This highlights the importance of identification of at-risk individuals with early nutritional, therapeutic and physical therapy intervention. This manuscript summarizes literature relevant to sarcopenia in cirrhosis, describes current knowledge, and elucidates possible future directions.

Nutrition Risk Is Associated with 3-Year Strength and Performance Indicators among Older Adults in the Canadian Longitudinal Study on Aging

OBJECTIVES

Determine if nutrition risk, as measured by SCREEN-8 is predictive of 3-year strength and performance indicators among community-living older adults after adjusting for key demographic and health variables. Sex-stratified analyses were also determined.

DESIGN

Cohort study with baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging (CLSA).

PARTICIPANTS

Participants 55 years and older at baseline were included (n = 22,502); those who reported nasogastric or abdominal tube feeding at either timepoint were excluded (n = 26). The final sample of participants available for analyses slightly varied depending on completion of the three outcome variables. List-wise deletion was used for nutrition risk and covariates to arrive at the sample available for analysis (n = 17,250).

MEASUREMENTS

The valid and reliable SCREEN-8 tool was used to measure nutrition risk. The minimum and maximum score of SCREEN-8 is 0 and 48, respectively, with lower scores indicating greater nutrition risk. Baseline SCREEN-8 score was used in analyses. Grip strength, chair rise test time and gait speed assessed at the 3-year follow-up were the strength and performance outcomes. Criteria outlined by the European Working Group on Sarcopenia in Older People 2 were used to determine low performance for grip strength (<27 kg for males and <16 kg for females), chair rise test time (>15 seconds) and gait speed (≤0.8 m/s).

RESULTS

Half of participants were female (49.4%) and mean age was 66.7 years (SD 7.9). Mean SCREEN-8 score was 39.2 (SD 6.0). Low grip strength, chair rise test performance and gait speed were found in 18.5%, 19.6% and 29.3% of participants, respectively. After adjusting for covariates (e.g., sex, age, education), SCREEN-8 score was significantly associated with grip strength (F = 11.21, p = .001; OR = 0.98, CI [0.97, 0.99]), chair rise time (F = 5.97, p = .015; OR = 0.99, CI [0.97, 0.997]), and gait speed (F = 9.99, p = .002; OR = 0.98, CI [0.97, 0.99]). Similar interpretation was seen in sex-stratified analyses, although chair rise time was not significant. Age, body mass index, Life Space Index Score and self-rated health were consistently associated with all outcome measures.

CONCLUSION

Nutrition risk, as measured by SCREEN-8, significantly predicted 3-year strength and performance measures. Greater nutrition risk is associated with an increased odds of low performance on grip strength, chair rise test, and gait speed. Future research should implement nutrition risk screening in primary care settings with subsequent assessment and treatment for at risk clients to determine if nutrition interventions implemented post screening can delay age-related losses in strength and performance.

Prevalence and associated factors of sarcopenia in community-dwelling older adults at risk of malnutrition

BACKGROUND

There is an increasingly strong association between sarcopenia and malnutrition in research findings. We aimed to determine the prevalence and factors associated with sarcopenia in community-dwelling older adults (≥ 65 years) at risk of malnutrition based on Malnutrition Universal Screening Tool (MUST).

METHODS

This was a cross-sectional study of 811 participants. Participants were recruited from the general population, community centers, senior activity centers, polyclinics, and hospital. Community-dwelling older adults at risk of malnutrition participated in the study. Participants' data and measurements were collected at the baseline visit. Data included socio-demographic information, anthropometric measurements, body composition, dietary intakes, and functional assessments. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus.

RESULTS

Of the 694 participants with complete datasets, overall prevalence of sarcopenia was 76% (n = 530); 57% (n = 393) had severe sarcopenia. In the overall cohort, compared to participants without sarcopenia, those with sarcopenia were older, had lower physical activity scale for the elderly score, leg strength, handgrip endurance, mid-upper arm circumference, calf circumference, and bone mass, and had lower dietary protein intake and poorer nutritional status (all p ≤ 0.015). After adjusting for confounders, sarcopenia was significantly associated with older age, male gender, higher risk of malnutrition, lower calf circumference, and lower bone mass (all p ≤ 0.044).

CONCLUSIONS

In community-dwelling older adults at risk of malnutrition, there is a high prevalence of sarcopenia and severe sarcopenia. As such, screening positive for either malnutrition risk or sarcopenia in older adults should prompt screening for the other risk factor, to allow early institution of disease modifying interventions to forestall adverse outcomes for both malnutrition and sarcopenia.

TRIAL REGISTRATION

The study was registered at clinicaltrials.gov as NCT03245047 .

Prevalence and Factors Influencing Sarcopenia Among Community-Dwelling Older Adults Using the Asian Working Group for Sarcopenia Definition

OBJECTIVE

This study aimed to explore the prevalence and impact of related factors for sarcopenia among community-dwelling older people in Chongming district, China, according to the diagnostic criteria of the Asia Working Group for Sarcopenia-2019.

METHODS

We conducted a cross-sectional study from April 2021 to December 2021. Diagnosis of sarcopenia (non-sarcopenia, possible sarcopenia, sarcopenia, and severe sarcopenia) was based on appendicular skeletal muscle mass index, handgrip strength, gait speed, and the 5-time chair stand test. Staff collected all subjects' clinical and sociodemographic characteristics, cardiovascular disease (CVD) risk factors, inflammatory markers, physical activity (PA), and daily lifestyle activities to identify sarcopenia-related factors.

RESULTS

A total of 1407 older people aged ≥ 65 years were enrolled into the study (58.7% female). The prevalence of confirmed sarcopenia was 19.6% (17.1% in females and 23.1% in males). The prevalence of possible sarcopenia, sarcopenia, and severe sarcopenia were 19.7% (22.2% in females, 16.2% in males), 11.9% (10.1% in females, 14.5% in males), and 7.7% (7% in females, 8.6% in males), respectively. Increasing age, gender, depression status, and high-fat mass were associated with an increased likelihood of sarcopenia in all subjects. In females, living alone, high-fat mass, lower body mass index (BMI), lower body weight, and have no time spent doing housework increased the likelihood of sarcopenia. In males, depression status, high-fat mass, higher neutrophils-to-lymphocytes ratio (NLR), lower BMI, lower body weight increased the likelihood of sarcopenia.

CONCLUSION

Our study showed a high prevalence of sarcopenia among community-dwelling older people in the Chongming district. Detection, prevention, and treatment efforts are needed to reduce the impact of sarcopenia in older, rural communities in China.

The combination of sarcopenia and biochemical factors can predict the survival of hepatocellular carcinoma patients receiving transarterial chemoembolization

BACKGROUND

Transarterial chemoembolization(TACE) is the suggested treatment for hepatocellular carcinoma (HCC) not amenable to curative treatments. We investigated the role of sarcopenia on overall survival in HCC patients receiving TACE and proposed a new prognostic scoring system incorporating sarcopenia.

MATERIALS AND METHODS

We retrospectively analyzed 260 HCC patients who received TACE between 2010 and 2015. Total psoas muscle was measured on a cross-sectional CT image before the first TACE session. Sarcopenia was defined by the pre-determined sex-specific cutoff value. We assessed the impact of sarcopenia and other biochemical factors on the overall survival and compared the new scoring system with other prognostic scoring systems.

RESULTS

One hundred and thirty patients (50%) were classified as sarcopenia before the first TACE. They were older with a higher male tendency and a significantly lower body mass index (BMI). Cox regression multivariate analysis demonstrated that sarcopenia, multiple tumors, maximal tumor diameter≥ 5cm, major venous thrombosis, sarcopenia, AFP ≥ 200 ng/ml, and albumin<3.5mg/dL were independent poor prognostic factors for overall survival in HCC patients receiving TACE. Our scoring system comprising these factors outperformed other major scoring systems in terms of predicting survival after TACE.

CONCLUSION

The current study demonstrated that sarcopenia was an independent prognostic factor for HCC undergoing TACE therapy. Our newly developed scoring system could effectively predict patient survival after TACE. Physicians could, based on the current score model, carefully select candidate patients for TACE treatment in order to optimize their survival. Further studies are warranted to validate our findings.

Prevalence of Risk of Sarcopenia in Polish Elderly Population—A Population Study

Sarcopenia in the elderly population is a public health challenge, and there are few data on its prevalence in Europe. In this study, we investigated the prevalence of sarcopenia in the elderly Polish population and its association with the level of obesity and co-existing diseases. We conducted a population-based cross-sectional study involving 823 men and 1177 women aged 65 years and older, randomly selected from the population living in the territory of the Republic of Poland between 2017 and 2020. We analyzed the results of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Risk of sarcopenia was assessed with the simple questionnaire to rapidly diagnose sarcopenia (SARC-F), and sarcopenic obesity risk was defined as the combination of anthropometry and SARC-F results. In addition, we collected disease data with an author questionnaire. The prevalence of risk of sarcopenia was 18.6% (22.3% in women and 13.2% in men), and its incidence significantly increased with age in both sexes. The risk of sarcopenic obesity was more common in women than in men, and it was higher in the older age group, except for sarcopenic obesity diagnosed by the WHR criteria. The group of elderly with concomitant diseases had a higher risk of developing sarcopenia, which emphasizes the need to monitor sarcopenia when concomitant diseases are diagnosed. In both groups, risk of sarcopenia was associated with motor and respiratory system diseases, type 2 diabetes, and neurological diseases. This study highlights that the risk of sarcopenia in the elderly population affects women to a greater extent than men. It is important to identify the elderly at risk of sarcopenia in routine clinical practice to develop long-term prevention strategies.

The effects of synbiotic and/or vitamin D supplementation on gut-muscle axis in overweight and obese women: a study protocol for a double-blind, randomized, placebo-controlled trial

BACKGROUND

Sarcopenia refers to an age-related loss of skeletal muscle content, strength, and function, leading to a decrease in mobility. Obesity may exacerbate age-related complications such as sarcopenia through inflammatory pathways. In addition, intestinal dysbiosis has been proposed as an emerging contributor to sarcopenia due to the stimulation of the immune system and elevated barrier permeability of the intestine. Targeting microbiome with synbiotic and vitamin D supplementation may modulate the microbiome followed by the enhancement of sarcopenia indices. Thus, the present study aims to evaluate the effect of synbiotic supplementation with or without vitamin D on the intestinal microbiome and its relationship with strength, muscle function, and body composition in middle-aged overweight and obese women.

METHODS

This multi-factorial, double-blind, randomized controlled trial will be conducted on 88 participants in eight weeks. The participants will be allocated into four groups receiving vitamin D placebo (weekly) and synbiotic placebo (daily), vitamin D and synbiotic placebo, vitamin D placebo and symbiotic, and vitamin D and synbiotic. Intestinal microbiome assessment will be done by DNA isolation and real-time polymerase chain reaction (PCR). In addition, anthropometric indices, body composition, muscle strength, and physical performance will be evaluated by standard methods. All measurements will be made at the beginning and end of the study.

DISCUSSION

The previous studies showed that probiotics were involved in reducing inflammation, insulin sensitivity, modulation of atrophy markers such as atherogen-1, and decreasing reactive oxygen indices. In addition, vitamin D was found to improve the intestinal microbiome and facilitate muscle anabolism. The present protocol is novel as it aims to investigate the impact of the co-supplementation of synbiotic and vitamin D on the gut microbiome and sarcopenia indices.

TRIAL REGISTRATION

This trial has been registered in the Iranian Registry of Clinical Trials (IRCT20090822002365N25, date of registration: March 2021).

A combined diagnostic approach based on serum biomarkers for sarcopenia in older patients with hip fracture

OBJECTIVE

To develop prediction models for sarcopenia in older patients with hip fracture based on a specific set of serum biomarkers aimed at estimating appendicular skeletal muscle mass and diagnosing sarcopenia.

METHODS

Older patients with hip fracture admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2020 to June 2021 were recruited, screened for sarcopenia and tested for peripheral blood levels of specific serum biomarkers preoperatively. Participants were randomly divided into a training set and test set. Common factors were extracted from selected biomarkers through factor analysis, and regression models were established in the training set and verified in the test set.

RESULTS

A total of 212 patients were enrolled, and the prevalence of sarcopenia was 22.8% in men and 19.5% in women. Significant differences in cystatin C, estimated glomerular filtration rate based on cystatin C, sarcopenia index, new sarcopenia index, haemoglobin and albumin were observed between patients with and without sarcopenia. Two regression models were developed in the training set. The validation of the test set confirmed that the linear regression model showed good consistency in predicting appendicular skeletal muscle mass index, while the logistic regression model showed high accuracy in predicting sarcopenia.

CONCLUSIONS

Both prediction models exhibited potential clinical application value for estimating appendicular skeletal muscle mass and predicting sarcopenia in older patients with hip fracture, providing new insights into the serological diagnosis of sarcopenia.

Importance of TP53 codon 72 and intron 3 duplication 16 bp polymorphisms and their haplotypes in susceptibility to sarcopenia in Iranian older adults

Background

Sarcopenia is described as age-related progressive skeletal muscle failure that results in marked reduction in the patient’s independence and life quality. In this study, we explored the association of TP53 exon 4 Arg72pro (rs1042522) and Intron 3 16-bp Del/Ins (rs17878362) polymorphisms and their haplotypes with sarcopenia, anthropometric, body composition and biochemical parameters.

Methods

A total of 254 older individuals (65 sarcopenic and 189 healthy) were recruited in this research and genotyped by PCR–RFLP. Linear regression was applied to find the correlation between TP53 polymorphism, and biochemical and anthropometric parameters. The correlation between TP53 polymorphism and haplotypes and the risk of sarcopenia was investigated by logistic regression.

Results

Arg/Pro genotype carriers was at a lower (ORadj = 0.175, 95% CI = 0.068 – 0.447; P < 0.001) risk of sarcopenia compared to the Arg/Arg group. In haplotypes analysis, Arg-Ins (ORadj: 0.484, 95% CI = 0.231 – 1.011, P = 0.043) and Pro-Ins (ORadj: 0.473, 95% CI = 0.210 – 1.068, P = 0.022) haplotypes showed decreased risk of developing sarcopenia. Moreover, in the case of codon 72 polymorphism, skeletal muscle mass, appendicular lean mass (ALM), skeletal muscle mass index (SMI), hand grip strength and Triglycerides, for Intron 3 16-bp Del/Ins polymorphism, albumin, calcium, cholesterol, and LDL were different, and for the haplotypes, skeletal muscle mass, SMI, ALM, HDL and triglycerides were significantly different between groups.

Conclusions

We suggested that the Arg/Pro genotype of the codon 72 polymorphism in exon 4 of TP53, and Arginine-Insertion and Proline-Insertion haplotypes might decrease the risk of sarcopenia in Iranian older adults.

Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review

BACKGROUND

Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia.

OBJECTIVES

this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia.

METHODS

In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages.

RESULTS

19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world.

CONCLUSION

It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.

Associated Factors of Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10-1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08-2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15-1.92), and underweight (OR = 3.78, 95% CI: 2.55-5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10-1.21), physical inactivity (OR = 1.73, 95% CI: 1.48-2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40-3.72), long (OR = 2.30, 95% CI: 1.37-3.86) and short (OR = 3.32, 95% CI: 1.86-5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00-2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18-1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05-2.51), heart diseases (OR = 1.14, 95% CI: 1.00-1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09-1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63-4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23-1.44), depression (OR = 1.46, 95% CI: 1.17-1.83), falls (OR = 1.28, 95% CI: 1.14-1.44), anorexia (OR = 1.50, 95% CI: 1.14-1.96), and anemia (OR = 1.39, 95% CI: 1.06-1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80-1.51; male: OR = 1.50, 95% CI: 0.96-2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17-0.44), drinking (OR = 0.92, 95% CI: 0.84-1.01), hypertension (OR = 0.98, 95% CI: 0.84-1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89-1.47), stroke (OR = 1.70, 95% CI: 0.69-4.17), cancer (OR = 0.88, 95% CI: 0.85-0.92), pain (OR = 1.08, 95% CI: 0.98-1.20), liver disease (OR = 0.88, 95% CI: 0.85-0.91), and kidney disease (OR = 2.52, 95% CI: 0.19-33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults.

Long-Term Mortality in Critically Ill Tracheostomized Patients Based on Home Mechanical Ventilation at Discharge

Data regarding the long-term outcomes for tracheostomized patients receiving home mechanical ventilation (HMV) are limited. We aimed to determine the 1-year mortality rate for critically ill tracheostomized patients with and without HMV. Data of tracheostomized patients between 1 January 2015 and 31 December 2019 were analyzed. A Kaplan-Meier analysis was performed to assess the survival curve of the patients. Among the 124 tracheostomized patients, 102 (82.3%) were weaned from mechanical ventilation (MV), and 22 (17.7%) required HMV at discharge. The overall 1-year mortality rate was 47.6%, and HMV group had a significantly higher 1-year mortality rate than those weaned from MV (41.2% vs. 77.3%, p = 0.002). In the Cox proportional hazards regression, BMI (HR 0.913 [95% CI 0.850-0.980], p = 0.012), Sequential Organ Failure Assessment (SOFA) score (HR 1.114 [95% CI 1.040-1.193], p = 0.002), transfer to a nursing facility (HR 5.055 [95% CI 1.558-16.400], p = 0.007), and HMV at discharge (HR 1.930 [95% CI 1.082-3.444], p = 0.026) were significantly associated with 1-year mortality. Critically ill tracheostomized patients with HMV at discharge had a significantly higher 1-year mortality rate than those weaned from MV. Low BMI, high SOFA score, transfer to a nursing facility, and HMV at discharge were significantly associated with 1-year mortality.

Acute sarcopenia changes following hospitalization: influence of pre-admission care dependency level

INTRODUCTION

Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated.

OBJECTIVE

Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization.

SETTING AND SUBJECTS

Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020.

METHODS

Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders.

RESULTS

Mean desirability ratio for dependent older people living at home ('middle dependent group') was lower (0.89) compared to independent older people (0.98; regression coefficient -0.09 [95% CI -0.16, -0.02]) and care home patients (1.05; -0.16 [95% CI -0.01, -0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results.

CONCLUSION

Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.

Clustering of Physical Activity and Sedentary Behavior Associated With Body Composition in Brazilian Older Adults

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases.

Status of dysphagia after ischemic stroke: A Korean nationwide study

OBJECTIVE

To identify the incidence of dysphagia after ischemic stroke and determine factors affecting the presence of dysphagia.

DESIGN

Retrospective case-control study. This was an interim analysis of a prospective multicenter Korean stroke cohort.

SETTING

Acute care university hospitals.

PARTICIPANTS

Patients (N=6000) with first-ever acute ischemic stroke. Patients were divided into two groups according to the presence or absence of dysphagia confirmed at 7 days after onset using the American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, which was determined after conducting screening or standardized tests.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Age at stroke onset, body mass index (BMI), premorbid modified Rankin Scale (mRS), brainstem lesions, National Institutes of Health Stroke Scale (NIHSS), post-stroke mRS, and ASHA-NOMS swallowing level at post-stroke day 7 were evaluated.

RESULTS

Among ischemic stroke patients, 32.3% (N=1940) had dysphagia at 7 days after stroke onset. At discharge, 80.5% (N=1561) still had dysphagia. The prediction model for the presence of dysphagia identified age at onset, underweight (BMI < 18.5 kg/m²), premorbid mRS, brainstem lesions, and NIHSS as independent predictors. The odds ratio (OR) for the presence of dysphagia significantly increased with underweight (OR [95% confidence interval]: 1.6684 [1.27-2.20]), increased age at onset (1.0318 [1.03-1.04]), premorbid mRS (1.1832 [1.13-1.24]), brainstem lesions (1.6494 [1.39-1.96]), and NIHSS (1.2073 [1.19-1.23]).

CONCLUSIONS

The incidence of dysphagia after ischemic stroke was 32.3%. The prediction model for the presence of dysphagia identified age, low BMI, premorbid disabilities, brainstem lesions, and NIHSS as predictive factors.

Trends in Natural Nutrients for Oxidative Stress and Cell Senescence

Due to the increase in the aged population and increased life expectancy, the underlying mechanisms involved in the aging process and cell senescence and the ways for modulating these processes in age-related diseases become important. One of the main mechanisms involved in aging and cell senescence, especially in the diseases related to aging, is the oxidative stress process and the following inflammation. Hence, the effects of antioxidants are highlighted in the literature due to their beneficial impacts on inhibiting telomere shortening or DNA damage and other processes related to aging and cell senescence in age-related diseases. Dietary components, foods, and dietary patterns rich in antioxidants can modulate the aging process and delay the progression of some chronic diseases such as cardiovascular diseases, diabetes, and Alzheimer's disease. Foods high in polyphenols, vitamin C, or carotenoids, olive oil, seeds, nuts, legumes, dietary supplements such as CoQ10, and some other dietary factors are the most important nutritional sources that have high antioxidant contents which can positively affect cell senescence and disease progression. Plant dietary patterns including Mediterranean diets can also inhibit telomere shortening following oxidative damages, and this can delay cell aging and senescence in age-related diseases. Further, olive oil can inhibit protein aggregation in Alzheimer's disease. It can be concluded that nutrition can delay the process of cell senescence in age-related diseases via inhibiting oxidative and inflammatory pathways. However, more studies are needed to better clarify the underlying mechanisms of nutrition and dietary components on cell senescence, aging, and disease progression, especially those related to age.

The association between TP53 rs1625895 polymorphism and the risk of sarcopenic obesity in Iranian older adults: a case-control study

Background

Aging and obesity are the two major global health concerns. Sarcopenia, an age-linked disease, wherein a progressive loss of muscle volume, muscle strength, and physical activity occurs. In this study we evaluated the association of TP53 rs1625895 polymorphism with the susceptibility to sarcopenic obesity in Iranian old-age subjects.

Methods

Total of 176 old individuals (45 sarcopenic and 131 healthy) were recruited in this research and genotyped by PCR–RFLP. BMI, Skeletal Muscle Mass Index, body composition, Handgrip Strength, Gait Speed (GS), and biochemical parameters were measured. Chi-square test was done for genotypes and alleles frequency. Linear regression was applied to find the correlation between TP53 rs1625895 polymorphism, and biochemical and anthropometric parameters. The correlation between TP53 rs1625895 and the risk of sarcopenia and sarcopenic obesity was investigated by logistic regression.

Results

G allele was significantly higher in sarcopenic obesity group [P = 0.037, OR (CI 95%) = 1.9 (1.03–3.5)] compared to A allele. BMI (P = 0.049) and LDL (P = 0.04) were significantly differed between genotypes when GG was compared to AA/AG genotype. The results revealed when GG genotype compared to AA/AG genotype in adjusted model for age, the risk of sarcopenic obesity [P value = 0.011, OR (CI 95%); 2.72 (1.25–5.91)] increased. Similarly, GG/AG genotype increased the risk of sarcopenic obesity [P value = 0.028, OR (CI 95%); 2.43 (1.10–5.36)] in adjusted model for age compared to AA genotype.

Conclusions

We suggested that TP53 rs1625895 polymorphism may increase the risk of sarcopenic obesity in Iranian population.

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD), as an airway limitation condition, is accompanied by alteration of muscle mass and function. We aimed to determine the relationship between disease severity and body composition, muscle function, and nutritional status in COPD patients. Methods: This cross-sectional study was conducted on 129 COPD participants. Muscle strength, body composition, and calf circumference (CC) were measured using a hydraulic hand dynamometer, bioelectrical impedance analysis (BIA), and a tape measure, respectively. Furthermore, fat-free mass index (FFMI), body mass index (BMI) and muscle mass value were calculated by equations. Forced expiratory volume in one second (FEV1) was assessed as well. Nutritional status was also evaluated by subjective global assessment (SGA) questionnaire. SPSS software (version 21 ) was used, chi-square, fisher's exact test, univariate and multivariate linear regression models were used for statistical analysis. P-values less than 0.05 were considered significant. Results: Based on FEV1 classification, 52.7% of the patients had severe conditions. The reports indicated that the prevalence of low CC was 54.2%, low muscle mass 38.7%, low FFMI 34.8%, low right handgrip strength 61.2% and low left handgrip strength 64.3%. Furthermore, there was an increasing trend based on FEV1 in low CC (p=0.032), low muscle mass (p=0.005), low FFMI (p=0.002), low right handgrip strength (p=0.004) and low left handgrip strength (p=0.014). The results of univariate analysis showed muscle mass (p=0.036), total protein (p=0.043), FFM (p=0.047), FFMI (p=0.007), SGA (p=0.029), right handgrip strength (p=0.004) and left hand grip strength (p=0.023) were associated with FEV1. In addition, the results of multivariate analysis demonstrated low values of FFMI (p=0.005) and right handgrip strength (p=0.042) were the main detrimental factors for FEV1. The results of multivariate analysis were confirmed by stepwise model. Conclusion: Low values of muscle mass and function are prevalent among COPD patients. The present study revealed that low FFMI and handgrip strength were closely related to disease severity.

Potentially modifiable risk factors for slow gait in community-dwelling older adults: A systematic review

PURPOSE

Slow gait speed in older adults is associated with increased risk for falls and fractures, functional dependence, multimorbidity, and even mortality. The risk of these adverse outcomes can be reduced by intervening on potentially modifiable risk factors. The purpose of this systematic review was to identify potentially modifiable risk factors associated with slow gait speed and clinically meaningful gait speed decline in older community-dwelling adults.

METHODS

Literature searches were conducted in MEDLINE, EMBASE, and CINAHL, Google Scholar, and in the bibliographies of retrieved articles.

RESULTS

Forty studies met the inclusion criteria for qualitative review. Study designs were cross-sectional and longitudinal. Operational definitions of 'slow gait' and 'meaningful gait speed decline' were variable and based on sample distributions (e.g. quartiles), external criteria (e.g. < 0.8 m/s), and dynamic changes over time (e.g. ≥ 0.05 m/s decline per year). Twenty-six potentially modifiable risk factors were assessed in at least two studies. The risk factors most commonly investigated and that showed significant associations with slow gait and/or meaningful gait speed decline include physical activity, education, body mass index-obesity, pain, and depression/depressive symptoms.

CONCLUSION

Our results suggest that there are modifiable targets to maintain gait speed that are amenable to potential treatment.