1
|
de Sousa IM, Fayh APT, Gonzalez MC, Silva FM. Prevalence of low calf circumference in hospitalized patients classified by raw or body mass index-adjusted values. Nutr Clin Pract 2024; 39:611-618. [PMID: 38443160 DOI: 10.1002/ncp.11138] [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: 09/29/2023] [Revised: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Adiposity can influence the estimation of muscle mass using calf circumference (CC) and underestimate the frequency of low CC. An adjustment for CC using body mass index (BMI) was proposed to reduce this effect. We aimed to compare the low CC frequency in hospitalized patients when considering raw and BMI-adjusted values and explore data by sex, age, and race (white and non-white). METHODS Secondary analysis from two cohort studies conducted with adult hospitalized patients using BMI and CC data collected in the first 72 h after hospital admission. We classified low CC by two approaches: (1) raw CC; (2) BMI-adjusted CC for patients with BMI ≥ 25. Cutoff values for low CC were ≤34 cm (men) and ≤33 cm (women). RESULTS Among 1272 patients (54.1 ± 15.3 years old; 51.7% women; 82.1% White race), low CC frequency was 30.6% and low BMI-adjusted CC was 68.9%. For all elevated BMI categories, the low CC frequency was higher when considering BMI-adjusted values (P < 0.001). Low CC was more frequent (P < 0.001) in older adults (38.7% by raw; 79.1% by BMI-adjusted value) than in younger adults (27.6% by raw; 65.2% by BMI-adjusted value) and it was not associated with race. Low CC by raw values was more frequent in men than in women (35.0% versus 26.4%; P = 0.001), but did not differ between sexes when classified by BMI-adjusted values (70.7% versus 67.1%; P = 0.184). CONCLUSION Low CC BMI adjusted was 2.2 times more frequent in comparison with raw CC values, and it was identified in >60% of patients with BMI ≥ 25.
Collapse
Affiliation(s)
- Iasmin M de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Flávia M Silva
- Nutrition Science Postgraduation Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
2
|
Enge M, Peelen FO, Nielsen RL, Beck AM, Olin AÖ, Cederholm T, Boström AM, Paur I. Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study. Eur J Nutr 2024; 63:927-938. [PMID: 38240774 PMCID: PMC10948466 DOI: 10.1007/s00394-023-03323-5] [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: 08/28/2023] [Accepted: 12/29/2023] [Indexed: 03/19/2024]
Abstract
PURPOSE In 2019, the Global Leadership Initiative on Malnutrition (GLIM) suggested a 2-step diagnostic format for malnutrition including screening and diagnosis. Prospective validation and feasibility studies, using the complete set of the five GLIM criteria, are needed. The aims of this study were to determine the prevalence of malnutrition, and investigate how the prevalence varied with mode of screening. Furthermore, we assessed the feasibility of GLIM in geriatric patients. METHODS Consecutive patients from two acute geriatric wards were included. For screening risk of malnutrition, the Mini Nutritional Assessment-Short Form (MNA-SF) or Malnutrition Screening Tool (MST) were used. In accordance with GLIM, a combination of phenotypic and etiologic criteria were required for the diagnosis of malnutrition. Feasibility was determined based on % data completeness, and above 80% completeness was considered feasible. RESULTS One hundred patients (mean age 82 years, 58% women) were included. After screening with MNA-SF malnutrition was confirmed by GLIM in 51%, as compared with 35% after screening with MST (p = 0.039). Corresponding prevalence was 58% with no prior screening. Using hand grip strength as a supportive measure for reduced muscle mass, 69% of the patients were malnourished. Feasibility varied between 70 and 100% for the different GLIM criteria, with calf circumference as a proxy for reduced muscle mass having the lowest feasibility. CONCLUSION In acute geriatric patients, the prevalence of malnutrition according to GLIM varied depending on the screening tool used. In this setting, GLIM appears feasible, besides for the criterion of reduced muscle mass.
Collapse
Affiliation(s)
- Maria Enge
- Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden
| | - Frida Ostonen Peelen
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Rikke Lundsgaard Nielsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Anne Marie Beck
- Dietetic and Nutritional Research Unit EATEN, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Ann Ödlund Olin
- Department of Quality and Patient Safety, Karolinska University Hospital Stockholm, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Tommy Cederholm
- Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Huddinge, Sweden
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Stockholms Sjukhem, Research and Development Unit, Stockholm, Sweden
| | - Ingvild Paur
- Norwegian Advisory Unit On Disease-Related Undernutrition, Oslo, Norway.
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Nydalen, Postbox 4950, 0424, Oslo, Norway.
- Institute for Clinical Medicine, Clinical Nutrition Research Group, UiT the Arctic University of Norway, Tromsø, Norway.
| |
Collapse
|
3
|
Lee ST, Lim JP, Tan CN, Yeo A, Chew J, Lim WS. SARC-F and modified versions using arm and calf circumference: Diagnostic performance for sarcopenia screening and the impact of obesity. Geriatr Gerontol Int 2024; 24 Suppl 1:182-188. [PMID: 38095277 DOI: 10.1111/ggi.14758] [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: 09/01/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 03/27/2024]
Abstract
AIM SARC-F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid-arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC-F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC-F, SARC-CalF, SARC-F + MAC, and SARC-CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance. METHODS We studied 230 healthy non-frail community-dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC-F, SARC-CalF, SARC-F + MAC and SARC-CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non-obese groups. RESULTS The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC-CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67-0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC-CalF (AUC 0.70, 95% CI 0.62-0.78; sensitivity 21.0%; specificity 95.8%). SARC-F (AUC 0.57, 95% CI 0.49-0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non-obese groups for SARC-F + MAC (AUC 0.75, 95% CI 0.65-0.85 vs. 0.58, 95% CI 0.46-0.70) and SARC-CalF + MAC (AUC 0.75, 95% CI 0.66-0.85 vs. 0.70, 95% CI 0.59-0.81). CONCLUSIONS The addition of arm circumference to SARC-CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC-CalF for community screening of sarcopenia amongst healthy community-dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182-188.
Collapse
Affiliation(s)
- Shi-Teng Lee
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
| | - Jun-Pei Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Cai-Ning Tan
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Audrey Yeo
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Justin Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| |
Collapse
|
4
|
Maruyama M, Kagaya Y, Kajiwara S, Oikawa T, Horikawa M, Fujimoto M, Sasaki M. The Validity of Quadriceps Muscle Thickness as a Nutritional Risk Indicator in Patients with Stroke. Nutrients 2024; 16:540. [PMID: 38398864 PMCID: PMC10891856 DOI: 10.3390/nu16040540] [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: 12/18/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to investigate whether quadriceps muscle thickness (QMT) is useful for nutritional assessment in patients with stroke. This was a retrospective cohort study. Nutritional risk was assessed using the Geriatric Nutritional Risk Index (GNRI), with GNRI < 92 indicating a risk of malnutrition and GNRI ≥ 92 indicating normal conditions. Muscle mass was assessed using QMT and calf circumference (CC). The outcome was Functional Independence Measure (FIM) effectiveness. The cutoff values of QMT and CC for discriminating between high and low GNRI were determined using the receiver operating characteristic curve. The accuracy of the nutritional risk discrimination model was evaluated using the Matthews correlation coefficient (MCC). Multiple regression analysis was performed to assess the relationship between nutritional risk, as defined by QMT and CC, and FIM effectiveness. A total of 113 patients were included in the analysis. The cutoff values of QMT and CC for determining nutritional risk were 49.630 mm and 32.0 cm for men (MCC: 0.576; 0.553) and 41.185 mm and 31.0 cm for women (MCC: 0.611; 0.530). Multiple regression analysis showed that only nutritional risk defined by QMT was associated with FIM effectiveness. These findings indicate that QMT is valid for assessing nutritional risk in patients with stroke.
Collapse
Affiliation(s)
- Motoki Maruyama
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
- Department of Physical Therapy, Akita University Graduate School of Health Science, 1-1-1 Hondo, Akita 010-8543, Japan
- Department of Rehabilitation Medicine, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Yuki Kagaya
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Sota Kajiwara
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Takuto Oikawa
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
- Department of Physical Therapy, Akita University Graduate School of Health Science, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Manabu Horikawa
- Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| | - Mika Fujimoto
- Department of Nutrition, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan;
| | - Masahiro Sasaki
- Department of Rehabilitation Medicine, Akita Cerebrospinal and Cardiovascular Center, 6-10 Senshu-Kubota-Machi, Akita 010-0874, Japan
| |
Collapse
|
5
|
Kiss CM, Bertschi D, Beerli N, Berres M, Kressig RW, Fischer AM. Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients. Aging Clin Exp Res 2024; 36:25. [PMID: 38321234 PMCID: PMC10847205 DOI: 10.1007/s40520-024-02694-x] [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: 08/05/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. METHODS In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. RESULTS In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). CONCLUSION In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults.
Collapse
Affiliation(s)
- Caroline M Kiss
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Dominic Bertschi
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadine Beerli
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Institute of Nursing Science, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas M Fischer
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| |
Collapse
|
6
|
Hansen SS, Munk T, Knudsen AW, Beck AM. Concordance between changes in calf circumference and muscle mass exists: A narrative literature review. Clin Nutr ESPEN 2024; 59:171-175. [PMID: 38220372 DOI: 10.1016/j.clnesp.2023.11.026] [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: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024]
Abstract
Technological methods such as BIA or DXA are not always accessible in clinical practice, thus GLIM supports the use of calf circumference measurements to examine muscle mass. However, it has not been described if measurements of calf circumference can detect a change in muscle mass to the same degree as the technological methods. The aim of this study was to assess, whether changes in calf circumference can be used as a valid proxy for changes in muscle mass. 10 studies including measurements of muscle mass by calf circumference and technological methods at baseline and follow-up were identified through a narrative literature review. Results were used to determine concordance between measurements. Predominantly concordance between changes in calf circumference and muscle mass assessed by BIA or DXA was reviled. However, the results were not uniform for hospitalized patients or older adults as groups. Thus, uncertainty whether changes in calf circumference can be used as a valid proxy for changes in muscle mass in these groups still exist.
Collapse
Affiliation(s)
- Signe Skovgaard Hansen
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Tina Munk
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Anne Wilkens Knudsen
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| | - Anne Marie Beck
- The Unit for Dieticians and Nutrition Research, EATEN, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, Denmark.
| |
Collapse
|
7
|
Sato R, Sawaya Y, Ishizaka M, Yin L, Shiba T, Hirose T, Urano T. Neck circumference is a highly reliable anthropometric measure in older adults requiring long-term care. PeerJ 2024; 12:e16816. [PMID: 38313007 PMCID: PMC10838066 DOI: 10.7717/peerj.16816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
The reliability of neck circumference measurement as an assessment tool for older adults requiring long-term care remains unknown. This study aimed to evaluate the reliability of neck circumference measurement in older adults requiring long-term care, and the effect of edema on measurement error. Two physical therapists measured the neck circumference. Intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to examine the reliability of neck circumference measurement. Correlation analysis was used to evaluate the relationship between edema values (extracellular water/total body water) and neck circumference measurement difference. For inter-rater reliability of neck circumference measurement, the overall ICC (2,1) was 0.98. The upper and lower limits of the difference between examiners ranged from -0.9 to 1.2 cm. There was no association between edema values and neck circumference measurement error. Thus, measurement of the neck circumference in older adults requiring long-term care is a reliable assessment tool, with a low error rate, even in older adults with edema.
Collapse
Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
| |
Collapse
|
8
|
Sato K, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Uchida S, Ueno K, Yamashita M, Noda T, Ogura K, Miki T, Hotta K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure. J Cardiol 2023:S0914-5087(23)00305-2. [PMID: 38135146 DOI: 10.1016/j.jjcc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Diagnosing sarcopenia in heart failure (HF) patients is important, but how to assess skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients. METHODS We included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males). Sarcopenia was diagnosed using grip strength, usual gait speed, and skeletal muscle mass according to international criteria. We used mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MAMC), calf circumference (CC), and skeletal muscle mass index (SMI) assessed by bioelectrical impedance analysis to assess skeletal muscle mass and defined sarcopenia in each of these measurements. Prognostic outcomes were composite events (all-cause death and HF rehospitalization) and cardiovascular disease (CVD) events (CVD death and CVD rehospitalization). Quality of life (QOL) was assessed using the 36-item Short-Form Health Survey physical functioning (SF-36PF) score. RESULTS The sarcopenia defined by MUAC [hazard ratio (HR): 2.50; 95 % confidence interval (95 % CI): 1.64-3.81; p < 0.001] or MAMC (HR: 1.98; 95 % CI: 1.35-2.92; p = 0.001) were associated with higher composite event rates than the non-sarcopenia. The sarcopenia defined by MUAC (HR: 1.88; 95 % CI: 1.25-2.83; p = 0.002) or MAMC (HR: 1.70; 95 % CI: 1.16-2.49; p = 0.007) were associated with higher CVD event rates than the non-sarcopenia. The sarcopenia defined by CC or SMI were not associated with prognoses. The sarcopenia defined by MUAC, MAMC, or CC were associated with low SF-36PF scores (all p < 0.05). CONCLUSIONS These results suggest that a diagnosis of sarcopenia based on MUAC or MAMC rather than CC or SMI reflects prognosis and QOL in older HF patients.
Collapse
Affiliation(s)
- Kaoru Sato
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Shota Uchida
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kensuke Ueno
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Division of Research, ARCE Inc., Sagamihara, Kanagawa, Japan
| | - Takumi Noda
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Ken Ogura
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Takashi Miki
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Kazuki Hotta
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| |
Collapse
|
9
|
Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Yin L, Urano T. Association between decreased neck circumference and impaired activities of daily living among older adults in long-term care. Geriatr Gerontol Int 2023; 23:906-911. [PMID: 37861100 DOI: 10.1111/ggi.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
AIM Assessment interventions for the decline of activities of daily living (ADLs) in older adults are crucial, as ADL decline increases hospitalization duration and mortality risk. Decreased neck circumference may result in various physical dysfunctions, including malnutrition. However, the association between neck circumference and ADLs has not been fully clarified. This study aimed to determine the association between decreased neck circumference and ADLs in older adults requiring long-term care. METHODS The study included 152 older adults deemed to require support or care under Japan's long-term care insurance system. Neck circumference was measured just below the thyroid cartilage with a measuring tape. The Barthel index was used to evaluate ADLs, and skeletal muscle mass and nutritional status were assessed by bioelectrical impedance analysis instruments. A multivariate analysis was conducted to investigate the association between neck circumference and ADLs. RESULTS Neck circumference demonstrated a significant inverse correlation with age and a significant positive correlation with body mass index, skeletal muscle mass index, phase angle, and Barthel index. In the multivariate analysis, ADLs was significantly associated with neck circumference (odds ratio [OR] = 0.51, P = 0.002) and phase angle (OR = 0.04, P < 0.001). CONCLUSIONS Neck circumference is associated with age, skeletal muscle mass, and nutritional status. Furthermore, a decrease in neck circumference is suggested as an independent risk factor for ADL decline in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23: 906-911.
Collapse
Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| |
Collapse
|
10
|
Hu Y, Zhang C, Zou C, Yang H, Chen Y, Liang T. Anthropometric measures and physical examination could be used to assess phenotypic GLIM (Global leadership initiative on malnutrition) criteria in heart failure patients. Nutr Metab Cardiovasc Dis 2023; 33:2419-2427. [PMID: 37788948 DOI: 10.1016/j.numecd.2023.07.034] [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: 03/13/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS The assessment of muscle mass using technology-based methods is less commonly performed when applying the Global Leadership Initiative on Malnutrition (GLIM) criteria due to the lack of skilled clinical nutrition practitioners and/or equipment. Based on the predictive validity of poor health outcomes and feasibility in clinical practice, this study aimed to analyze whether the measurement of calf circumference (CC), mid-upper arm circumference (MAC), and the physical examination could be used as substitutes for muscle mass assessment, as well as handgrip strength (HGS) used as a substitution when applying the GLIM criteria in hospitalized HF patients. METHODS AND RESULTS From June 2022 to January 2023, a single-center prospective study including 216 patients was performed. Additionally, covariates were identified by a directed acyclic graph. The multivariate logistic regression analysis was also used to analyze and compare the association between poor health outcomes and malnutrition (based on 5 types of GLIM criteria). Cohen-kappa coefficient and TELOS-feasibility score were calculated. The prevalence of malnutrition ranged from 35.2% to 42.6%, depending on the tool used. After adjusting for covariates, malnutrition assessed using CC, MAC, or physical examination within the GLIM criteria was independently associated with poor clinical outcomes (90-day HF-related readmission or all-cause mortality and prolonged hospital stay) but not with HGS. CONCLUSION CC, MAC and results from physical examination but not HGS may serve as a substitutive metric of muscle mass contained in the GLIM criteria to diagnose malnutrition and predict poor clinical outcomes among HF patients. REGISTRATION NUMBER This study was registered at Chinese Clinical Trial Registry. (ChiCTR2200057876) on 20 Mar. 2022.
Collapse
Affiliation(s)
- Yule Hu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Chen Zhang
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Changhong Zou
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Haojie Yang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Yingdi Chen
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Tao Liang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China.
| |
Collapse
|
11
|
Nakanishi N, Inoue S, Ono Y, Sugiyama J, Takayama K, Arai Y, Nakamura K, Oto J, Kotani J. Ultrasound-based upper limb muscle thickness is useful for screening low muscularity during intensive care unit admission: A retrospective study. Clin Nutr ESPEN 2023; 57:569-574. [PMID: 37739707 DOI: 10.1016/j.clnesp.2023.07.089] [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: 06/05/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Malnutrition is associated with poor outcomes. Muscle mass is an important malnutrition indicator included in Global Leadership Initiative on Malnutrition (GLIM) criteria. Although bioelectrical impedance analysis and dual-energy X-ray absorptiometry are common muscle mass assessment methods, they are unreliable during intensive care unit (ICU) admission due to the influence of dynamic fluid changes. We hypothesized that ultrasound-based upper limb muscle assessment would be useful for assessing muscularity at ICU admission. METHODS We retrospectively analyzed prospectively obtained ultrasound data from patients admitted to an ICU. We excluded patients without computed tomography (CT) imaging of the third lumbar vertebra within 2 days of ICU admission. Primary outcomes were the diagnostic utility of ultrasound-based upper limb muscle thickness for assessing low muscularity by CT. Low muscularity was defined as a skeletal muscle index of 36.0 cm2/m2 for males and 29.0 cm2/m2 for females at the cross-sectional area of the third lumbar vertebrae. Secondary outcomes of this study included the relationships between upper limb muscle thickness and biceps brachii muscle cross-sectional area, quadriceps femoris thickness, rectus femoris cross-sectional area. RESULTS Among 64 patients assessed by ultrasound, 52 had CT examination records and were included in the analysis. The mean age was 70 ± 13 years, and the mean body mass index was 23.3 ± 4.2 kg/m2. Upper limb muscle thickness had the discriminative power to assess low muscularity at an area under the curve of 0.77 (95% CI [confidence interval], 0.63-0.91); the cutoff value (26.8 cm) had 84.6% sensitivity and 66.7% specificity. The upper limb muscle index had the discriminative power to assess low muscularity at an area under the curve of 0.80 (95% CI, 0.68-0.93); the cutoff value (9.9 mm/m2) had 76.9% sensitivity and 71.8% specificity. Upper limb muscle thickness was correlated with upper limb muscle cross-sectional area, quadriceps femoris muscle thickness, rectus femoris muscle cross-sectional area (r = 0.39-0.76, p < 0.01, n = 52). CONCLUSIONS Ultrasound-based upper limb muscle thickness assessments can screen for low muscularity upon ICU admission.
Collapse
Affiliation(s)
- Nobuto Nakanishi
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan.
| | - Shigeaki Inoue
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Yuko Ono
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Jun Sugiyama
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Kazushi Takayama
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Yuta Arai
- Department of Radiology, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Kensuke Nakamura
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Jun Oto
- Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Joji Kotani
- Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| |
Collapse
|
12
|
Ren SS, Zhang KW, Chen BW, Yang C, Xiao R, Li PG, Zhu MW. Machine Learning-Based Prediction of Complications and Prolonged Hospitalization with the GLIM Criteria Combinations Containing Calf Circumference in Elderly Asian Patients. Nutrients 2023; 15:4146. [PMID: 37836430 PMCID: PMC10574169 DOI: 10.3390/nu15194146] [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: 08/29/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND AND AIMS Malnutrition is widely present and influences the prognosis of elderly inpatients, so it is helpful to be able to identify it with a convenient method. However, in the widely accepted criteria for malnutrition, the Global Leadership Initiative on Malnutrition (GLIM), a lot of metrics can be used to define the phenotypic and etiological criteria. To identify muscle mass reduction, anthropometric parameters such as calf circumference (CC) and hand grip strength (HGS) are preferable to other expensive methods in many situations because they are easy and inexpensive to measure, but their applicability needs to be verified in specific clinical scenarios. This study aims to verify the value of CC- and HGS-identified muscle loss in diagnosing malnutrition and predicting in-hospital complications (IHC) and prolonged length of hospital stay (PLOS) in elderly inpatients using machine learning methods. METHODS A sample of 7122 elderly inpatients who were enrolled in a previous multicenter cohort study in China were screened for eligibility for the current study and were then retrospectively diagnosed for malnutrition using 33 GLIM criteria that differ in their combinations of phenotypic and etiological criteria, in which CC or CC+HGS were used to identify muscle mass reduction. The diagnostic consistency with the subjective global assessment (SGA) criteria at admission was evaluated according to Kappa coefficients. The association and the predictive value of the GLIM-defined malnutrition with 30-day IHC and PLOS were evaluated with logistic regression and randomized forest models. RESULTS In total, 2526 inpatients (average age 74.63 ± 7.12 years) were enrolled in the current study. The prevalence of malnutrition identified by the 33 criteria combinations ranged from 3.3% to 27.2%. The main IHCs was infectious complications (2.5%). The Kappa coefficients ranged from 0.130 to 0.866. Logistic regression revealed that malnutrition was identified by 31 GLIM criteria combinations that were significantly associated with 30-day IHC, and 22 were significantly associated with PLOS. Random forest prediction revealed that GLIM 15 (unconscious weight loss + muscle mass reduction, combined with disease burden/inflammation) performs best in predicting IHC; GLIM 30 (unconscious weight loss + muscle mass reduction + BMI reduction, combined with disease burden/inflammation) performs best in predicting PLOS. Importantly, CC alone performs better than CC+HGS in the criteria combinations for predicting adverse clinical outcomes. CONCLUSION Muscle mass reduction defined by a reduced CC performs well in the GLIM criteria combinations for diagnosing malnutrition and predicting IHC and PLOS in elderly Asian inpatients. The applicability of other anthropometric parameters in these applications needs to be further explored.
Collapse
Affiliation(s)
- Shan-Shan Ren
- Department of Clinical Nutrition, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China;
- The Key Laboratory of Geriatrics, National Center of Gerontology, National Health Commission, Beijing Hospital, Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Kai-Wen Zhang
- School of Public Health, Capital Medical University, Beijing 100069, China; (K.-W.Z.); (C.Y.)
- Beijing Key Laboratory of Environmental Toxicology, Beijing 100069, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Bo-Wen Chen
- Sir Run Run Shaw Hospital, Hangzhou 310016, China;
| | - Chun Yang
- School of Public Health, Capital Medical University, Beijing 100069, China; (K.-W.Z.); (C.Y.)
- Beijing Key Laboratory of Environmental Toxicology, Beijing 100069, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Rong Xiao
- School of Public Health, Capital Medical University, Beijing 100069, China; (K.-W.Z.); (C.Y.)
- Beijing Key Laboratory of Environmental Toxicology, Beijing 100069, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Peng-Gao Li
- School of Public Health, Capital Medical University, Beijing 100069, China; (K.-W.Z.); (C.Y.)
- Beijing Key Laboratory of Environmental Toxicology, Beijing 100069, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Ming-Wei Zhu
- Department of Clinical Nutrition, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China;
- The Key Laboratory of Geriatrics, National Center of Gerontology, National Health Commission, Beijing Hospital, Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| |
Collapse
|
13
|
Kandinata SG, Widajanti N, Ichwani J, Firdausi H, Aryana IGPS, Alkaff FF. Diagnostic performance of calf circumference, SARC-F, and SARC-CalF for possible sarcopenia screening in Indonesia. Sci Rep 2023; 13:9824. [PMID: 37330539 PMCID: PMC10276820 DOI: 10.1038/s41598-023-36585-4] [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: 02/26/2023] [Accepted: 06/06/2023] [Indexed: 06/19/2023] Open
Abstract
Asian working group for sarcopenia (AWGS) recently introduced "possible sarcopenia" diagnosis for early identification of sarcopenia in the primary healthcare. For initial screening, 3 modalities, i.e. calf circumference (CC) measurement, strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire, and a combination of both (SARC-CalF), are recommended. However, no validation study has been done until now. Therefore, this study aims to evaluate the diagnostic performance of the recommended screening modalities using data from Indonesia. This cross-sectional study included subjects aged ≥ 60 years old who visited primary healthcare in Surabaya, Indonesia. The diagnosis of possible sarcopenia was confirmed with hand-grip strength and repeated chair stand test. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance. Among 266 subjects, 186 (70%) were diagnosed with possible sarcopenia. Using the recommended cut-off, the area under the curve, sensitivity, and specificity were 0.511, 48.39% and 53.75% for CC, 0.543, 8.60% and 100% for SARC-F, and 0.572, 19.35% and 95% for SACRC-CalF. Our findings indicate that the diagnostic performance of the recommended screening modalities is poor. Multicenter studies from different areas in Indonesia should be done to confirm these findings.
Collapse
Affiliation(s)
| | - Novira Widajanti
- Division of Geriatrics, Department of Internal Medicine, Dr. Soetomo General Academic Hospital - Faculty of Medicine Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No 6-8, Surabaya, Indonesia.
| | - Jusri Ichwani
- Division of Geriatrics, Department of Internal Medicine, Dr. Soetomo General Academic Hospital - Faculty of Medicine Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No 6-8, Surabaya, Indonesia
| | - Hadiq Firdausi
- Division of Geriatrics, Department of Internal Medicine, Dr. Soetomo General Academic Hospital - Faculty of Medicine Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No 6-8, Surabaya, Indonesia
| | - I G P S Aryana
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Udayana, Sanglah Teaching Hospital, Bali, Indonesia
| | - Firas F Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No 47, Surabaya, Indonesia.
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
| |
Collapse
|
14
|
Silva MZC, Cederholm T, Gonzalez MC, Lindholm B, Avesani CM. GLIM in chronic kidney disease: What do we need to know? Clin Nutr 2023; 42:937-943. [PMID: 37099985 DOI: 10.1016/j.clnu.2023.04.019] [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: 01/30/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Abstract
The lack of consensus on diagnostic criteria for malnutrition has hampered developments in research and clinical practice pertaining to nutrition. This opinion paper describes the applicability and other aspects of using the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnutrition in patients with chronic kidney disease (CKD). We examine the purpose of GLIM, the particularities of CKD that can affect the nutritional and metabolic status and the diagnosis of malnutrition. In addition, we make an appraisal of previous studies that used GLIM in the context of CKD and discuss the value and relevance of using the GLIM criteria in patients with CKD.
Collapse
Affiliation(s)
- Maryanne Zilli Canedo Silva
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil.
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
| | | | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden.
| | - Carla Maria Avesani
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden.
| |
Collapse
|
15
|
Hishikawa N, Sawada K, Shono S, Sakurai M, Yokozeki M, Maeda H, Ohashi S, Ueshima K, Mikami Y. Accurate diagnosis of sarcopenia without using a body composition analyzer in a convalescent rehabilitation ward. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2023; 14:26-32. [PMID: 37859793 PMCID: PMC10585011 DOI: 10.11336/jjcrs.14.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 10/21/2023]
Abstract
Hishikawa N, Sawada K, Shono S, Sakurai M, Yokozeki M, Maeda H, Ohashi S, Ueshima K, Mikami Y. Accurate diagnosis of sarcopenia without using a body composition analyzer in a convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2023; 14: 26-32. Objective The Asian Working Group for Sarcopenia 2019 recommends diagnosing sarcopenia without using a body composition analyzer and initiating treatment early. The present study aimed to investigate the accuracy of diagnosing sarcopenia without a body composition analyzer in a convalescent rehabilitation ward. Methods Eighty-five patients admitted to a convalescent rehabilitation ward were included, and sarcopenia diagnoses were performed with and without a body composition analyzer. To assess the accuracy of diagnosing sarcopenia without using a body composition analyzer, sensitivity, specificity, positive predictive value, and negative predictive value were calculated relative to sarcopenia diagnoses made using a body composition analyzer. Results The sensitivity of the technique for diagnosing sarcopenia was 0.94, specificity was 0.77, positive predictive value was 0.86, and negative predictive value was 0.90. Conclusion The accuracy of diagnosing sarcopenia without using a body composition analyzer was high. However, this technique may miss sarcopenia cases in patients with increased calf circumference due to adipose tissue and/or edema.
Collapse
Affiliation(s)
- Norikazu Hishikawa
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koshiro Sawada
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Development of Multidisciplinary Promote for Physical Activity, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sawa Shono
- Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Momoko Sakurai
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Megumi Yokozeki
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Rehabilitation Unit, University Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Maeda
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Suzuyo Ohashi
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Rehabilitation Unit, University Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiichiro Ueshima
- Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Yasuo Mikami
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Rehabilitation Unit, University Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
16
|
Wang X, Ying Y, Pei M, Ma X, Sun Y, Wang Y, Li N. Calf circumference change and all-cause mortality among community-dwelling Chinese older people. Clin Nutr 2023; 42:277-281. [PMID: 36724725 DOI: 10.1016/j.clnu.2023.01.002] [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: 09/10/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Previous studies have described an association between single time point calf circumference (CC) and mortality. Evidence of associations between CC change and mortality is lacking. We aimed to determine the relationship between the CC change over time and all-cause mortality. METHODS We conducted a retrospective cohort study of 906 participants in the 2014-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Restricted cubic splines were used to analyze associations between the relative CC change (exposure) and all-cause mortality (primary outcome). When there was evidence of non-linearity, a piecewise Cox regression model was next fitted, adjusting for sociodemographic characteristics, health behaviours, health status and baseline CC. RESULTS The mean (SD) age was 83.8 (12.2) years old, and 50.2% (455/906) of participants were male. We observed a U-shaped association between the relative CC change (%) and all-cause mortality (P for non-linearity <0.001). Participants with stable CC over time had the lowest risk of death. After adjusting for covariates, when CC decreased over time, the hazard ratio per 10% higher in CC change was 1.32 (1.01-1.69). When CC increased over time, the hazard ratio per 10% higher in CC change was 1.35 (1.10-1.66). CONCLUSION Stable CC over time was associated with the lowest mortality risk. Our findings indicate the practical significance of monitoring CC change in older adult.
Collapse
Affiliation(s)
- Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Youyou Ying
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Minyue Pei
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Xinjie Ma
- The Third Clinical Medical College, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Yuehao Sun
- The Third Clinical Medical College, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Yupeng Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| |
Collapse
|
17
|
Rodrigues RG, Dalboni MA, Correia MDA, Dos Reis LM, Moyses RMA, Elias RM. Calf Circumference Predicts Falls in Older Adults on Hemodialysis. J Ren Nutr 2023; 33:363-367. [PMID: 36155086 DOI: 10.1053/j.jrn.2022.08.003] [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: 02/15/2022] [Revised: 07/06/2022] [Accepted: 08/21/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Older patients with chronic kidney disease (CKD) undergoing maintenance hemodialysis are at a higher risk of falling. However, there is no standard method to screen patients at higher risk. We have evaluated whether calf circumference (CC) measurement would be able to predict falls in this population. METHODS This is a prospective study that enrolled patients aged ≥65 years on conventional hemodialysis, followed for 6 months. The presence of falls was associated with demographical, clinical, and biochemical data. Reduced CC was set at <34 cm for men and <33 cm for women. We evaluated physical status using Duke activity status index (DASI) and hand grip strength (HGS). RESULTS Ninety-one patients were included (age 73.7 ± 5.4 years, 69.2% men, 56% with diabetes). Mean CC was 32.6 ± 3.7 cm, with a high prevalence of reduced CC (61.5%). During the follow-up, 13 falls were identified (1 had a fracture and died). These patients were older and heavier (P = .017 and P = .025, respectively). Most falls occurred in patients with sarcopenic obesity (BMI >27 kg/m2 plus reduced HGS or reduced CC). In a logistic regression model, reduced CC (hazard ratio (HR) 7.81, confidence interval (CI): 1.13-53.86, P = .037), higher age (HR 1.19, CI: 1.04-1.36, P = .011), and higher body weight (relative risk (RR) 1.13, CI: 1.04-1.22, P = .003) were independently associated with falls in a fully adjusted model. CONCLUSION CC measurement, an easy and nonexpensive tool, was able to predict falls in older patients on HD. Further studies should test the inclusion of CC in a fall risk assessment in older patients on hemodialysis.
Collapse
Affiliation(s)
| | | | | | - Luciene M Dos Reis
- LIM-16, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Brazil
| | - Rosa M A Moyses
- LIM-16, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Brazil
| | - Rosilene M Elias
- Post Graduation, Universidade Nove de Julho (UNINOVE), Brazil; LIM-16, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Brazil.
| |
Collapse
|
18
|
Abe T, Yoshimura Y, Sato Y, Nagano F, Matsumoto A. Validity of sarcopenia diagnosis defined by calf circumference for muscle mass to predict functional outcome in patients with acute stroke. Arch Gerontol Geriatr 2023; 105:104854. [PMID: 36370655 DOI: 10.1016/j.archger.2022.104854] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined the association between sarcopenia diagnosed by defining muscle mass with calf circumference and physical function at hospital discharge in patients with acute stroke and to perform a comparison with sarcopenia diagnosis according to the Asian Working Group for Sarcopenia. RESEARCH METHODS & PROCEDURES This retrospective cohort study included patients with acute stroke. We calculated the calf circumference cut-off value defining low skeletal muscle index for the Asian Working Group for Sarcopenia diagnostic criteria and used a combination of low calf circumference and low grip strength to define sarcopenia-calf circumference. A combination of low skeletal muscle index and low grip strength defined sarcopenia-Asian Working Group for Sarcopenia. Associations between sarcopenia-calf circumference, sarcopenia-Asian Working Group for Sarcopenia, and Functional Independence Measure motor score were evaluated using multiple regression analysis. RESULTS The study included 308 patients (198 men; mean age, 73.2 years). Sarcopenia-calf circumference prevalence was 24.7% in men and 46.4% in women. In men, sarcopenia-calf circumference (β=-0.178; 95% CI: -0.284, -0.073; p=0.001) and sarcopenia-Asian Working Group for Sarcopenia (β=-0.228; 95% CI: -0.330, -0.127; p<0.001) were significantly associated with Functional Independence Measure motor score at discharge. CONCLUSIONS Sarcopenia diagnosed by defining muscle mass with calf circumference was negatively associated with physical function at discharge in male patients with acute stroke. Sarcopenia diagnosed using Asian Working Group for Sarcopenia criteria was superior to sarcopenia-calf circumference for predicting physical function at discharge. Our findings suggest that the use of CC enables assessment of sarcopenia even at facilities where muscle mass measurements may be difficult.
Collapse
Affiliation(s)
- Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, 4132, Urasa, Minamiuonuma City, Niigata, 949-7302, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo Town, Kikuchi County, Kumamoto, 869-1106, Japan.
| | - Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, 4132, Urasa, Minamiuonuma City, Niigata, 949-7302, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo Town, Kikuchi County, Kumamoto, 869-1106, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo Town, Kikuchi County, Kumamoto, 869-1106, Japan
| |
Collapse
|
19
|
Sousa IM, Fayh APT, Lima J, Gonzalez MC, Prado CM, Silva FM. Low calf circumference adjusted for body mass index is associated with prolonged hospital stay. Am J Clin Nutr 2023; 117:402-407. [PMID: 36863830 DOI: 10.1016/j.ajcnut.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/07/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Calf circumference (CC) is of emerging importance because of its practicality, high correlation with skeletal muscle, and potential predictive value for adverse outcomes. However, the accuracy of CC is influenced by adiposity. CC adjusted for BMI (BMI-adjusted CC) has been proposed to counteract this problem. However, its accuracy to predict outcomes is unknown. OBJECTIVES To evaluate the predictive validity of BMI-adjusted CC in hospital settings. METHODS A secondary analysis of a prospective cohort study in hospitalized adult patients was conducted. The CC was adjusted for BMI by reducing 3, 7, or 12 cm for BMI (in kg/m2) of 25-29.9, 30-39.9, and ≥40, respectively. Low CC was defined as ≤34 cm for males and ≤33 cm for females. Primary outcomes included length of hospital stay (LOS) and in-hospital death, and secondary outcomes were hospital readmissions and mortality within 6 mo after discharge. RESULTS We included 554 patients (55.2 ± 14.9 y, 52.9% men). Among them, 25.3% presented with low CC, whereas 60.6% had BMI-adjusted low CC. In-hospital death occurred in 13 patients (2.3%), and median LOS was 10.0 (5.0-18.0) d. Within 6 mo from discharge, 43 patients (8.2%) died, and 178 (34.0%) were readmitted to the hospital. BMI-adjusted low CC was an independent predictor of LOS ≥ 10 d (odds ratio = 1.70; 95% confidence interval: 1.18, 2.43], but it was not associated with the other outcomes. CONCLUSIONS BMI-adjusted low CC was identified in more than 60% of hospitalized patients and was an independent predictor of longer LOS.
Collapse
Affiliation(s)
- Iasmin M Sousa
- Graduate Program in Nutrition and Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Graduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana Paula T Fayh
- Graduate Program in Nutrition and Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Graduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Júlia Lima
- Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Cristina Gonzalez
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Rio Grande do Sul, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Flávia M Silva
- Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Department of Nutrition, Nutrition Science Graduate Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| |
Collapse
|
20
|
Ueshima J, Maeda K, Shimizu A, Nagano A, Ishida Y, Takeuchi T, Nonogaki T, Matsuyama R, Yamanaka Y, Murotani K, Mori N. Cachexia staging score predicts survival in patients with cancer who receive palliative care. Nutrition 2023; 106:111880. [PMID: 36436335 DOI: 10.1016/j.nut.2022.111880] [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: 07/17/2022] [Revised: 09/20/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to validate the cachexia staging score (CSS), a multidimensional, item-based diagnostic method of cachexia severity, for patients with advanced cancer receiving palliative care. METHODS Eligible patients were those with cancer who received palliative care during hospitalization between May 2019 and April 2020. All data were collected retrospectively from medical records. Cachexia was graded into four levels according to the CSS. Kaplan-Meier curves were constructed with or without death as the outcome, comparing prognoses among different levels of cachexia with Bonferroni correction. Cox proportional hazards regression analysis was performed to identify factors affecting mortality. RESULTS The mean age of the 196 patients was 65.8 ± 14 y. Men made up 42% of the study population. Lower body mass index, increased rate of weight loss, increased strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) points, decline in activities of daily living, appetite loss, and abnormal blood biomarkers were significantly more common with increasing severity of cachexia, and survival was shorter (P < 0.001). The hazard ratio (HR) increased with worsening severity of cachexia according to CSS classification (precachexia: HR, 2.78; 95% confidence interval [CI], 0.62-12.46, P = 0.182; cachexia: HR, 4.77; 95% CI, 1.09-20.80; P = 0.038; and refractory cachexia: HR, 11.00; 95% CI, 2.37-51.07; P = 0.002). CONCLUSIONS The CSS predicted life expectancy in a population of patients receiving palliative care and had excellent prognostic discriminative power to classify patients at different stages of cachexia.
Collapse
Affiliation(s)
- Junko Ueshima
- Department of Nutrition Service, NTT Medical Center Tokyo, Tokyo, Japan; Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan
| | - Keisuke Maeda
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Akio Shimizu
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan; Department of Health Science, Faculty of Health and Human Development, University of Nagano, Nagano, Japan
| | - Ayano Nagano
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan; Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo, Japan
| | - Yuria Ishida
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan; Department of Nutrition, Aichi Medical University Hospital, Aichi, Japan
| | - Tomoko Takeuchi
- Department of Nutrition, Aichi Medical University Hospital, Aichi, Japan
| | - Tomoyuki Nonogaki
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan; Department of Pharmacy, Aichi Medical University Hospital, Aichi, Japan
| | - Remi Matsuyama
- Department of Dentistry and Oral Surgery, Aichi Medical University, Aichi, Japan
| | - Yosuke Yamanaka
- Department of Dentistry and Oral Surgery, Aichi Medical University, Aichi, Japan
| | | | - Naoharu Mori
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan
| |
Collapse
|
21
|
Prado CM, Ford KL, Gonzalez MC, Murnane LC, Gillis C, Wischmeyer PE, Morrison CA, Lobo DN. Nascent to novel methods to evaluate malnutrition and frailty in the surgical patient. JPEN J Parenter Enteral Nutr 2023; 47 Suppl 1:S54-S68. [PMID: 36468288 PMCID: PMC9905223 DOI: 10.1002/jpen.2420] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 12/11/2022]
Abstract
Preoperative nutrition status is an important determinant of surgical outcomes, yet malnutrition assessment is not integrated into all surgical pathways. Given its importance and the high prevalence of malnutrition in patients undergoing surgical procedures, preoperative nutrition screening, assessment, and intervention are needed to improve postoperative outcomes. This narrative review discusses novel methods to assess malnutrition and frailty in the surgical patient. The Global Leadership Initiative for Malnutrition (GLIM) criteria are increasingly used in surgical settings although further spread and implementation are strongly encouraged to help standardize the diagnosis of malnutrition. The use of body composition (ie, reduced muscle mass) as a phenotypic criterion in GLIM may lead to a greater number of patients identified as having malnutrition, which may otherwise be undetected if screened by other diagnostic tools. Skeletal muscle loss is a defining criterion of malnutrition and frailty. Novel direct and indirect approaches to assess muscle mass in clinical settings may facilitate the identification of patients with or at risk for malnutrition. Selected imaging techniques have the additional advantage of identifying myosteatosis (an independent predictor of morbidity and mortality for surgical patients). Feasible pathways for screening and assessing frailty exist and may determine the cost/benefit of surgery, long-term independence and productivity, and the value of undertaking targeted interventions. Finally, the evaluation of nutrition risk and status is essential to predict and mitigate surgical outcomes. Nascent to novel approaches are the future of objectively identifying patients at perioperative nutrition risk and guiding therapy toward optimal perioperative standards of care.
Collapse
Affiliation(s)
- Carla M. Prado
- Department of Agricultural, Food & Nutritional ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - Katherine L. Ford
- Department of Agricultural, Food & Nutritional ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - M. Cristina Gonzalez
- Postgraduate Program in Health and BehaviorCatholic University of PelotasPelotasBrazil
| | - Lisa C. Murnane
- School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
- Department of Nutrition and DieteticsAlfred HealthMelbourneVictoriaAustralia
| | - Chelsia Gillis
- School of Human NutritionMcGill UniversityMontrealQuebecCanada
| | - Paul E. Wischmeyer
- Departments of Anesthesiology and SurgeryDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Chet A. Morrison
- Department of SurgeryCentral Michigan UniversitySaginawMichiganUSA
| | - Dileep N. Lobo
- Gastrointestinal SurgeryNottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical CentreNottinghamUK
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life SciencesUniversity of Nottingham, Queen's Medical CentreNottinghamUK
| |
Collapse
|
22
|
Tung HT, Chen KM, Chou CP, Belcastro F, Hsu HF, Kuo CF. Acupunch Exercise Improved Muscle Mass, Hand Grip Strength, and Sleep Quality of Institutional Older Adults with Probable Sarcopenia. J Appl Gerontol 2022; 42:888-897. [PMID: 36448359 DOI: 10.1177/07334648221141413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
This study tested the effectiveness of a 6-month vitality acupunch (VA) exercise program on muscle mass, hand grip strength, and sleep quality in institutional older adults with probable sarcopenia. A cluster randomized controlled trial was conducted. A total of 103 older adults were assigned to the experimental group ( n = 52) and control group ( n = 51) according to the institution they inhabited. After the 6-month VA exercise intervention, the experimental group showed significant increases in muscle mass ( F = 5.93, p = .017), hand grip strength ( F = 56.73, p < .001), and improved sleep quality ( F = 23.20, p < .001) compared to the control group. Based on the meridian theory that promotes qi and blood circulation, VA exercise has positive effects on muscle mass, hand grip strength, and sleep quality in older adults with probable sarcopenia.
Collapse
Affiliation(s)
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Pei Chou
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, Iowa, USA
| | - Hui-Fen Hsu
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chuan-Feng Kuo
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
23
|
Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Assessing nutritional status in older adults requiring long-term care: Interchangeability of bioelectrical impedance analysis and manual methods for upper arm anthropometric measurements. Geriatr Gerontol Int 2022; 22:938-942. [PMID: 36151781 DOI: 10.1111/ggi.14486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022]
Abstract
AIM In older adults, arm circumference and arm muscle circumference are common nutritional assessment tools. Bioelectrical impedance analysis devices can automatically measure arm circumference and arm muscle circumference. However, the interchangeability of the measurements made by bioelectrical impedance analysis with the actual manual measurements has not been clarified. This study examined the interchangeability of these two measurements and their relationship with sarcopenia. METHODS The interchangeability between bioelectrical impedance analysis and manual arm circumference and arm muscle circumference measurements was calculated using Bland-Altman analysis in 112 older adults certified to require long-term care in the Japanese system. Furthermore, multivariate analysis was used to investigate the association between arm circumference and arm muscle circumference obtained using the bioelectrical impedance analysis method and sarcopenia. RESULTS The bioelectrical impedance analysis and manual methods were interchangeable, with a percentage error of <15% (arm circumference 13.54% and arm muscle circumference 13.54%) for the upper arm anthropometric measurement. In multivariate analysis, decreased arm muscle circumference was significantly associated with sarcopenia risk. CONCLUSIONS Values obtained using the bioelectrical impedance analysis method were interchangeable with the values obtained using manual measurement. This shows that upper arm anthropometric measurement using bioelectrical impedance analysis might be useful as a nutritional assessment tool for older adults requiring long-term care. Geriatr Gerontol Int 2022; ••: ••-••.
Collapse
Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| |
Collapse
|
24
|
Katano S, Honma S, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Ohori K, Kouzu H, Hashimoto A, Katayose M, Yano T. Anthropometric parameters-derived estimation of muscle mass predicts all-cause mortality in heart failure patients. ESC Heart Fail 2022; 9:4358-4365. [PMID: 36065759 PMCID: PMC9773643 DOI: 10.1002/ehf2.14121] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/23/2022] [Accepted: 08/15/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS Reduction in appendicular skeletal muscle mass index (ASMI) assessed by dual-energy X-ray absorptiometry (DEXA) has been shown to be independently associated with a higher mortality rate in patients with heart failure (HF). However, DEXA is not suitable for measurement of muscle mass in a daily clinical setting and in large population-based studies. The aim of this study was to determine whether ASMI predicted from anthropometric indicators (predicted ASMI) serves as an alternative to DEXA-measured ASMI for predicting all-cause death in HF patients. METHODS AND RESULTS Data for 539 HF patients who received a DEXA scan and measurements of calf circumferences (CC) and mid-arm circumferences (MAC) in our hospital were analysed. Predicted ASMI was calculated as we previously reported: predicted ASMI (kg/m2 ) = [0.214 × weight (kg) + 0.217 × CC (cm) - 0.189 × MAC (cm) + 1.098 (male = 1, female = -1) + 0.576]/height2 (m2 ). Low ASMI values were defined as <7.00 kg/m2 and <5.40 kg/m2 for men and women, respectively, according to the criteria of the Asian Working Group for Sarcopenia. The median follow-up period was 1.75 years (interquartile range, 0.96-2.37 years), and 79 patients (15%) died. Kaplan-Meier survival curves showed that patients with low DEXA-measured ASMI and patients with low predicted ASMI had significantly lower survival rates than those for patients with high ASMI. In multivariate Cox proportional hazard analyses adjusted for age, sex, logarithmic B-type natriuretic peptide, cystatin C based-estimated glomerular filtration rate, and gait speed, DEXA-measured ASMI [hazard ratio (HR), 0.982; 95% confidence interval (CI), 0.967-0.998; P = 0.026] and predicted ASMI (HR, 0.979; 95% CI, 0.962-0.996; P = 0.018) were independent predictors of all-cause mortality. Inclusion of predicted ASMI into the adjustment model significantly improved continuous net reclassification improvement (0.338; 95% CI, 0.103-0.572; P < 0.01) and integrated discrimination improvement (0.020; 95% CI, 0.004-0.035; P < 0.05) for predicting mortality after discharge. CONCLUSIONS Predicted ASMI, as well as DEXA-measured ASMI, can predict all-cause death in HF patients, and calculation of predicted ASMI will be useful for detecting high-risk patients in a daily clinical setting and in large population-based studies.
Collapse
Affiliation(s)
- Satoshi Katano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Suguru Honma
- Department of RehabilitationSapporo Cardiovascular HospitalSapporoJapan
| | - Ryohei Nagaoka
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Ryo Numazawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Kotaro Yamano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Yusuke Fujisawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Department of CardiologyHokkaido Cardiovascular HospitalSapporoJapan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Division of Health Care Administration and ManagementSapporo Medical University School of MedicineSapporoJapan
| | - Masaki Katayose
- Second Division of Physical TherapySapporo Medical University School of Health SciencesSapporoJapan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| |
Collapse
|
25
|
Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
|
26
|
Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Neck circumference may predict sarcopenia in Japanese older adults requiring long-term care. Geriatr Nurs 2022; 47:159-163. [PMID: 35914493 DOI: 10.1016/j.gerinurse.2022.07.005] [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: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
Several studies have established the advantage of using anthropometric measurements as indicators of sarcopenia. Nevertheless, no study has explored the association between sarcopenia and neck circumference. In this cross-sectional study, we examined the data of 90 older adults requiring long-term care to evaluate this association and establish cut-off points for individuals at risk of sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) 2019. A significant association was found between sarcopenia and neck circumference using binomial logistic regression and receiver operating characteristic analyses. The optimal cut-off value for neck circumference associated with increased risk for sarcopenia among older adults was 32.8 cm for females and 38.0 cm for males. Given the potential of declining neck circumference as an anthropometric marker of sarcopenia, it has clinical applications in screening for sarcopenia in older adults requiring long-term care.
Collapse
Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
| |
Collapse
|
27
|
Camargo Pereira C, Pagotto V, de Oliveira C, Silveira EA. Low muscle mass and mortality risk later in life: A 10-year follow-up study. PLoS One 2022; 17:e0271579. [PMID: 35901119 PMCID: PMC9333286 DOI: 10.1371/journal.pone.0271579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/05/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Little is known about the impact of low muscle mass (MM) assessed by calf circumference (CC), arm circumference (AC), arm muscle circumference (AMC), and corrected arm muscle circumference (CAMC)—on mortality risk later in life. We aimed to investigate the impact of low MM assessed by CC, AC, AMC and, CAMC on all-cause, cardiovascular, and cancer mortality risk. Methods Data came from 418 older adults who participated in a 10-year follow-up prospective cohort study. Low MM was defined as a CC < 33 cm for women and < 34 cm for men and by the lowest tertile of AC, AMC, and CAMC stratified by sex. The log rank test, Kaplan-Meier curves, and Cox regression were used. Results There were 147 deaths: 49 related to CVD and 22 to cancer. A small CC (HR = 1.57, 95% CI, 1.12–2.20), AMC (HR = 1.61, 95% CI, 1.13–2.30) and CAMC (HR = 1.45, 95% CI, 1.03–2.04) were associated with all-cause mortality. A small CAMC was a protective factor for CVD mortality (HR = 0.46, 95% CI, 0.22–0.98). In the Kaplan-Meier analysis, older adults with LMM presented low all-cause mortality survival, with AC (p < 0.05), AMC (p < 0.005), CAMC (p < 0.002), and CC (p < 0.001). Cancer mortality was associated with low CAMC (p < 0.020). Conclusions Low MM assessed by anthropometric measures (AC, AMC, CAMC and CC) increased the all-cause mortality risk. A small CAMC decreased the CVD mortality.
Collapse
Affiliation(s)
- Cristina Camargo Pereira
- Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil
| | - Valéria Pagotto
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Goiania, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
- * E-mail:
| |
Collapse
|
28
|
da Silva RP, Martinez D, Uribe Ramos JM, Martins EF, Tedesco-Silva LM, Lopez P, Cadore EL. TheHE effectsEFFECTS ofOF resistanceRESISTANCE exerciseEXERCISE onON obstructiveOBSTRUCTIVE sleepSLEEP apneaAPNEA severitySEVERITY andAND bodyBODY waterWATER contentCONTENT inIN olderOLDER adultsADULTS: A randomizedRANDOMIZED controlledCONTROLLED trialTRIAL. Sleep Med 2022; 95:37-46. [DOI: 10.1016/j.sleep.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 11/15/2022]
|
29
|
Mortality and Length of Stay in Critically Ill Patients With Low Muscle Mass. TOP CLIN NUTR 2022. [DOI: 10.1097/tin.0000000000000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
30
|
Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr 2022; 41:990-1000. [DOI: 10.1016/j.clnu.2021.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 02/08/2023]
|
31
|
Correia MIT, Tappenden KA, Malone A, Prado CM, Evans DC, Sauer AC, Hegazi R, Gramlich L. Utilization and validation of the Global Leadership Initiative on Malnutrition (GLIM): A scoping review. Clin Nutr 2022; 41:687-697. [DOI: 10.1016/j.clnu.2022.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/05/2022] [Accepted: 01/20/2022] [Indexed: 12/27/2022]
|
32
|
Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts 2022; 15:321-335. [PMID: 35196654 PMCID: PMC9210010 DOI: 10.1159/000521241] [Citation(s) in RCA: 173] [Impact Index Per Article: 86.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. AIMS AND METHODS The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. CONCLUSIONS ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition.
Collapse
Affiliation(s)
| | | | | | | | | | - John A. Batsis
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yves Boirie
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Dror Dicker
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Stefano Frara
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | - Gema Frühbeck
- Clínica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | | | | | - Andrea Giustina
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | | | - Ho-Seong Han
- Seoul National University Bundang Hospital (SNUBH), Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | | - Yves Rolland
- Gerontopole of Toulouse, INSERM 1027, Toulouse University Hospital, Toulouse, France
| | | | | | - Hanping Shi
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Cornel C. Sieber
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Mario Siervo
- University of Nottingham, Nottingham, United Kingdom
| | | | | | - Dorothee Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Jianchun Yu
- Peking Union Medical College Hospital, Beijing, China
| | | | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- **Rocco Barazzoni,
| |
Collapse
|
33
|
Katano S, Yano T, Ohori K, Nagano N, Honma S, Shimomura K, Ishigo T, Watanabe A, Honma R, Fujito T, Koyama M, Kouzu H, Hashimoto A, Katayose M, Miura T. Novel prediction equation for appendicular skeletal muscle mass estimation in patients with heart failure: Potential application in daily clinical practice. Eur J Prev Cardiol 2021; 28:e18-e21. [DOI: 10.1177/2047487320904236] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Suguru Honma
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Kanako Shimomura
- Division of Rehabilitation, Sapporo Medical University Hospital, Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital, Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital, Japan
| | - Remi Honma
- Division of Nursing, Sapporo Medical University Hospital, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan
| |
Collapse
|
34
|
de Sousa IM, Silva FM, de Carvalho ALM, da Rocha IMG, Fayh APT. Accuracy of isolated nutrition indicators in diagnosing malnutrition and their prognostic value to predict death in patients with gastric and colorectal cancer: A prospective study. JPEN J Parenter Enteral Nutr 2021; 46:508-516. [PMID: 34036614 DOI: 10.1002/jpen.2199] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The study aims to evaluate the accuracy of isolated nutrition indicators in diagnosing malnutrition in patients with gastric and colorectal cancer and their association with mortality. METHODS Prospective cohort study involving patients with cancer (n = 178) attending a reference center of oncology at any point in the disease trajectory or treatment. Nutrition status was evaluated in a unique moment by body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength (HGS), and calf circumference (CC). Kappa coefficient, accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) were calculated for each nutrition indicator (PG-SGA as the reference method). The Cox proportional hazards model was used to assess hazard ratio (HR) and CI of mortality. RESULTS From the total patients, 11% were underweight, 48% were malnourished (PG-SGA B or C), 43% had low HGS, and 55% presented low CC. There were 46 deaths (25.8%). BMI, HGS, and CC showed poor and fair agreements (κ < 0.30 for all ) and poor accuracy (AUC < 0.70 for all) in identifying malnutrition by PG-SGA. After the adjustment for confounders (age, treatment performed, site, and stage of cancer), PG-SGA (HR, 2.9; 95% CI, 1.5-5.9) and low CC (HR, 2.4; 95% CI, 1.1-5.2) were independent predictors of mortality. CONCLUSION The nutrition indicators are not accurate in diagnosing malnutrition, whereas PG-SGA and low CC could predict mortality in gastric and colorectal cancer patients. Thus, CC should be combined with PG-SGA in nutrition assessments.
Collapse
Affiliation(s)
- Iasmin Matias de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Health Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Flávia Moraes Silva
- Nutrition Department and Postgraduate Program in Nutrition Science, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Ana Lucia Miranda de Carvalho
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Health Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ilanna Marques Gomes da Rocha
- Postgraduate Program in Health Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Gastroenterology, University of São Paulo, São Paulo, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Health Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
35
|
Nagae M, Umegaki H, Yoshiko A, Fujita K, Komiya H, Watanabe K, Yamada Y, Kuzuya M. Echo intensity is more useful in predicting hospital-associated complications than conventional sarcopenia-related parameters in acute hospitalized older patients. Exp Gerontol 2021; 150:111397. [PMID: 33965558 DOI: 10.1016/j.exger.2021.111397] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/22/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hospital-associated complications are associated with adverse outcomes after discharge, and a method to help predict the occurrence of these complications needs to be established. Sarcopenia is thought to be one of the factors associated with hospital-associated complication, but sarcopenia assessment in hospitalized patients is often difficult. Focus has recently been placed on morphological and qualitative evaluation of muscle by ultrasound as an index of sarcopenia. Therefore, in this study, we sought to clarify the association of hospital-associated complication with muscle thickness or echo intensity measured by ultrasound and with commonly used sarcopenia-related parameters. METHODS This is a prospective observational cohort study with 156 hospitalized older patients recruited over a year. Bilateral thigh muscle thickness of rectus femoris and vastus intermedius, echo intensity and corrected echo intensity of rectus femoris were measured by ultrasound. Also measured were the sarcopenia-related parameters of handgrip strength, skeletal muscle index, and maximum calf circumference. Hospital-associated complication was defined as the occurrence of any of the following complications: delirium, functional decline, incontinence, falls, pressure injuries, and nosocomial infections. RESULTS Of 156 patients enrolled at admission, hospital-associated complication was observed in 70 (54.3%). With-hospital-associated complication group had a higher prevalence of emergency admission and a higher corrected echo intensity than without-hospital-associated complication group. Multivariate logistic regression analysis showed that only higher corrected echo intensity was associated with hospital-associated complication (odds ratio 1.036; 95% confidence interval, 1.001-1.072), while handgrip strength, bilateral thigh muscle thickness, skeletal muscle index, and maximum calf circumference were not. CONCLUSIONS Corrected echo intensity might be a useful parameter to help predict hospital-associated complication in acute hospitalized older patients and might contribute to establishing a strategy to prevent hospital-associated complication.
Collapse
Affiliation(s)
- Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.
| | - Akito Yoshiko
- School of International Liberal Studies, Chukyo University, Aichi, Japan
| | - Kosuke Fujita
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| |
Collapse
|
36
|
Miyazaki S, Hayashino S, Matsumoto I, Kurozumi M, Namba T, Takagi Y, Kunikata J, Minamino T. Mid-arm muscle circumference as an indicator of exercise tolerance in chronic heart failure. Geriatr Gerontol Int 2021; 21:411-415. [PMID: 33821564 DOI: 10.1111/ggi.14154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/18/2021] [Accepted: 03/09/2021] [Indexed: 01/07/2023]
Abstract
AIM Skeletal muscle mass is associated with exercise tolerance in patients with chronic heart failure (CHF). Anthropometric indicators are used to evaluate skeletal muscle mass, as these can be easily assessed in clinical practice. However, the association between anthropometric indicators and exercise tolerance is unclear. This study aimed to investigate the association between anthropometric indicators and exercise tolerance in CHF patients. METHODS We evaluated 69 patients with CHF. Mid-arm circumference, mid-arm muscle circumference (MAMC), calf circumference and body mass index were measured as the anthropometric indicators. Exercise tolerance was evaluated according to the peak oxygen uptake (VO2 ). Correlation analyses were carried out to determine the association between peak VO2 and anthropometric indicators. Furthermore, univariate and multiple regression analyses were carried out using peak VO2 as the dependent variable, and age, male, left ventricular ejection fraction, angiotensin II receptor blocker or angiotensin converting enzyme inhibitor, diuretics, B-type natriuretic peptide, estimated glomerular filtration rate, hemoglobin and anthropometric indicators as the independent variables. RESULTS There were significant positive correlations between the peak VO2 and mid-arm circumference (rs = 0.378, P = 0.001), MAMC (r = 0.634, P < 0.001) and calf circumference (r = 0.292, P = 0.015). In multiple regression analysis, MAMC (β = 0.721, P < 0.001) and estimated glomerular filtration rate (β = 0.279, P = 0.007) were independent factors associated with peak VO2 . CONCLUSIONS MAMC is independently associated with peak VO2 in CHF patients. Thus, MAMC could be an indicator of exercise tolerance, which is closely related to the severity and prognosis of CHF. Geriatr Gerontol Int 2021; 21: 411-415.
Collapse
Affiliation(s)
- Shinjiro Miyazaki
- Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu, Japan.,Graduate School of Medicine, Kagawa University, Kita-gun, Japan
| | | | - Ichiro Matsumoto
- Department of Cardiology, KKR Takamatsu Hospital, Takamatsu, Japan
| | - Mizuki Kurozumi
- Department of Cardiology, KKR Takamatsu Hospital, Takamatsu, Japan
| | - Tsunetatsu Namba
- Department of Cardiology, KKR Takamatsu Hospital, Takamatsu, Japan
| | - Yuichiro Takagi
- Department of Cardiology, KKR Takamatsu Hospital, Takamatsu, Japan
| | - Jun Kunikata
- Clinical Research Support Center, Kagawa University Hospital, Kita-gun, Japan
| | - Tetsuo Minamino
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| |
Collapse
|
37
|
Ito A, Ishizaka M, Kobayashi K, Sawaya Y, Hara T, Nagasaka Y, Yakabi A, Watanabe M, Kubo A. Changes in the screening efficacy of lower calf circumference, SARC-F score, and SARC-CalF score following update from AWGS 2014 to 2019 sarcopenia diagnostic criteria in community-dwelling older adults. J Phys Ther Sci 2021; 33:241-245. [PMID: 33814711 PMCID: PMC8012190 DOI: 10.1589/jpts.33.241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022] Open
Abstract
[Purpose] To identify changes in the efficacy of the Asia Working Group for Sarcopenia
(AWGS) screening tools and the differences between the different screening tools following
the updates from the AWGS 2014 to 2019 criteria for community-dwelling older adults.
[Participants and Methods] We included 139 community-dwelling older adults aged ≥65 years.
We assessed the lower calf circumference, SARC-F score, SARC-CalF score, skeletal muscle
mass, grip strength, and gait speed. Moreover, we investigated the sensitivity,
specificity, likelihood ratios, and area under the ROC curve of the lower calf
circumference, SARC-F score, and SARC-CalF score using the AWGS 2014 and 2019 criteria for
sarcopenia diagnosis. [Results] The prevalences of sarcopenia were 10.8% and 12.9%, and
5.0% using the AWGS 2014 and 2019, and 2019 severe sarcopenia diagnostic criteria,
respectively. Using AWGS 2014 criteria, the sensitivity and specificity of lower calf
circumference, SARC-F score, and SARC-CalF score, were 86.7% and 62.1%, 13.3% and 91.9%,
and 66.7% and 80.6%, respectively. Using AWGS 2019 criteria, the sensitivity and
specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 83.3% and
62.8%, 11.1% and 91.7%, and 66.7% and 81.8%, respectively. Using AWGS 2019 severe
sarcopenia criteria, the sensitivity and specificity of lower calf circumference, SARC-F
score, and SARC-CalF score were 100% and 59.8%, 14.3% and 91.7%, and 71.4% and 78.0%,
respectively. [Conclusion] All screening tools used in AWGS 2014 and 2019 were similar in
terms of efficacy; however, the AWGS 2019 severe sarcopenia criteria had different
characteristics.
Collapse
Affiliation(s)
- Akihiro Ito
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Yoshihisa Nagasaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan
| |
Collapse
|
38
|
Kinoshita H, Kobayashi M, Kajii Y, Satonaka A, Suzuki N. Calf circumference positively correlates with calf muscle thickness and negatively correlates with calf subcutaneous fat thickness and percent body fat in non-obese healthy young adults. J Sports Med Phys Fitness 2021; 62:343-349. [PMID: 33687177 DOI: 10.23736/s0022-4707.21.12152-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Calf circumference is measured for assessing sarcopenia, nutrition status, percent body fat or obesity. However, there has been no study that investigated the relationship between calf circumference and calf subcutaneous fat tissue thickness. Therefore, the purpose of this study was to investigate the relationship between calf circumference, calf muscle thickness, and calf subcutaneous fat tissue thickness in nonobese healthy young adults. METHODS The study participants were non-obese 22 women (20.1 ± 0.8 years) and 21 men (20.0 ± 0.8 years). The right calf circumference was measured in prone position at the point where the circumference was maximal by visual recognition using a measuring tape. Then, thickness of calf subcutaneous fat tissue and calf muscles were measured with an ultrasonic diagnostic equipment. RESULTS There was a positive relationship between calf circumference and calf muscle thickness both in women (r = 0.58, P < 0.01) and men (r = 0.46, P < 0.05), negative relathionship between calf circumference and calf subcutaneous fat tissue thickness both in women (r = -0.43, P < 0.05) and men (r = -0.67, P < 0.001), no correlation between calf circumference and percent body fat both in women (r = 0.04, P = 0.87) and men (r = 0.41, P = 0.06), and a negative relationship between calf subcutaneous fat tissue thickness and percent body fat both in women (r = -0.48, P < 0.05) and men (r = -0.46, P < 0.05). CONCLUSIONS Our present study showed that a larger calf indicated larger calf muscle thickness, and largely different from previous studies, a lower calf subcutaneous fat tissue thickness. That is because when the calf circumference increases, calf subcutaneous fat tissue thickness should be thinner to keep the percent body fat equal in non-obese healthy young adults. The finding will help to get a better understanding of the nature of the calf.
Collapse
Affiliation(s)
- Hina Kinoshita
- Department of Physical Therapy, General Aoyama Hospital, Toyokawa, Japan
| | - Mayu Kobayashi
- Department of Physical Therapy, Ichinomiya Onsen Hospital, Huehuki, Japan
| | - Yuta Kajii
- Heimat Okazaki Long-Term Care Facility, Okazakikai Medical Corporation, Hamamatsu, Japan
| | - Ayako Satonaka
- Department of Physical Therapy, Biwako Professional University of Rehabilitation, Higashiomi, Japan.,Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Department of Physical Therapy, Tokoha University, Hamamatsu, Japan
| | - Nobuharu Suzuki
- Department of Physical Therapy, Tokoha University, Hamamatsu, Japan -
| |
Collapse
|
39
|
Association of Lower Nutritional Status and Education Level with the Severity of Depression Symptoms in Older Adults-A Cross Sectional Survey. Nutrients 2021; 13:nu13020515. [PMID: 33557348 PMCID: PMC7914802 DOI: 10.3390/nu13020515] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022] Open
Abstract
The study analyzes the relationship between nutritional status and depression symptoms severity in the older population. A total of 1975 older outpatients (1457 women and 518 men, median age 75) were included in the study. Depression symptoms severity was assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to GDS score. Group A: 0–5 points—without depression symptoms (1237, W:898, M:339), and group B: 6–15 points—with depression symptoms (738, W:559, M:179). The nutritional status of the patients was assessed with Mini Nutritional Assessment (MNA) and basic anthropometric variables (waist, hips, calf circumferences, body mass index (BMI), waist to hip ratio (WHR), and waist to height ratio (WHtR)). Education years and chronic diseases were also noted. Women with higher depression symptoms severity had significantly lower MNA scores [A: 26.5 (24–28) (median (25%−75% quartiles)) vs. B:23 (20.5–26)], shorter education time [A:12 (8–16) vs. B:7 (7–12)], smaller calf circumference [A:36 (33–38) vs. B: 34 (32–37)], and higher WHtR score [A:57.4 (52.3–62.9) vs. B:58.8 (52.1–65.6)]. Men with depression symptoms had lower MNA scores [A:26.5 (24.5–28) vs. B:24 (20.5–26.5)], shorter education [A:12 (9.5–16), B:10 (7–12)], and smaller calf circumference [A:37 (34–39), B:36 (33–38)]. In the model of stepwise multiple regression including age, years of education, anthropometric variables, MNA and concomitant diseases nutritional assessment, and education years were the only independent variables predicting severity of depression symptoms both in women and men. Additionally, in the female group, odds were higher with higher WHtR. Results obtained in the study indicate a strong relationship between proper nutritional status and education level with depression symptoms severity in older women and men.
Collapse
|
40
|
Inoue T, Maeda K, Shimizu A, Nagano A, Ueshima J, Sato K, Murotani K. Calf circumference value for sarcopenia screening among older adults with stroke. Arch Gerontol Geriatr 2020; 93:104290. [PMID: 33171328 DOI: 10.1016/j.archger.2020.104290] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke. MATERIALS AND METHODS This cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values. RESULTS We enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia. CONCLUSIONS The AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke.
Collapse
Affiliation(s)
- Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, 950-3198, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wagokita, Naka-ku, Hamamatsu, Shizuoka, 433-8127, Japan
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo, 663-8211, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Keisuke Sato
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, 6-2-1, Matsumoto, Okinawa, Okinawa, 904-2151, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Asahi Machi, 67, Kurume, Fukuoka, 830-0011, Japan
| |
Collapse
|
41
|
Ueshima J, Maeda K, Murotani K, Shimizu A, Nagano A, Sato K, Ishida Y, Mori N, Suenaga M. Estimating appendicular muscle mass in older adults with consideration on paralysis. Geriatr Gerontol Int 2020; 20:1145-1150. [PMID: 33037756 DOI: 10.1111/ggi.14056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/05/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to develop appendicular skeletal muscle mass (ASM) estimating formulas that also consider the presence of paralysis for older adults and people with disabilities. METHODS This retrospective study analyzed 315 consecutive patients, post-stroke, aged ≥65 years, in a rehabilitation hospital. Six different ASM estimating formulas were developed using a five-fold cross-validation method and compared with the measured ASM obtained from bioelectrical impedance analysis. These formulas included age, gender, height, weight, arm circumference, triceps skinfold, calf circumference and presence of paralysis. Using Pearson's correlation coefficients (r) and intraclass correlation coefficient (ICC), we examined the correlation between the formulas and the measured ASM. The accuracy of the ASM estimating formula for detecting decreased muscle mass was evaluated using the F-value and Matthew's correlation coefficient. RESULTS Patients' mean ± SD age was 79.0 ± 8.1 years, and 51.4% of them were men. The mean ± SD bioelectrical impedance analysis-measured ASM was 13.7 ± 4.3 kg. Furthermore, 241 (76.5%) patients had decreased measured ASM. The mean adjusted R2 of the developed six formulas was 0.861-0.871. In all formulas, the r and ICC of the estimated ASM for the measured ASM were strong (r = 0.936-0.930 and ICC = 0.928-0.934). These formulas revealed excellent sensitivity (86.0-88.2%), specificity (72.5-81.1%), accuracy (0.838-0.870), F-value (0.899-0.918) and Matthew's correlation coefficient (0.509-0.612) for measured ASM depletion. CONCLUSIONS We successfully developed ASM estimating formulas using anthropometric measurements considering the presence of paralysis. Thus, these formulas are beneficial for diagnosing sarcopenia in older adults, without requiring any special equipment. Geriatr Gerontol Int 2020; 20: 1145-1150.
Collapse
Affiliation(s)
- Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Shinagawa-ku, Japan.,Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Keisuke Maeda
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan.,Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Akio Shimizu
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan.,Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Keisuke Sato
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, Okinawa, Japan
| | - Yuria Ishida
- Department of Nutrition, Aichi Medical University Hospital, Nagakute, Japan
| | - Naoharu Mori
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Masaki Suenaga
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, Okinawa, Japan
| |
Collapse
|
42
|
Abe K, Yano T, Katano S, Ohori K, Ishigo T, Kouzu H, Moniwa N, Miura T. Reply to the comments on “Utility of the sarcopenia index for assessment of muscle mass and nutritional status in patients with chronic heart failure: Comparison with anthropometric parameters”. Geriatr Gerontol Int 2020; 20:998-999. [DOI: 10.1111/ggi.14001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Koki Abe
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of Nephrology Teine‐Keijinkai Hospital Sapporo Japan
| | - Toshiyuki Yano
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Satoshi Katano
- Division of Rehabilitation Sapporo Medical University Hospital Sapporo Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of Cardiology Hokkaido Cardiovascular Hospital Sapporo Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy Sapporo Medical University Hospital Sapporo Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Norihito Moniwa
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Tetsuji Miura
- Department of Cardiovascular Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| |
Collapse
|
43
|
Kawakami R, Miyachi M, Sawada SS, Torii S, Midorikawa T, Tanisawa K, Ito T, Usui C, Ishii K, Suzuki K, Sakamoto S, Higuchi M, Muraoka I, Oka K. Cut-offs for calf circumference as a screening tool for low muscle mass: WASEDA'S Health Study. Geriatr Gerontol Int 2020; 20:943-950. [PMID: 32886830 PMCID: PMC7590124 DOI: 10.1111/ggi.14025] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/29/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
Aim To re‐evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual‐energy X‐ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. Methods In total, 1239 adults participated in this cross‐sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. Results Calf circumference was positively correlated with BIA‐measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA‐measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2. The optimal calf circumference cut‐offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. Conclusions Calf circumference is positively correlated with BIA‐ and DXA‐measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943–950.
Collapse
Affiliation(s)
- Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Taishi Midorikawa
- College of Health and Welfare, J. F. Oberlin University, Tokyo, Japan
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoko Ito
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chiyoko Usui
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| |
Collapse
|
44
|
Yuguchi S, Asahi R, Kamo T, Azami M, Ogihara H. Gastrocnemius thickness by ultrasonography indicates the low skeletal muscle mass in Japanese elderly people. Arch Gerontol Geriatr 2020; 90:104093. [PMID: 32526562 DOI: 10.1016/j.archger.2020.104093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/14/2020] [Accepted: 05/02/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND This study aimed to examine the relationship between gastrocnemius thickness by ultrasonography and the skeletal muscle mass in Japanese elderly people. METHODS The total of 195 healthy Japanese aged ≥65 years participated (average age, 72.4 ± 4.3y; male, n = 72). The skeletal muscle mass index (SMI) was measured using the bioelectrical impedance analysis (BIA) and the gastrocnemius thickness and collected echo intensity (CEI) were measured using ultrasonography. The low SMI was defined as <7.0 kg/m2 in men and <5.7 kg/m2 in women, and participants were classified into the low SMI and the normal group. Association of the gastrocnemius thickness with the low SMI was analyzed by the logistic regression analysis after adjusting age, gender, body mass index (BMI), physical performances and CEI. The cut-off value of gastrocnemius thickness to indicate the low SMI was calculated by a receiver operating characteristic curve analysis. RESULTS The low SMI rate was 16.9% (n = 33). BMI was significantly lower (19.9 vs 22.5 kg/m2; p < 0.01), the gastrocnemius thickness lower (11.0 vs 13.3 mm; p < 0.01), and CEI higher (97.5 vs 87.0; p = 0.02) in the low SMI group than those in the normal group. The gastrocnemius thickness was independently associated with the low SMI (OR, 0.584; 95% CI, 0.416-0.818; p < 0.01). The cut-off value of gastrocnemius thickness was <11.6 mm (AUC, 0.83; sensitivity, 0.83; specificity, 0.73; p < 0.01). CONCLUSION Gastrocnemius thickness by ultrasonography was associated with low skeletal muscle mass, and the cut-off value to indicate the low skeletal muscle mass was revealed.
Collapse
Affiliation(s)
- Satoshi Yuguchi
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Japan.
| | - Ryoma Asahi
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Japan
| | - Tomohiko Kamo
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Japan
| | - Masato Azami
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Japan
| | - Hirofumi Ogihara
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, Japan
| |
Collapse
|
45
|
Krzymińska-Siemaszko R, Deskur-Śmielecka E, Kaluźniak-Szymanowska A, Lewandowicz M, Wieczorowska-Tobis K. Comparison of Diagnostic Performance of SARC-F and Its Two Modified Versions (SARC-CalF and SARC-F+EBM) in Community-Dwelling Older Adults from Poland. Clin Interv Aging 2020; 15:583-594. [PMID: 32425513 PMCID: PMC7196242 DOI: 10.2147/cia.s250508] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/28/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Older adults should be routinely screened for sarcopenia, which threatens healthy, independent aging. The most popular screening tool is the SARC-F questionnaire. As its sensitivity is unsatisfactory, two modified versions of the questionnaire have been published: SARC-CalF (including calf circumference as an additional item) and SARC-F+EBM (assessing additionally age and Body Mass Index). The diagnostic performance of the three versions of the questionnaire has not been compared. The analysis aimed to assess the diagnostic value of SARC-F, SARC-CalF, and SARC-F+EBM questionnaires, and to compare their psychometric properties against two reference standards of sarcopenia diagnosis, ie, EWGSOP1 and modified EWGSOP2 criteria. MATERIALS AND METHODS We performed the sensitivity/specificity analysis and compared the overall diagnostic accuracy of SARC-F, SARC-CalF (31cm) (cut-off point 31 cm for both genders), SARC-CalF (33/34cm) (cut-off points: 33 cm for women and 34 cm for men), and SARC-F+EBM in 115 community-dwelling volunteers aged ≥ 65 yrs from Poland. RESULTS Depending on the version of the SARC-F questionnaire used, from 10.4% [SARC-CalF (31cm)] to 33.0% (SARC-F+EBM) were identified as having an increased risk of sarcopenia. Sarcopenia was identified in 17.4% by the EWGSOP1 criteria and in 13.9% by the modified EWGSOP2 criteria. With respect to the two reference standards used, the sensitivity of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm), and SARC-F+EBM ranged 30.0-37.5%, 35.0-37.5%, 60.0-62.5%, 55.0% (the same value for both reference standards), respectively. The specificity ranged 85.3-85.9%, 93.9-94.7%, 88.4-86.9%, 70.7-71.6%, respectively. The AUC of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm) and SARC-F+EBM ranged 0.644-0.693, 0.737-0.783, 0.767-0.804, 0.714-0.715, respectively. CONCLUSION The modified versions of SARC-F have better diagnostic performance as compared to the original questionnaire. Since an ideal screening tool should have reasonably high sensitivity and specificity, and an AUC value above 0.7, the SARC-CalF (33/34cm) seems to be the best screening tool for sarcopenia in community-dwelling older adults.
Collapse
Affiliation(s)
| | - Ewa Deskur-Śmielecka
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Marta Lewandowicz
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | |
Collapse
|
46
|
Abe K, Yano T, Katano S, Ohori K, Ishigo T, Moniwa N, Miura T. Utility of the sarcopenia index for assessment of muscle mass and nutritional status in patients with chronic heart failure: Comparison with anthropometric parameters. Geriatr Gerontol Int 2020; 20:388-389. [DOI: 10.1111/ggi.13876] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/16/2019] [Accepted: 01/09/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Koki Abe
- Department of CardiovascularRenal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of NephrologyTeine‐Keijinkai Hospital Sapporo Japan
| | - Toshiyuki Yano
- Department of CardiovascularRenal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Satoshi Katano
- Division of RehabilitationSapporo Medical University Hospital Sapporo Japan
| | - Katsuhiko Ohori
- Department of CardiovascularRenal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of CardiologyHokkaido Cardiovascular Hospital Sapporo Japan
| | - Tomoyuki Ishigo
- Division of Hospital PharmacySapporo Medical University Hospital Sapporo Japan
| | - Norihito Moniwa
- Department of CardiovascularRenal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Tetsuji Miura
- Department of CardiovascularRenal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| |
Collapse
|
47
|
Ishida Y, Maeda K, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Mori N. Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults. Nutrients 2020; 12:nu12020541. [PMID: 32093144 PMCID: PMC7071417 DOI: 10.3390/nu12020541] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
Malnutrition leads to poor prognoses, including a predisposition to falls. Few studies have investigated the relationship between malnutrition and falls during hospitalization. This study aimed to determine malnutrition’s association with falls during hospitalization. A retrospective observational study was conducted. Patients aged ≥65 years that were admitted to and discharged from a university hospital between April 2018 and March 2019 were examined. Patients with independent basic activities of daily living were included. Diagnosis of malnutrition was based on the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria at admission. Disease information such as the Charlson Comorbidity Index (CCI) and reasons for hospitalization were reviewed. Kaplan–Meier curve and multivariate Cox regression analyses were performed. Data from 6081 patients (mean age: 74.4 ± 6.1 years; males: 58.1%) were analyzed. The mean CCI was 2.3 ± 2.8 points. Malnutrition was detected in 668 (11.0%) and falls occurred in 55 (0.9%) patients. Malnourished patients experienced a higher fall rate than those without malnutrition (2.4% vs. 0.7%, log-rank test p < 0.001). In multivariate analysis, malnutrition had the highest hazard ratio for falls among covariates (hazard ratio 2.78, 95% confidence interval 1.51–5.00, p = 0.001). In conclusion, malnutrition at the time of admission to hospital predicts in-hospital falls.
Collapse
Affiliation(s)
- Yuria Ishida
- Department of Nutrition, Aichi Medical University Hospital, Nagakute 480-1195, Japan;
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Correspondence: ; Tel.: +81-561-62-3311; Fax: +81-561-78-6364
| | - Tomoyuki Nonogaki
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8511, Japan;
| | - Yosuke Yamanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Ryoko Kato
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| |
Collapse
|
48
|
Ishida Y, Maeda K, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Ueshima J, Murotani K, Mori N. SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. J Nutr Health Aging 2020; 24:1053-1060. [PMID: 33244560 DOI: 10.1007/s12603-020-1462-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECT The SARC-F questionnaire is a sarcopenia screening tool. However, the validity of the SARC-F score ≥4 (SARC-F≥4) for the evaluation of sarcopenia in the hospital setting has not been investigated. This study investigated the validity of SARC-F≥4 as a screening tool for sarcopenia among hospitalized older adults. DESIGN Cross-sectional retrospective study. SETTING A university hospital. PARTICIPANTS This study included older adult patients (age ≥65 years) who were hospitalized at, and subsequently discharged from, the hospital between April and September 2019 and underwent a nutritional assessment by the nutrition support team during their hospitalization. MEASUREMENTS SARC-F was recorded at the time of admission, and the criteria specified by the Asia Working Group for Sarcopenia in 2019 (AWGS 2019) were applied to diagnose sarcopenia and possible sarcopenia. Appendicular muscle mass was estimated through validated equations, and three different models were developed for sarcopenia diagnosis. The sensitivity, specificity, and positive/negative likelihood ratios were calculated to analyze the accuracy of the SARC-F≥4 for sarcopenia and possible sarcopenia. Receiver-operating characteristic analyses were conducted to calculate the area under the curve (AUC). RESULTS In total, 1,689 patients (mean age: 77.2±7.3 years; male: 54.4%) were analyzed, and 636 patients (37.7%) had SARC-F≥4. Patients with SARC-F≥4 had a statistically significant higher prevalence of AWGS 2019-defined sarcopenia than patients with SARC-F <4 in the models (65.4-78.9% vs 40.9-45.2%, p<0.001). The sensitivity, specificity, and positive/negative likelihood ratios of SARC-F≥4 for sarcopenia and possible sarcopenia were 49.1-51.3%, 73.9-81.2%, and 1.88-2.72/0.60-0.69 and 48.0%, 84.5%, and 3.11/0.62, respectively. The AUC for sarcopenia and possible sarcopenia were 0.644-0.695 and 0.708, respectively. The AUC of SARC-F for possible sarcopenia was equivalent to or larger than that for sarcopenia (DeLong test p=0.438, 0.088, and <0.001 vs the three models). CONCLUSIONS SARC-F≥4 is suitable as a screening tool for sarcopenia in hospitalized older adults. SARC-F assessment could facilitate the detection and exclusion of sarcopenia at hospitalization and may lead to early adoption of a therapeutic and preventive approach.
Collapse
Affiliation(s)
- Y Ishida
- Keisuke Maeda, Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan, Phone: +81-562-46-2311; FAX: +81-562-44-8518, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|