Prevalence of sarcopenia in Chinese community-dwelling elderly: a systematic review

Dyrk1b as a potential biomarker for sarcopenia in older adults

BACKGROUND

Sarcopenia is characterized by the progressive loss of muscle mass and function due to aging. Dual-specificity tyrosine-regulated kinase 1b (Dyrk1b) plays a key role in muscle differentiation by regulating transcription, cell cycle progression, and cell survival. However, the relationship between Dyrk1b levels and sarcopenia is unclear. This study aimed to evaluate the association of serum Dyrk1b level with sarcopenia in the elderly of community-dwelling.

METHODS

A total of 939 community-dwelling elderly people (median age = 76.0 years) were recruited, including 524 men and 415 women. Serum Dyrk1b was measured by enzyme-linked immunosorbent assay. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were taken to assess sarcopenia.

RESULTS

We found that serum Dyrk1b levels in patients with sarcopenia [median (IQR) = 67.37 (55.13-82.56) pg/mL] were lower than those in elderly people without sarcopenia [70.40 (58.34-92.35) pg/mL, P < 0.001]. Receiver operating characteristic curve analysis indicated that the optimal cutoff value of serum Dyrk1b level for predicting sarcopenia was 44.73 pg/mL, with a sensitivity of 94.8% and a specificity of 14.7% (AUC = 0.577, 95% CI = 0.540-0.613, P < 0.001. Multivariate logistic regression analysis showed that high serum Dyrk1b levels (> 44.73 pg/mL) were related to decreased risk of sarcopenia (adjusted OR = 0.342, 95%CI = 0.194-0.603, P < 0.001). Moreover, serum Dyrk1b concentration was positively correlated with ASMI (r = 0.169, P < 0.001), grip strength (r = 0.157, P < 0.001) and gait speed (r = 0.164, P < 0.001).

CONCLUSIONS

In summary, our results indicate that low serum Dyrk1b level is associated with an increased risk of sarcopenia in the elderly, suggesting that Dyrk1b may be valuable as a surrogate biomarker for screening and evaluation of sarcopenia.

A predictive nomogram based on triglyceride glucose index to body mass index ratio for low appendicular skeletal muscle mass

The aim of this study was to investigate risk factors, develop, and assess the predictive nomogram for low appendicular skeletal muscle mass index (ASMI) in middle-aged and elderly populations. A total of 3,209 inpatients were divided into a Training Set (n = 2,407) and a Validation Set (n = 802). A nomogram was developed using R software for internal validation, and external validation was performed using the Validation Set. Gender (male), age, height, weight, triglyceride levels, alanine aminotransferase levels, alcohol consumption, and the triglyceride-glucose index to body-mass index ratio (TyG/BMI) were identified as predictors for the nomogram of low ASMI. In the Training Set, Q1-Q4 subgroups were performed for TyG/BMI, and logistic regression analysis showed that a TyG/BMI ratio greater than 0.37 was significantly associated with an increased risk of developing low ASMI (P < 0.001), with an area under the receiver operating characteristic curve (AUC) of 0.879 for the nomogram. In the Validation Set, the nomogram also demonstrated excellent calibration and discrimination, with an AUC of 0.881. Decision curve analysis (DCA) indicated excellent clinical utility of the nomogram. The study innovatively used TyG/BMI to predict low ASMI, which can reduce the impact of obesity on the diagnosis of sarcopenia. The nomogram can be effectively used to screen for possible sarcopenia in community settings. Due to the cross-sectional study design and unable to obtain complete data on the assessment of muscle strength, the predictive efficacy of our nomogram model requires further confirmation through external validation by large, multicenter prospective studies on sarcopenia population.

Effect of Resistance Training on Older Adults with Sarcopenic Obesity: A Comprehensive Systematic Review and Meta-Analysis of Blood Biomarkers, Functionality, and Body Composition

Background/Objectives: Sarcopenic obesity (SO) is a clinical condition in which there is an excess of fat mass and a loss of muscle mass, strength, and function. Its prevalence increases with age, particularly in adults over 65 years old. However, debate persists on the definition and assessment of SO. The purpose of this review is to examine the impact of resistance training on older adults with sarcopenic obesity. Methods: This review included studies investigating the effects of resistance training interventions in older adults with SO. A comprehensive literature search was conducted across six databases (PubMed, SCOPUS, Cochrane Library, Embase, EBSCO, and Web of Science), yielding 1882 articles. The risk of bias in the included studies was assessed using the PEDro scale and the GRADE system. Results: Eleven randomized clinical trials were analyzed qualitatively and nine were analyzed quantitatively. The meta-analysis demonstrated that exercise interventions revealed the positive effects of exercise mainly on physical performance ([SMD] = 0.36, [95% CI] = 0.03, 0.69, p = 0.003) and body composition ([SMD] = 0.35, [95% CI] = 0.12, 0.57, p = 0.003), with no significant differences in biomarkers ([SMD] = 0.1, [95% CI] = -0.28, 0.49, p = 0.52). Conclusions: Resistance training benefits older adults with SO, improving body composition and physical function, whereas there were no significant differences in blood biomarkers. The present review highlights the limitations of the existing evidence base. Many included studies exhibited methodological shortcomings, necessitating the cautious interpretation of findings. Future research should prioritize rigorous study designs, including larger sample sizes and extended follow-up periods, to enhance the precision and generalizability of results.

Low serum HSPA12B levels are associated with an increased risk of sarcopenia in a Chinese population of older adults

Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass and function. Heat shock protein (HSP) A12B is essential for angiogenesis and endothelial function. However, the association of HSPA12B levels with sarcopenia remains unclear. A total of 936 community-dwelling elderly people were recruited, and serum HSPA12B was measured by enzyme-linked immunosorbent assay. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were taken to assess sarcopenia. We found that serum HSPA12B levels in patients with sarcopenia (median [interquartile range] = 182.15 [137.58-225.86] ng/mL) were lower than those in elderly people without sarcopenia (228.96 [193.03-292.93] ng/mL, P < 0.001). Receiver operating characteristic curve analysis indicated that the optimal cut-off value of serum HSPA12B level for predicting sarcopenia was 185.50 ng/mL, with a sensitivity of 52.6% and a specificity of 80.8% (area under curve = 0.742, 95% confidence interval [CI] = 0.711-0.772, P < 0.001). Moreover, serum HSPA12B concentration was positively correlated with ASMI (r = 0.354, P < 0.001), grip strength (r = 0.381, P < 0.001), and gait speed (r = 0.169, P < 0.001). Multivariate logistic regression analysis showed that decreased serum HSPA12B levels (<185.50 ng/mL) were a risk factor for increased risk of sarcopenia (adjusted odds ratio = 4.335, 95% CI = 3.136-5.993, P < 0.001). In addition, serum HSPA12B level was also positively correlated with serum levels of angiogenesis markers, vascular endothelial growth factor (r = 0.080, P = 0.014), and angiopoietin-1 (r = 0.108, P = 0.001). In summary, our results indicate that low serum HSPA12B level is associated with an increased risk of sarcopenia in the elderly, suggesting a potential role of HSPA12B in the development of sarcopenia.

Association between dietary patterns and sarcopenia among community-dwelling older adults in five provinces of China: a cross-sectional study

Background

Sarcopenia is prevalent in older adults and not only severely affects their health, but also brings a greater economic burden on the patient's family as well as society. High-quality diet is one of influencing factors of sarcopenia, particularly important for muscle mass and function. This study aims to examine the dietary patterns of community-dwelling older adults in a typical region of China and explore the relationship between these dietary patterns and sarcopenia.

Methods

We used data of the Nutrition and Health Follow-up Study of the Chinese Population in 2021. Food frequency questionnaires were used to obtain food items intake frequency during the last year. Appendicular skeletal muscle mass (ASM), muscle strength and physical performance were assessed according to the Asian Sarcopenia Working Group (AWGS2019) criteria. Exploratory factor analysis was used to identify dietary patterns. Logistic regression models were used to examine the association between dietary patterns and sarcopenia.

Results

A total of 1,967 participants over the age of 65 were included in the study, and the prevalence of sarcopenia was 17.0%. According to the factor loadings of all of the 18 food groups, three dietary patterns were identified. These dietary patterns include the diversified dietary pattern, which is mainly characterized by the intake of soybeans, fungi and algae, animal meat, fruits, and legumes; the traditional dietary pattern, which is mainly defined by the consumption of rice, pork, poultry, vegetables, and aquatic products; and the wheat-based dietary pattern, which is mainly characterized by the intake of wheat, tubers, and other cereals. The diversified dietary pattern (OR = 0.54, p < 0.05) and the traditional dietary pattern (OR = 0.51, p < 0.05) were linked to a lower risk of developing sarcopenia, whereas the wheat-based dietary pattern (OR = 3.54, p < 0.05) was associated with a higher risk of sarcopenia. All three dietary patterns exhibited significantly correlated with muscle mass, grip strength, and physical performance (p < 0.05).

Conclusion

Dietary patterns are associated with sarcopenia in community-dwelling older adults in China. Adopting a healthy and sensible balanced diet and avoiding a single dietary preference may reduce the risk of sarcopenia in older adults.

Prevalence and influencing factors of sarcopenia among older adults in rural coastal areas of Ningbo City

Sarcopenia has become a critical health concern in the global older population. However, limited studies have investigated the epidemiological characteristics and potential risk factors of sarcopenia in older individuals residing in rural coastal areas of China. This cross-sectional study involving sarcopenia screening was conducted in Ningbo City, including body composition measurements, and questionnaire surveys. Sarcopenia was diagnosed using the criteria outlined in the Asian Working Group for Sarcopenia 2019 Consensus. A total of 902 older adults aged ≥ 60 years (average age: 69.76 years) were included using a two-stage random sampling method from three villages in Ningbo. The prevalence of sarcopenia was 11.53%, with men (16.36%) exhibiting higher rates than women (7.93%). Multivariate logistic regression analysis identified age (odds ratio [OR]: 6.708, 95% confidence interval [CI]: 2.520-17.855), stroke (OR: 9.232, 95% CI: 1.917-44.447), and waist circumference (OR: 1.095, 95% CI: 1.030-1.165) as factors positively correlated with the occurrence of sarcopenia. Conversely, body mass index (OR: 0.347, 95% CI: 0.270-0.445) was negatively correlated with sarcopenia development. These findings underscore the need for specific health education, the collaborative prevention of comorbidities, and active screening for sarcopenia in the older population to reduce its disease burden.

Associations of nutritional intake and inflammatory factors with sarcopenia in community-dwelling older adults: a cross-sectional study

PURPOSE

Sarcopenia is an age-related disease that is related to nutritional intake and chronic low-grade inflammation. The aim of this study was to investigate the association of dietary intake, inflammatory markers and sarcopenia among the community-dwelling older adults.

METHODS

A total of 1001 older adults aged 60 and above were recruited. According to the criteria established by the Asian Working Group for Sarcopenia 2019, this paper assessed the presence of sarcopenia and using a Food Frequency Questionnaire to evaluate daily dietary intake. Serum levels of inflammatory markers were measured using the ELISA method.

RESULTS

A total of 1001 participants took part in the study (mean 70.6 years), comprising 396 males and 605 females, the prevalence of sarcopenia was 19.6%. Multivariate analysis revealed that high levels of leucine, methionine, threonine, histidine, aspartic acid, calcium, zinc, and vitamin C were associated with a lower risk of sarcopenia. Higher dietary inflammatory index scores were associated with a higher risk of sarcopenia (OR  1.67, 95% CI 1.12-2.47). Higher tumor necrosis factor-like weak inducer of apoptosis (TWEAK) (OR 1.04, 95% CI 1.02-1.07) was associated with a higher risk of sarcopenia, and a lower skeletal muscle mass, strength, and physical function. Conversely, higher insulin-like growth factor-1 (IGF-1) (OR 0.83, 95% CI 0.74-0.94) and glutathione S-transferase (GST) (OR 0.75, 95% CI 0.61-0.91) were associated with a lower risk of sarcopenia.

CONCLUSIONS

This cross-sectional study revealed alterations in amino acid and micronutrient intake among older adults with sarcopenia. The levels of TWEAK were associated with an increased risk of sarcopenia, whereas IGF-1 and GST were associated with a reduced risk of sarcopenia.

Gut dysbiosis in primary sarcopenia: potential mechanisms and implications for novel microbiome-based therapeutic strategies

Primary sarcopenia is characterized by a progressive loss of skeletal muscle mass, strength, and physical function that occurs with aging. Despite the related adverse or even serious health outcomes, no medications are currently available for treating primary sarcopenia. Here, we discuss recent advancements in understanding the mechanistic role of gut microbiota-muscle cross-talk in primary sarcopenia, and the therapeutic implications. The mechanistic insights encompass a causal role of gut dysbiosis in primary sarcopenia, potentially mediated through gut microbiota-derived bioactive metabolites, such as short-chain fatty acids (SCFAs), secondary bile acids, and their associated signaling pathways, which may be translated into the development of new microbiome-based treatment and diagnostic approaches. Furthermore, we identify challenges that need addressing in future studies to facilitate the translation into potential novel treatment and differential diagnosis for older individuals with sarcopenia.

The Dietary Inflammatory Index and Sarcopenia in Older Adults in Four Chinese Provinces: A Cross-Sectional Study

Background: Sarcopenia associated with aging severely affects the quality of life of the elderly; diets have been shown to elicit an inflammatory response in the body, and diets that promote inflammation may lead to damage to muscles. The Dietary Inflammatory Index (DII) has been developed to quantify the inflammatory potential of individual diets. Therefore, this study aimed to investigate the association between the DII, sarcopenia and its components in elderly Chinese people. Methods: In this study, data were obtained from the China Nutrition Improvement Strategies and Applications for the Elderly Research Programme. An assessment of sarcopenia was carried out according to the Asian Working Group on Sarcopenia's (AWGS2019) criteria. The DII was calculated using food intake data obtained using the FFQ method, and then the quartile method was used to categorize the subjects into four groups. Multifactor logistic regression was conducted to examine the associations between DII, sarcopenia and its components. Results: This study included 993 subjects over the age of 65, and the prevalence of sarcopenia was 20.2%. The mean DII score of the study population was 0.99 ± 0.1. After adjusting for the confounders age, gender, marital status, and educational level, the risk of sarcopenia was 1.66 times higher in group Q4 than in group Q1 (p-trend < 0.05). However, this relationship is not statistically significant when other more confounding factors are added. Nevertheless, when further analyzing the relationship between DII and sarcopenia components, it was found that after adjusting the model, a higher DII was associated with a risk of muscle strength loss (OR = 1.65, p-trend < 0.05). Conclusions: Higher DII scores increase the risk of muscle strength loss in older adults. By guiding older adults to adopt a more anti-inflammatory diet, muscle health can be improved in terms of increased muscle strength. Further cohort or interventional studies are necessary to validate our findings.

Prevalence and associated body composition factors of sarcopenia in community-dwelling older adults

BACKGROUND

The objective of this investigation was to examine the frequency and determinants related to body composition of sarcopenia among aging individuals residing in the Beijing community through implementation of the diagnostic criteria for sarcopenia outlined by the 2019 Asian Working Group for Sarcopenia (AWGS).

METHODS

A cross-sectional examination employing multistage cluster sampling was conducted on a sample consisting of 933 individuals aged 50 years or above. The study utilized the AWGS 2019 criteria for muscle mass, muscle strength, and physical function to gauge sarcopenia. In addition, data on demographic characteristics, anthropometry, and body composition were collected. Logistic regression analysis was carried out to ascertain the relationships between sarcopenia and correlated factors.

RESULTS

The study found that the overall prevalence of sarcopenia was 8.3%. Sex (p < 0.001) and body mass index (BMI p < 0.001) were determined to have a significant association with the occurrence of sarcopenia. The adjusted analyses demonstrated that with each standard deviation increase in fat-free mass index (OR = 0.02 (0.01-0.05), of 95%), skeletal muscle mass (OR = 0.17 (0.12-0.25), of 95%), and other body composition indicators (including total body water 0.26 (0.2-0.35), intracellular water 0.1 (0.06-0.17), protein 0.01 (0-0.02), soft lean mass 0.35 (0.28-0.44), BMI 0.58 (0.51-0.67), body cell mass 0.21 (0.15-0.29), OR < 0.60, of 95%), the risk of sarcopenia decreased by more than 40%. Certain straightforwardly accessible anthropometric indices such as upper arm circumference (correlation coefficient 0.94 (0.9-0.97), 0.97 (0.95-1), 1.01 (0.99-1.03), respectively, of 95%), waist circumference (0.94(0.92-0.96), 1.01 (0.99-1.03), 1.02 (1-1.03), of 95%), hip circumference (0.93 (0.9-0.96), 0.99 (0.97-1.02), 1.02 (1-1.04), of 95%), waist-to-hip ratio (0.93 (0.87-1), 1.04 (1-1.08), 1 (0.97-1.03), of 95%), body fat percentage (1 (0.98-1.02), 1.02(1-1.04), 1.01 (0.99-1.02), of 95%), and phase angle (0.91 (0.89-0.93), 0.96 (0.94-0.98), 0.99 (0.98-1), of 95%) exhibited substantial correlation with skeletal muscle index, muscle strength or physical performance. However, no noteworthy link between sarcopenia and most variables associated with physical function was discovered.

CONCLUSIONS

The findings of the study highlight the prevalence of sarcopenia among the aging residents of Beijing. Certain easily measured anthropometric indices demonstrated strong correlation with muscle strength or physical performance, thereby providing an avenue for screening and diagnosing sarcopenia in older people who may not be able to undergo grip strength or physical function assessments. To investigate causal relationships, future studies employing longitudinal or interventional designs with a more comprehensive population are warranted.

Pleiotropic effects on Sarcopenia subphenotypes point to potential molecular markers for the disease

Sarcopenia is a progressive age-related muscle disease characterized by low muscle strength, quantity and quality, and low physical performance. The clinical overlap between these subphenotypes (reduction in muscle strength, quantity and quality, and physical performance) was evidenced, but the genetic overlap is still poorly investigated. Herein, we investigated whether there is a genetic overlap amongst sarcopenia subphenotypes in the search for more effective molecular markers for this disease. For that, a Bioinformatics approach was used to identify and characterize pleiotropic effects at the genome, loci and gene levels using Genome-wide association study results. As a result, a high genetic correlation was identified between gait speed and muscle strength (rG=0.5358, p=3.39 × 10-8). Using a Pleiotropy-informed conditional and conjunctional false discovery rate method we identified two pleiotropic loci for muscle strength and gait speed, one of them was nearby the gene PHACTR1. Moreover, 11 pleiotropic loci and 25 genes were identified for muscle mass and muscle strength. Lastly, using a gene-based GWAS approach three candidate genes were identified in the overlap of the three Sarcopenia subphenotypes: FTO, RPS10 and CALCR. The current study provides evidence of genetic overlap and pleiotropy among sarcopenia subphenotypes and highlights novel candidate genes and molecular markers associated with the risk of sarcopenia.

Associations between multimorbidity patterns and sarcopenia transitions in Chinese older adults

AIM

Previous studies have shown that chronic diseases are strongly linked to the development of sarcopenia. Few studies have assessed the relationship between multimorbidity patterns and sarcopenia. This study aimed to investigate the impact of multimorbidity patterns on sarcopenia transitions in Chinese older adults.

METHODS

A total of 3842 older adults (aged 66.7 ± 6.2 years) with complete data at baseline and at least one follow-up record (2 years) were included from the China Health and Retirement Longitudinal Study. Multimorbidity patterns were identified using latent class analysis. Sarcopenia was determined by the Asian Working Group for Sarcopenia 2019 criteria. Multistage Markov modeling was used to explore the association of multimorbidity patterns with sarcopenia transitions after controlling for covariates in demographic features, health status and health-related behaviours.

RESULTS

Four multimorbidity patterns were identified at baseline: respiratory (17.73%), osteoarthritis-hypertension (22.23%), digestive-osteoarthritis (26.78) and cardiometabolic (33.27%). Participants with non-sarcopenia had 1-year transition probability of developing possible sarcopenia (10.1%) or sarcopenia (5.4%). Compared with the group without chronic diseases, the presence of cardiometabolic pattern increased the risk of progression from non-sarcopenia to possible sarcopenia (HR 1.43, 95% CI 1.05-2.95). The presence of the osteoarthritis-hypertension pattern (HR 1.55, 95% CI 1.00-2.41) and the digestive-osteoarthritis pattern (HR 1.78, 95% CI 1.20-2.66) were associated with the transition toward sarcopenia from non-sarcopenia.

CONCLUSIONS

Sarcopenia is a dynamic condition in older adults. To address sarcopenia in older adults, tailored interventions should be targeted at populations with different multimorbidity patterns. Geriatr Gerontol Int 2024; 24: 1137-1143.

The application of Chinese version of SARC-F and SARC-CalF in sarcopenia screening against five definitions: a diagnostic test accuracy study

BACKGROUND

SARC-F questionnaire is a simple and convenient tool for sarcopenia screening, and SARC-CalF is a modified version of it. The developments of their Chinese versions are warranted for the clinical use for Chinese population. This study aimed to culturally adapt the SARC-F questionnaire into Chinese using standardized methods, validate the reliability and diagnostic accuracy of the Chinese version SARC-F and SARC-CalF against five sarcopenia diagnosis criteria, and determine optimal cut-off values for clinical practice in Chinese population.

METHODS

The translation and cross-cultural adaptation of SARC-F into Chinese were conducted following the methodological report from European Union Geriatric Medicine Society Sarcopenia Special Interest Group. The Chinese version of SARC-F was validated through a diagnostic test, using diagnostic criteria of sarcopenia recommended by the revised 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, Asian Working Group for Sarcopenia (AWGS2019) consensus, the International Working Group on Sarcopenia (IWGS), the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium and the Sarcopenia Definition and Outcomes Consortium (SDOC). Additional analysis was done against the criteria of severe sarcopenia according to the revised EWGSOP2 and AWGS2019.

RESULTS

The Chinese version of SARC-F was well translated and demonstrated good reliability and acceptability. The diagnostic test included 1859 community-dwelling older individuals from two medical centers. Against five different definitions of sarcopenia, the Chinese version of SARC-F showed reasonable diagnostic accuracy for sarcopenia screening (AUC 0.614-0.821), and was demonstrated low sensitivity (13.7-37.9%) but high specificity (94.8-97.7%) with a cut-off value of ≥ 4. SARC-CalF significantly enhanced the diagnostic accuracy of SARC-F when using definitions of EWGSOP2, AWGS2019 and IWGS (all P ≤ 0.001). A score of ≥ 2 for SARC-F and ≥ 7 for SARC-CalF were established as optimal cut-off points for identifying older individuals as at risk of sarcopenia in Chinese population.

CONCLUSIONS

The Chinese version SARC-F is of reasonable reliability and validity for sarcopenia screening. Despite its low sensitivity, it proves to be a useful tool to identify severe cases in community taking advantage of its simplicity. SARC-CalF appears to be a more suitable screening tool for clinical use in detecting sarcopenia.

Knowledge, attitude, and practice toward sarcopenia among older adults in two cities in Zhejiang province, China

Objective

To explore the knowledge, attitudes, and practice (KAP) towards sarcopenia among older adults in Zhejiang province, China.

Methods

This cross-sectional study was conducted between April 2023 and January 2024 among older community residents who participated in a physical examination in Shaoxing People's Hospital Physical Examination Center, Shaoxing Yuecheng District Fushan Street Community Health Service Center, Shaoxing Yuecheng District Beihai Street Community Health Service Center, Shaoxing City, and Outpatient Department of Yongkang First People's Hospital. Their demographic characteristics and KAP towards sarcopenia were collected by a self-designed questionnaire. Structural equation modeling (SEM) was used to explore the relationship among KAP dimensions.

Results

A total of 1092 valid questionnaires were included. The median knowledge, attitude, and practice scores were 0 (0, 0) (possible range: 0-22), 31 (30, 31) (possible range: 8-40), and 17 (15, 21) (possible range: 6-30), respectively. The SEM showed that knowledge directly positively influenced attitude (β = 0.121, P < 0.001) and practice (β = 0.171, P < 0.001). Attitude directly positively influenced practice (β = 0.116, P < 0.001); therefore, the knowledge showed an indirect influence on practice via attitude.

Conclusion

Older adults in two cities in Zhejiang province, China, showed insufficient knowledge but moderate attitude and practice towards sarcopenia. It is imperative to design interventions to improve knowledge about sarcopenia and improve self-management and patient outcomes.

Associations of serum arginine acid with sarcopenia in Chinese eldely women

BACKGROUND

The prevalence of sarcopenia is increasing in worldwide with accelerated aging process. The high dietary protein intakes are associated with improved muscle mass and strength especially in Asian countries. However, there are few researches on amino acid levels or mechanism exploration. We conducted a case-control study to explore the amino acid metabolic characteristics and potential mechanism of elderly women with sarcopenia using targeted amino acid metabolomics approach combined with an analysis of dietary intake.

METHODS

For our case-control study, we recruited women (65-75 y) from a Shanghai community with 50 patients with sarcopenia and 50 healthy controls. The consensus updated by the Asian Working Group on Sarcopenia in 2019 was used to screening for sarcopenia and control groups. We collected fasting blood samples and evaluated dietary intake. We used the amino acid-targeted metabolomics by ultra performance liquid chromatography tandem mass spectrometry to identify metabolic differentials between the case and control groups and significantly enriched metabolic pathways.

RESULTS

The case (sarcopenia) group had a lower intake of energy, protein, and high-quality protein (P < 0.05) compared to the control (healthy) group. We identified four differential amino acids: arginine (P < 0.001) and cystine (P = 0.003) were lower, and taurine (P = 0.001) were higher in the case group.

CONCLUSION

Low levels of arginine in elderly women are associated with a higher risk of sarcopenia.

The prevalence of sarcopenia and risk factors in the older adult in China: a systematic review and meta-analysis

Background

Understanding the epidemiological information of a certain disease is the first step in related prevention and control work. This article aims to understand the prevalence and associated risk factors of sarcopenia among the older adult (≥60 years old) in China and to provide an evidence-based basis for early identification, management, and prevention of sarcopenia patients.

Methods

We searched seven databases: CNKI, Wanfang, VIP, PubMed, Web of Science, Embase, and Cochrane Library databases from the establishment of the database until January 31, 2024. The Quality evaluation criteria of cross-sectional studies recommended by the Agency for Healthcare Research and Quality (AHRQ) were used for literature quality evaluation. Stata 18.0 software was used for statistical analysis.

Results

We finally included 45 studies, involving a total of 37,571 cases. After statistical analysis, we found that the prevalence of sarcopenia among the older adult in China was 20.7% [95% CI (18.3, 23.0%)]. The results of subgroup analysis suggest that: ① According to gender, the prevalence rate of sarcopenia in women (21.6%) is higher than that in men (19.2%); ② According to age, the prevalence rate of older adult people aged ≥80 (45.4%) was the highest, followed by 70-79 (27.2%) and 60-69 (15.7%). ③ According to region, the prevalence rate of the older adult in the south (21.7%) is higher than that in the north (19.0%); ④ According to the time of publication, the prevalence of sarcopenia among the older adult in China has increased (from 19.2% in 2014-2018 to 21.4% in 2019-2024); ⑤ According to the diagnostic criteria, the detection rate of AWGS (2019) is higher than that of AWGS (2014) (24.5% vs. 19.3%). Finally, aging, low BMI, low leg circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are all risk factors for sarcopenia among the older adult in China.

Conclusion

The prevalence of sarcopenia in the older adult in China was higher (20.7%), which should be paid attention to by relevant health authorities. In addition, aging, low BMI, low calf circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are risk factors for the development of sarcopenia in the older adult in China. For these high-risk populations, early identification, prevention, and intervention can be carried out to delay the occurrence and progression of sarcopenia.

Physical activity intensity, frequency, duration, volume and the risk of possible sarcopenia in middle-aged and older adults

This study explored the association of physical activity (PA) from different dimensions including intensity, frequency, duration, and volume with possible sarcopenia (PSA), and established the PA cut-off value to identify PSA in middle-aged and older adults. The data in this study were from the China Health and Retirement Longitudinal Study in 2015. There were 7,957 adults aged over 45 years in the analysis. PA was assessed using a modified version of the International Physical Activity Questionnaire Short Form. Muscle strength and physical performance were measured to define PSA. Results showed that men spending at least 3 days each week, more than 10 min each time on vigorous-intensity PA, or a minimum of 933 Mets on total PA each week had a lower risk of PSA. In women, spending at least 3 days each week, more than 30 min each time on moderate-intensity PA, or taking at least 6 days each week, more than 120 min each time on low-intensity PA, or a minimum of 933 Mets on total PA each week was associated with a lower risk of PSA. In older adults (≥ 65 years), spending at least one day each week, more than 30 min each time on vigorous-intensity PA, or taking a minimum of 933 Mets on total PA each week was linked with a decreased risk of PSA. However, no significant associations were found between any PA dimensions and PSA in middle-aged adults (45-64 years). A receiver operating characteristic analysis showed that the PA cut-off value was 695 and 693 Mets each week for predicting PSA for men and women. The findings suggested that the intensity, frequency, duration, and weekly volume of PA is associated with the risk of PSA in middle-aged and older adults, and the association largely depends on sex and age. The PA cut-off value may be an early indication for a higher risk of sarcopenia.

Prevalence and factors associated with sarcopenia among Brazilian older adults: An exploratory network analysis

OBJECTIVES

This study aimed to verify the prevalence of sarcopenia and its associations with sociodemographic, clinical and psychological factors in community-dwelling older adults.

STUDY DESIGN

A randomized cross-sectional study was extracted from a probabilistic cluster conducted on individuals aged 65 years or older residing in the community.

METHODS

Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Associations were analyzed using networks based on mixed graphical models. Predictability indices of the estimated networks were assessed using the proportion of explained variance for numerical variables and the proportion of correct classification for categorical variables.

RESULTS

The study included 278 participants, with a majority being female (61 %). The prevalence of sarcopenia was 39.57 %. Among those with sarcopenia, 67 % were women and 33 % were men. In the network model, age, race, education, family income, bone mass, depression, cardiovascular disease, diabetes, total cholesterol levels and rheumatism were associated with sarcopenia. The covariates demonstrated a high accuracy (62.9 %) in predicting sarcopenia categories.

CONCLUSION

The prevalence of sarcopenia was high, especially in women. In addition, network analysis proved useful in visualizing complex relationships between sociodemographic and clinical factors with sarcopenia. The results suggest early screening of sarcopenia for appropriate treatment of this common geriatric syndrome in older adults in Brazil.

Muscle density, but not size, is independently associated with cognitive health in older adults with hip fractures

Emerging evidence indicates a complex interplay between skeletal muscle and cognitive function. Despite the known differences between muscle quantity and quality, which can be measured via computed tomography (CT), the precise nature of their associations with cognitive performance remain underexplored. To investigate the links between muscle size and density and cognitive impairment (CI) in the older adults with hip fractures, we conducted a post hoc, cross-sectional analysis within a prospective cohort study on 679 patients with hip fractures over 65. Mini-Mental State Examination (MMSE) and routine hip CT imaging were utilized to assess cognition function and muscle characteristics in older adults with hip fractures. The CT scans provided data on cross-sectional area and attenuation for the gluteus maximus (G.MaxM) and the combined gluteus medius and minimus (G.Med/MinM). Participants were categorized into CI and non-CI groups based on education levels and MMSE scores. Multivariate logistic regressions, propensity score (PS) methods, and subgroup analysis were employed to analyze associations and validate findings. This study included 123 participants (81.6 ± 6.8 years, 74% female) with CI and 556 participants (78.5 ± 7.7 years, 72% female) without. Compared to the non-CI group, muscle parameters, especially density, were significantly lower in the CI group. Specifically, G.Med/Min muscle density, but not size was robustly associated with CI (odds ratio (OR) = 0.77, 95% confidence interval = 0.62-0.96, P = 0.02), independent of other medical situations. Sensitivity analysis corroborated that G.Med/Min muscle density was consistently lower in the CI group than the non-CI group, as evidenced in the PS matched (P = 0.024) and weighted cohort (P = 0.033). Enhanced muscle parameters, particularly muscle density in the G.Med/MinM muscle, correlate with a lower risk of CI. Muscle density demonstrates a stronger association with cognitive performance than muscle size, highlighting its potential as a key focus in future cognitive health research.

Association of High-Density Lipoprotein Cholesterol with Sarcopenia in Chinese Community-Dwelling Middle-Aged and Older Adults: Evidence from 4-Year Longitudinal Study

INTRODUCTION

There is inconsistent evidence on the associations between high-density lipoprotein cholesterol (HDL-C) and risk of sarcopenia. The aim of the study was to determine the evidence existing between HDL-C and sarcopenia in Chinese middle-aged and older adults.

METHODS

We used a panel study design of the China Health and Retirement Longitudinal Study (CHARLS), with 7,415 participants (mean age 57.5 years) from 2011, 2013, and 2015. HDL-C was measured by colorimetric test of venous serum samples. Sarcopenia was defined as low muscle mass, plus low muscle strength, or low physical performance. Muscle mass was estimated by anthropometric measures. Muscle strength was measured by handgrip strength using dynamometer. Physical performance was measured by 5-time chair stand test, gait speed test, and short physical performance battery.

RESULTS

With 961 (13.0%) sarcopenia cases, each 1-unit increase (1 SD = 15.4 mg/dL) of HDL-C levels was associated with 42% increased odds of incident sarcopenia (OR = 1.42, 95% confidence interval [CI] = 1.28-1.58) at 4-year follow-up. Females with high HDL-C levels (HDL-C >60 mg/dL) had a higher risk of sarcopenia (OR = 2.49, 95% CI = 1.76-3.52). The restricted cubic spline curves showed a J-shaped association between HDL-C and risk of sarcopenia in females. HDL-C was negatively associated with muscle mass (β = -0.23, 95% CI = -0.27 to -0.20) and hand grip strength (β = -0.05, 95% CI = -0.19 to 0.09).

CONCLUSION

High HDL-C levels were associated with higher risk of sarcopenia among middle-aged and older Chinese adults, and appropriate control of its high levels informs the management of sarcopenia.

Reevaluation of the protein requirement in Chinese elderly adults without sarcopenia with the indicator amino acid oxidation technique

It is now generally believed that elderly may have slightly higher dietary protein requirements than those of the young-middle-aged adults. We have previously conducted related studies by the indicator amino acid oxidation (IAAO) technique, but more research data are needed to revise the protein requirements of the elderly. The main objective was to reevaluate the dietary protein requirements of healthy Chinese adults (65-80 years) without sarcopenia by using the IAAO technique. Nine healthy adult men and seven healthy adult women participated in the study, with protein intakes ranging from 0·1 to 1·8 g/(kg·d). Diets that delivered energy at a 1·5 resting energy expenditure were isocaloric. The amounts of phenylalanine and tyrosine needed to remain constant for each protein dosage. By applying a nonlinear mixed-effects model analysis on the F13CO2 data, which revealed a breakpoint in F13CO2 in response to graded protein intakes, the mean protein requirement was calculated. The mean estimated average requirement (EAR) for healthy elderly Chinese adults without sarcopenia was determined to be 0·94 g/(kg·d). The protein recommended nutrient intake (RNI) determined using various derivation approaches ranged from 1·13 to 1·36 g/(kg·d). The EAR for Chinese adults without sarcopenia aged 65-80 years in this study is 6·8 % higher than the current recommended EAR (0·88 g/(kg·d)). The RNI derived using various derivation approaches are all greater than the current RNI (0·98 g/(kg·d)). This trial was registered with the Chinese clinical trial registry as ChiCTR2200061382.

Blood Profiles of Community-Dwelling People with Sarcopenia: Analysis Based on the China Health and Retirement Longitudinal Study

INTRODUCTION

Routine blood factors can be economical and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China.

METHODS

A total of 1,307 participants and 17 routine blood indices were selected from two waves (year 2011 and year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The diagnosis of sarcopenia was based on the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019). Generalized mixed-effects models were performed for association analyses. A logistic regression (LR) model was conducted to examine the predictive power of identifying significant blood factors for sarcopenia.

RESULTS

A higher sarcopenia risk was cross-sectionally associated with elevated blood concentrations of high-sensitivity C-reactive protein (hsCRP) (OR = 1.030, 95% CI [1.007, 1.053]), glycated hemoglobin (HbA1c) (OR = 1.407, 95% CI [1.126, 1.758]) and blood urea nitrogen (BUN) (OR = 1.044, 95% CI [1.002, 1.089]), and a decreased level of glucose (OR = 0.988, 95% CI [0.979, 0.997]). A higher baseline hsCRP value (OR = 1.034, 95% CI [1.029, 1.039]) and a greater over time change in hsCRP within 4 years (OR = 1.034, 95% CI [1.029, 1.039]) were associated with a higher sarcopenia risk. A higher BUN baseline value was related to a decreased sarcopenia risk over time (OR = 0.981, 95% CI [0.976, 0.986]), while a greater over time changes in BUN (OR = 1.034, 95% CI [1.029, 1.040]) and a smaller over time change in glucose (OR = 0.992, 95% CI [0.984, 0.999]) within 4 years were also related to a higher sarcopenia risk. LR based on significant blood factors (i.e., hsCRP, HbA1c, BUN, and glucose), and sarcopenia status in year 2015 yielded an area under the curve of 0.859 (95% CI: 0.836-0.882).

CONCLUSION

Routine blood factors involved in inflammation, protein metabolism, and glucose metabolism are significantly associated with sarcopenia. In clinical practice, plasma hsCRP, BUN, blood sugar levels, sex, age, marital status, height, and weight might be helpful for sarcopenia evaluation and monitoring.

Correlational analysis of sarcopenia and multimorbidity among older inpatients

BACKGROUND

Sarcopenia and multimorbidity are common in older adults, and most of the available clinical studies have focused on the relationship between specialist disorders and sarcopenia, whereas fewer studies have been conducted on the relationship between sarcopenia and multimorbidity. We therefore wished to explore the relationship between the two.

METHODS

The study subjects were older patients (aged ≥ 65 years) who were hospitalized at the Department of Geriatrics of the First Affiliated Hospital of Chongqing Medical University between March 2016 and September 2021. Their medical records were collected. Based on the diagnostic criteria of the Asian Sarcopenia Working Group in 2019, the relationship between sarcopenia and multimorbidity was elucidated.

RESULTS

1.A total of 651 older patients aged 65 years and above with 2 or more chronic diseases were investigated in this study, 46.4% were suffering from sarcopenia. 2. Analysis of the relationship between the number of chronic diseases and sarcopenia yielded that the risk of sarcopenia with 4-5 chronic diseases was 1.80 times higher than the risk of 2-3 chronic diseases (OR 1.80, 95%CI 0.29-2.50), and the risk of sarcopenia with ≥ 6 chronic diseases was 5.11 times higher than the risk of 2-3 chronic diseases (OR 5.11, 95% CI 2.97-9.08), which remained statistically significant, after adjusting for relevant factors. 3. The Charlson comorbidity index was associated with skeletal muscle mass index, handgrip strength, and 6-meter walking speed, with scores reaching 5 and above suggesting the possibility of sarcopenia. 4. After adjusting for some covariates among 14 common chronic diseases in older adults, diabetes (OR 3.20, 95% CI 2.01-5.09), cerebrovascular diseases (OR 2.07, 95% CI 1.33-3.22), bone and joint diseases (OR 2.04, 95% CI 1.32-3.14), and malignant tumors (OR 2.65, 95% CI 1.17-6.55) were among those that still a risk factor for the development of sarcopenia.

CONCLUSION

In the hospitalized older adults, the more chronic diseases they have, the higher the prevalence of sarcopenia. When the CCI is 5, attention needs to be paid to the occurrence of sarcopenia in hospitalized older adults.

Effect of Different Exercise Interventions on Grip Strength, Knee Extensor Strength, Appendicular Skeletal Muscle Index, and Skeletal Muscle Index Strength in Patients with Sarcopenia: A Meta-Analysis of Randomized Controlled Trials

Sarcopenia is a systemic skeletal muscle disease that is more prevalent in older adults. The role of exercise in improving the disease has been demonstrated. However, due to the variety of exercise modalities, it is not clear what type of exercise provides the best benefit. The aim of this meta-analysis was to analyze the effects of different exercise modalities on grip strength, appendicular skeletal muscle index, skeletal muscle index, and knee extensor strength in elderly patients with sarcopenia. The protocol for this evaluation was registered on the PROSPERO website and the databases PubMed, WOS, Cochrane Library, and Embase were searched. Thirteen studies were included in the analysis. The results showed that exercise interventions had positive effects on grip strength and knee extension muscle strength, with resistance training being the most effective. There was no significant improvement in appendicular skeletal muscle index or skeletal muscle index. This study still has limitations. For example, age group and exercise duration were not considered. Future studies should further explore benefits in age groups as well as other relevant outcome indicators.

Prevalence of sarcopenia and depressive symptoms among older adults: a scoping review

Sarcopenia causes a loss of skeletal muscle mass and decreases muscle strength and function. Depressive symptoms are a common cause of distress among geriatrics, significantly affecting the quality of life of older adults. Recently, studies have shown that a correlation exists between sarcopenia and depression. To determine the prevalence of sarcopenia and depressive symptoms and identify the factors associated with sarcopenia, we systematically searched the SCOPUS, Science Direct, and PubMed databases for papers on sarcopenia and depressive symptoms published from 2012 to 2022. We reviewed the literature on sarcopenia, depressive symptom prevalence, the prevalence of subjects with both sarcopenia and depressive symptoms, and the factors associated with sarcopenia. Only cross-sectional studies were included. Nineteen articles met the inclusion criteria for review, with overall sarcopenia prevalence ranging from 3.9% to 41.7%. The prevalence of depressive symptoms was reported in seven studies, ranging from 8.09% to 40%. The most commonly used tools to diagnose sarcopenia and depressive symptoms were the European Working Group on Sarcopenia in Older People consensus and the Geriatric Depression Scale, respectively. Being aged, malnourished, obese, having comorbidities (hypertension and diabetes), having impaired cognitive function, and having polypharmacy were found to be the factors associated with sarcopenia. Sarcopenia and depressive symptoms have been found to cause adverse health outcomes among older people. Appropriate nutritional assessments and interventions should be taken to manage these two geriatric conditions. Further studies should be planned, considering multidomain intervention strategies to improve sarcopenia and older people's mental health.

Prevalence and factors associated with sarcopenia among older adults in a post-acute hospital in Singapore

BACKGROUND

Sarcopenia is common in older adults worldwide, but its prevalence varies widely owing to differences in diagnostic criteria, population sampled, and care setting. We aimed to determine the prevalence and factors associated with sarcopenia in patients aged 65 and above admitted to a post-acute hospital in Singapore.

METHODS

This was a cross-sectional study of 400 patients recruited from a community hospital in Singapore. Data including socio-demographics, physical activity, nutritional status, cognition, clinical and functional status, as well as anthropometric measurements were collected. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria [AWGS2019].

RESULTS

Of the 383 patients with complete datasets, overall prevalence of sarcopenia was 54% while prevalence of severe sarcopenia was 38.9%. Participants with increased age, male gender and a low physical activity level were more likely to be sarcopenic, while those with higher hip circumference and higher BMI of ≥27.5m/kg2 were less likely to be sarcopenic. Other than the above-mentioned variables, cognitive impairment was also associated with severe sarcopenia.

CONCLUSIONS

More than 1 in 2 older adults admitted to a post-acute hospital in Singapore are sarcopenic. There is an urgent need to address this important clinical syndrome burden and to identify patients at risk of sarcopenia in post-acute settings in Singapore for early intervention.

The association of lipid metabolism and sarcopenia among older patients: a cross-sectional study

Sarcopenia has become a heavy disease burden among the elderly. Lipid metabolism was reported to be involved in many degenerative diseases. This study aims to investigate the association between dysregulated lipid metabolism and sarcopenia in geriatric inpatients. This cross-sectional study included 303 patients aged ≥ 60, of which 151 were diagnosed with sarcopenia. The level of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine (HCY), BMI, and fat percentage, were compared between sarcopenia and non-sarcopenia patients. The Spearman correlation coefficient was used to estimate the association between sarcopenia and the level of lipid metabolism. To determine risk factors related to sarcopenia, a multivariate logistic regression analysis was carried out. Risk prediction models were constructed based on all possible data through principal component analysis (PCA), Logistic Regression (LR), Support Vector Machine (SVM), k-Nearest Neighbor (KNN), and eXtreme Gradient Boosting (XGboost). We observed rising prevalence of sarcopenia with increasing age, decreasing BMI, and fat percentage (p < 0.001, Cochran Armitage test). Multivariate logistic regression analysis revealed sarcopenia's risk factors, including older age, male sex, lower levels of BMI, TC, and TG, and higher levels of LDL and HCY (p < 0.05). The sarcopenia risk prediction model showed the risk prediction value of sarcopenia, with the highest area under the receiver operating curve (AUC) of 0.775. Our study provided thorough insight into the risk factors associated with sarcopenia. It demonstrated that an increase in lipid metabolism-related parameters (BMI, TG, TC), within normal reference ranges, may be protective against sarcopenia. The present study can illuminate the direction and significance of lipid metabolism-related factors in preventing sarcopenia.

Influencing factors of sarcopenia in older adults based on the Newman system model: a case-control study

PURPOSE

Research on sarcopenia has primarily focused on single fields such as physiology or psychology. However, there is a lack of clear evidence to determine the influence of social factors on sarcopenia. Therefore, our aim was to explore the multidimensional factors that contribute to sarcopenia in older adults within the community.

METHODS

In this retrospective case-control study, we applied the diagnostic criteria from The Asian Working Group on Sarcopenia (AWGS) 2019 to categorize study subjects into control and case groups. Our aim was to examine the impact of physical, psychological, and social factors on community-dwelling older adults with sarcopenia across multiple dimensions. We utilized descriptive statistics, as well as simple and multivariate logistic regression analyses, to analyze the data. We compared the odds ratios (OR) of the factors between the two groups and ranked the importance of the influencing factors using the XGBoost algorithm in Python software.

RESULTS

Combined with multivariate analysis and XGBoost algorithm results, it can be seen that physical activity is the strongest predictor of sarcopenia [OR] = 0.922(95% CI 0.906-0.948), followed diabetes mellitus [OR] = 3.454(95% CI 1.007-11.854), older age [OR] = 1.112(95% CI 1.023-1.210), divorced or widowed [OR] = 19.148 (95% CI 4.233-86.607), malnutrition [OR] = 18.332(95% CI 5.500-61.099), and depressed [OR] = 7.037(95% CI 2.391-20.710).

CONCLUSIONS

Factors associated with the development of sarcopenia in community-dwelling older adults cover a multiplicity of physical, psychological, and social factors, physical activity, diabetes mellitus, age, marital status, nutrition, and depression were important factors that have an impact on sarcopenia.

REGISTRATION NUMBER

ChiCTR2200056297.

Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study

PURPOSE

The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults.

METHODS

This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia.

RESULTS

Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41-0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58-0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52-0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48-0.98) was associated with a lower risk of sarcopenia.

CONCLUSION

Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.

Prevalence of Sarcopenia in Africa: A Systematic Review

Objective

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

Study Design and Setting

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

Results

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

Conclusion

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

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

Objective

To analyze the correlation between preoperative nutritional status, frailty, sarcopenia, body composition, and anthropometry in geriatric inpatients undergoing major pancreatic and biliary surgery.

Methods

This is a cross-sectional study of the database from December 2020 to September 2022 in the department of hepatopancreatobiliary surgery, Beijing Hospital. Basal data, anthropometry, and body composition were recorded. NRS 2002, GLIM, FFP 2001, and AWGS 2019 criteria were performed. The incidence, overlap, and correlation of malnutrition, frailty, sarcopenia, and other nutrition-related variables were investigated. Group comparisons were implemented by stratification of age and malignancy. The present study adhered to the STROBE guidelines for cross-sectional study.

Results

A total of 140 consecutive cases were included. The prevalence of nutritional risk, malnutrition, frailty, and sarcopenia was 70.0, 67.1, 20.7, and 36.4%, respectively. The overlaps of malnutrition with sarcopenia, malnutrition with frailty, and sarcopenia with frailty were 36.4, 19.3, and 15.0%. There is a positive correlation between every two of the four diagnostic tools, and all six p-values were below 0.002. Albumin, prealbumin, CC, GS, 6MTW, ASMI, and FFMI showed a significantly negative correlation with the diagnoses of the four tools. Participants with frailty or sarcopenia were significantly more likely to suffer from malnutrition than their control groups with a 5.037 and 3.267 times higher risk, respectively (for frailty, 95% CI: 1.715-14.794, p = 0.003 and for sarcopenia, 95% CI: 2.151-4.963, p<0.001). Summarizing from stratification analysis, most body composition and function variables were worsen in the ≥70 years group than in the younger group, and malignant patients tended to experience more intake reduction and weight loss than the benign group, which affected the nutrition diagnosis.

Conclusion

Elderly inpatients undergoing major pancreatic and biliary surgery possessed high prevalence and overlap rates of malnutrition, frailty, and sarcopenia. Body composition and function deteriorated obviously with aging.

Association between Intrinsic Capacity and Sarcopenia in Hospitalized Older Patients

OBJECTIVES

This study aimed to clarify the association between intrinsic capacity (IC) and sarcopenia in hospitalized older patients.

DESIGN

A cross-sectional study.

SETTING

Hospital-based.

PARTICIPANTS

This study included 381 inpatients aged ≥ 60 years (225 men and 156 women).

MEASUREMENTS

IC was evaluated in five domains defined by the World Health Organization: cognition (Mini-Mental State Examination), locomotion (Short Physical Performance Battery test), vitality (Short-Form Mini Nutritional Assessment), sensory (self-reported hearing and vision) and psychological (5-item Geriatric Depression Scale) capacities. IC composite score (0-5) was calculated based on five domains, with lower scores representing greater IC. Sarcopenia was defined in accordance with the criteria recommended by the Asian Working Group for Sarcopenia (AWGS) 2019. Multiple linear and logistic regressions were performed to explore the associations between IC composite score and IC domains with sarcopenia and its defining components.

RESULTS

The mean age of 381 patients included was 81.95±8.42 years. Of them, 128 (33.6%) patients had sarcopenia. The median IC composite score was 1 (1, 2). Cognition, locomotion, vitality, sensory and psychological capacities were impaired in 22.6%, 63.5%, 18.9%, 27.3% and 11.3% of patients. Multiple linear regression analyses showed that favorable IC domain scores in cognition, locomotion and vitality were associated with a stronger handgrip strength. A higher vitality score was associated with a greater appendicular skeletal muscle mass index (ASMI), and a higher locomotion score was associated with a greater gait speed. The multiple logistic regression analysis showed that only vitality impairment was associated with sarcopenia. A higher IC composite score was associated with higher risks of sarcopenia, as well as low ASMI, handgrip strength and gait speed.

CONCLUSION

This study indicated that a more serious impairment of IC was associated with a greater risk of sarcopenia. Vitality was the domain most strongly associated with sarcopenia. IC may be employed to detect and manage sarcopenia.

Sarcopenia and echocardiographic parameters for prediction of cardiovascular events and mortality in patients undergoing maintenance hemodialysis

Background

Sarcopenia is prevalent and is associated with the occurrence of cardiovascular complications in patients undergoing maintenance hemodialysis (MHD). It is unknown how skeletal muscle may be associated with aspects of myocardial structure and function. This study aimed to evaluate the association between sarcopenia and cardiac structure and function in patients undergoing MHD. We also examined the prognostic role of sarcopenia for mortality and cardiovascular events (CVE) in this population.

Methods

Participants from a single center underwent bioimpedance body composition analysis to measure skeletal muscle and echocardiography to assess myocardial structure and function. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia criteria. The end points were all-cause mortality and CVE.

Results

Of the 158 participants, 46 (29.1%) had sarcopenia, 102 (64.6%) had left ventricular diastolic dysfunction (LVDD), and 106 (67.0%) had left ventricular hypertrophy (LVH). Participants with sarcopenia had smaller right ventricular sizes (2.54 ± 0.77 vs 2.76 ± 0.28; P < 0.01), inter-ventricular thickness (1.07 ± 0.19 vs 1.14 ± 0.20; P = 0.039), and left ventricular posterior wall thickness (0.96, 0.89-1.10 vs 1.06, 0.95-1.20; P = 0.018). Skeletal muscle mass was strongly correlated with left ventricular mass (LVM) (r = 0.577; P < 0.0001). Furthermore, the risk of LVDD (OR: 4.92, 95% confidence interval (CI) [1.73-13.95]) and LVH (OR: 4.88, 95% CI [1.08-21.96]) was much higher in the sarcopenic group than in the non-sarcopenic group. During a follow-up period of 18 months, 11 (6.9%) patients died, of which seven died (4.4%) of CVE, and 36 (22.8%) experienced CVE. The presence of sarcopenia (adjusted hazard ratio (HR), 6.59; 95% CI [1.08-39.91]; P = 0.041) and low skeletal muscle index (HR, 3.41; 95% CI [1.01-11.57]; P = 0.049) and handgrip strength (HR, 0.88; 95% CI [0.78-0.99]; P = 0.037) independently predicted death. Sarcopenia was a significant predictor of CVE (HR, 10.96; 95% CI [1.14-105.10]; P = 0.038).

Conclusion

Our findings demonstrated that sarcopenia is associated with LVDD and LVH, and is associated with a higher probability of death and CVE.