Sarcopenia and malnutrition: commonly occurring conditions in the older population

Association of Vegetable and Fruit Consumption Patterns with Cognitive Function in Older People with Different BMI Ranges: Findings from China

Purpose

There is a lack of research on how vegetable and fruit consumption patterns affect cognitive function in older adults with varying BMIs. Therefore, this study aims to explore their relationship, with a special focus on gender differences.

Patients and Methods

A cross-sectional survey was conducted in Anhui Province, China, between July and September 2019, and information was collected from 6211 participants regarding socio-demographics, the frequency of vegetable and fruit consumption per week, and cognitive function. The study utilized descriptive analysis and binary logistic regression to determine the association between cognitive function and consumption patterns of vegetable and fruit.

Results

There were no statistically significant associations between vegetable and fruit consumption patterns and cognitive function in underweight and obese older adults. Among normal weight men, older adults in the V+/F- (AOR=1.65; 95% CI: 1.16-2.35) and V-/F- (AOR=3.95; 95% CI: 1.86-8.42) groups were more likely to have cognitive impairment compared with the V+/F+ group. However, no associations were observed between the two in women of normal weight. For the overweight women, a higher risk of cognitive impairment was found in the V+/F- group (AOR=1.54; 95% CI: 1.12-2.11), while older men did not.

Conclusion

The correlation between vegetable and fruit consumption patterns and cognitive function varies among older adults with different BMIs. Findings suggest the need for targeted nutritional interventions for these communities to maintain cognitive function in older adults.

Determinants of limitations in activities of daily living among community-dwelling persons aged 80 years and older: Longitudinal national evidence from the Health, Aging and Retirement in Thailand study, 2015-2022

AIM

Few studies have longitudinally assessed the determinants of limitations in activities of daily living (LADL) among persons aged ≥80 years. The aim of this study was to estimate the determinants of LADL among persons aged ≥80 years based on 4-wave national longitudinal data from Thailand.

METHODS

Data from the Health, Aging and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons aged ≥80 years (analytic sample: n = 3113 observations). For the pooled sample, the average age was 85.4 years (range 80-117 years). Established measurements were used to assess LADL. Linear fixed effects regression was applied to assess the time-varying determinants and outcomes.

RESULTS

Linear fixed effects regressions showed that increasing age, an increase in the number of chronic conditions, an increase in depressive symptoms, higher religious involvement and being underweight increased LADL, whereas increases in exercise frequency and increases in subjective life expectancy decreased LADL. In addition, in subgroup analysis among 60-79-year-olds, transitioning to widowhood and work status decreased LADL. Further differences between ≥80-year-olds and 60-79-year-olds include that an increase in depressive symptoms and increase in chronic conditions only increased LADL among ≥80-year-olds and not among 60-79-year-olds.

CONCLUSIONS

This longitudinal study enhances our understanding of the determinants of LADL among persons aged ≥80 years. Strategies to delay or decrease depressive symptoms and chronic conditions, proper weight management and increasing physical activity might help in reducing LADL. Geriatr Gerontol Int 2025; 25: 403-410.

Gut microbiota in patients with sarcopenia: a systematic review and meta-analysis

Background

Intestinal dysbiosis was considered a pivotal pathological mechanism underlying sarcopenia. Despite the fervor surrounding research in this domain, substantial controversy persists regarding the obtained outcomes.

Objective

To systematically summarized the disparities in gut microbiota composition between the group afflicted by sarcopenia and non-sarcopenia controls.

Methods

PubMed, Medline, CINAHL, EMBASE, Scopus, Web of Science and Google Scholer, Cochrane Library and gray literature sources were systematically searched for in randomized controlled trials. Meta-analysis and random-effects meta-regression were conducted using Rev. Man 5.3. Overall effect was measured using Hedges's g and determined using Z-statistics. Cochran's Q test and I 2 were used to investigate heterogeneity. The Newcastle-Ottawa Scale was used to assess overall quality of evidence.

Results

Ten studies, including 421 cases of sarcopenia and 1,642 cases of controls, were included in the meta-analysis. Patients with sarcopenia showed significantly reduced gut microbiota in α diversity, and β diversity was significantly different in 8/9 of included studies. We also found more abundance of phylum Proteobacteria and genus Escherichia-Shigella, and less abundance of phylum Firmicutes and genus Faecalibacterium, Prevotella 9, Blautia in the sarcopenia group.

Conclusion

The gut microbiota composition in patients with sarcopenia has undergone alterations, serving as a fundamental reference for further investigation into the potential pathogenic mechanisms and treatment strategies for sarcopenia.

Development and validation of a predicative model for identifying sarcopenia in Chinese adults using nutrition indicators (AHLC)

Background

Sarcopenia, a condition characterized by low muscle mass, plays a critical role in the health of older adults. Early identification of individuals at risk is essential to prevent sarcopenia-related complications. This study aimed to develop a predictive model using readily available clinical nutrition indicators to facilitate early detection.

Methods

A total of 1,002 participants were categorized into two groups: 819 with normal skeletal muscle mass (SMM) and 183 with low muscle mass (sarcopenia). A predictive model was developed for sarcopenia risk via multivariate logistic regression, and its performance was assessed using four analyses: receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA), a nomogram chart, and external validation. These methods were used to evaluate the model's discriminative ability and clinical applicability.

Results

In the low-SMM group, more females (55.73% vs. 40.42%) and older individuals (median 61 vs. 55 years) were observed. These patients had lower albumin (41.00 vs. 42.50 g/L) and lymphocyte levels (1.60 vs. 2.02 × 109/L) but higher HDL (1.45 vs. 1.16 mmol/L) and calcium levels (2.24 vs. 2.20 mmol/L) (all p < 0.001). Using LASSO regression, we developed a nutritional AHLC (albumin + HDL cholesterol + lymphocytes + calcium) model for sarcopenia risk prediction. AUROC and DCA analyses, as well as nomogram charts and external validation, confirmed the robustness and clinical relevance of the AHLC model for predicting sarcopenia.

Conclusion

Our study employs serum nutrition indicators to aid clinicians in promoting healthier aging. The AHLC model stands out for weight-independent evaluations. This novel approach could assess sarcopenia risk in the Chinese population, thereby enhancing aging and quality of life.

Association between the systemic immune-inflammation index and sarcopenia: a systematic review and meta-analysis

BACKGROUND

Sarcopenia is associated with increased morbidity and mortality. The systemic immune-inflammation index (SII) has been correlated to a variety of disorders. The present study conducted a systematic review and meta-analysis to investigate the relationship between SII and sarcopenia.

METHODS

A literature search was performed in Web of Science, PubMed, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and VIP Chinese Science and Technology Database, from inception to March 2024. Then, the literature quality was assessed. After the heterogeneity test, a random effects or fixed effects model was applied to establish the forest plot, and investigate the relationship between SII and sarcopenia. Then, the sensitivity analysis and publication bias were examined.

RESULTS

Nine articles, which included 18,634 adults, were analyzed. Sarcopenic adults had higher SII levels, when compared to non-sarcopenic adults (standardized mean difference [SMD] = 0.66, 95% confidence interval [CI] = 0.22 - 0.19, p = 0.003). The high SII level was associated to the increased risk of sarcopenia (odds ratio = 1.52, 95% CI = 1.09-2.13, p = 0.01). In addition, the subgroup analysis revealed that the SII levels were higher in the sarcopenic group, when compared to the non-sarcopenic group, in elderly adults, as well as in adults with or without gastrointestinal disorders. The analysis was robust with a low risk of publication bias.

CONCLUSIONS

SII is closely associated to sarcopenia. Sarcopenic adults had elevated SII levels. The high SII level increased the risk of sarcopenia. Large scale multi-center prospective studies are required to validate these study findings.

Relationships between sarcopenia, nutrient intake, and gut microbiota in Chinese community-dwelling older women

BACKGROUND

The relationship among gut microbiota, sarcopenia components, and influencing factors in female sarcopenic patients has been poorly investigated.

METHODS

Female participants completed questionnaires of physical activity and dietary frequency and were assessed for the presence of sarcopenia by the Asian Working Group of Sarcopenia 2019 (AWGS 2019) criteria. Fecal samples were collected from 17 sarcopenia and 30 non-sarcopenia subjects for 16S sequencing and short chain fatty acid (SCFA) detection.

RESULTS

The prevalence of sarcopenia was 19.20% among 276 participants. The dietary protein, fat, dietary fiber, vitamin B1, niacin, vitamin E, phosphorus, magnesium, iron, zinc, and cooper intake of sarcopenia were all remarkably low. In addition, the richness of gut microbiota (Chao1 and ACE indexes) was considerably reduced in sarcopenic patients, and the sarcopenic gut microbiota and its metabolite were decreased in Firmicutes/Bacteroidetes, Agathobacter, Dorea and Butyrate and were enriched in Shigella and Bacteroides. Correlation analysis showed that Agathobacter and Acetate were positively correlated with grip strength and gait speed, respectively, and Bifidobacterium was negatively correlated with grip strength and appendicular skeletal muscle index (ASMI). Moreover, the protein intake was positively related to Bifidobacterium.

CONCLUSIONS

This cross-sectional study revealed the alterations of gut microbiota composition, SCFA, and nutrient intake in women with sarcopenia and their relation to sarcopenic components. These results provide insights into further studies on the role of nutrition and gut microbiota in sarcopenia and its use as a therapeutic approach.

Factors Associated With Functional Limitations in Daily Living Among Older Adults in Korea: A Cross-Sectional Study

Objective: This paper assesses the relationship between demographics, health parameters, and functional limitations among older adults in Korea, including limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Methods: We analyzed data from the Korean Longitudinal Study of Aging survey in 2020 and included only participants aged 65 and older. Multinomial logistic regression models were conducted to evaluate the factors that predicted functional limitations. Results: The prevalence of at least one ADL and IADL limitations were 6.14% (severe 1.94% and moderate 4.20%) and 15.49% (severe 3.11% and moderate 12.38%), respectively. People aged 85 and older had high rates of severe disability with 7.37% for ADLs and 12.06% for IADLs. High rates also occurred among people with low education, underweight, physical inactivity, depression, and three or more chronic diseases. Conclusion: Factors associated with functional limitations were age, educational status, body mass index, physical activity, depression, and chronic diseases. To prevent and improve functional limitations in the older populations, active and applicable interventions should be considered for modifiable factors such as physical activity, depression, and abnormal weight.

Bioelectrical Impedance Analysis for the Assessment of Body Composition in Sarcopenia and Type 2 Diabetes

Sarcopenia is emerging as a severe complication in type 2 diabetes (T2DM). On the other hand, it has been documented that nutritional aspects, such as insufficient protein or total energy intake, increase sarcopenia risk. The analysis of body composition is a relevant approach to assess nutritional status, and different techniques are available. Among such techniques, bioelectrical impedance analysis (BIA) is particularly interesting, since it is non-invasive, simple, and less expensive than the other techniques. Therefore, we conducted a review study to analyze the studies using BIA for body composition analysis in T2DM patients with sarcopenia or at risk of catching it. Revised studies have provided important information concerning relationships between body composition parameters (mainly muscle mass) and other aspects of T2DM patients’ conditions, including different comorbidities, and information on how to avoid muscle mass deterioration. Such relevant findings suggest that BIA can be considered appropriate for body composition analysis in T2DM complicated by sarcopenia/muscle loss. The wide size of the patients’ cohort in many studies confirms that BIA is convenient for clinical applications. However, studies with a specific focus on the validation of BIA, in the peculiar population of patients with T2DM complicated by sarcopenia, should be considered.

DXA-Derived Indices in the Characterisation of Sarcopenia

Sarcopenia is linked with increased risk of falls, osteoporosis and mortality. No consensus exists about a gold standard "dual-energy X-ray absorptiometry (DXA) index for muscle mass determination" in sarcopenia diagnosis. Thus, many indices exist, but data on sarcopenia diagnosis agreement are scarce. Regarding sarcopenia diagnosis reliability, the impact of influencing factors on sarcopenia prevalence, diagnosis agreement and reliability are almost completely missing. For nine DXA-derived muscle mass indices, we aimed to evaluate sarcopenia prevalence, diagnosis agreement and diagnosis reliability, and investigate the effects of underlying parameters, presence or type of adjustment and cut-off values on all three outcomes. The indices were analysed in the BioPersMed cohort (58 ± 9 years), including 1022 asymptomatic subjects at moderate cardiovascular risk. DXA data from 792 baselines and 684 follow-up measurements (for diagnosis agreement and reliability determination) were available. Depending on the index and cut-off values, sarcopenia prevalence varied from 0.6 to 36.3%. Height-adjusted parameters, independent of underlying parameters, showed a relatively high level of diagnosis agreement, whereas unadjusted and adjusted indices showed low diagnosis agreement. The adjustment type defines which individuals are recognised as sarcopenic in terms of BMI and sex. The investigated indices showed comparable diagnosis reliability in follow-up examinations.