Besides Sarcopenia, Pre-Sarcopenia Also Predicts All-Cause Mortality in Older Chileans

The prevalence patterns and risk factor profiles of poor muscle health and its associated components in multiethnic older Asians: The PIONEER study

BACKGROUND

We aim to determine the multiethnic patterns of the prevalence and associated factors of poor muscle health and its associated components in older Chinese, Malays, and Indian Asian adults.

METHODS

We included 2199 participants (mean age ± SD: 72.9 ± 8.3 years; 54.3% female) from the baseline assessment of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER; 2017-2022) cohort study. Poor muscle health was defined as the presence of either low muscle mass (DEXA), or low muscle strength (handgrip strength), or low physical performance (gait speed). Its components include poor muscle function (low muscle strength and/or low physical performance without low muscle mass), pre-sarcopenia (low muscle mass only), and any sarcopenia (low muscle mass with low muscle strength and/or low physical performance). Sociodemographic, clinical, and lifestyle factors were assessed using biochemistry, clinical tests, and validated questionnaires. Regression models were utilized to evaluate the independent risk factors of poor muscle health and its components.

RESULTS

The national census-adjusted prevalence of poor muscle health (88%) was similar across the three ethnic groups. However, Chinese individuals had higher prevalence of pre-sarcopenia and any sarcopenia, and a lower prevalence of poor muscle function compared with Indians or Malays. We observed ethnic differences in modifiable risk factors (low physical activity, diabetes, osteoporosis, and obesity) of poor muscle health and its components. Although obesity was protective of pre-sarcopenia (RRR = 0.19, 95% CI: 0.11, 0.36) and any sarcopenia (RRR = 0.29, 95% CI: 0.18, 0.47) in the overall population and across ethnic groups, it was associated with 1.7 times (95% CI: 1.07, 2.67) the likelihood of poor muscle function in the entire population.

CONCLUSIONS

Almost 90% of community dwelling Singaporean aged ≥60 years have poor muscle health across the three ethnic groups with ethnic disparities in modifiable risk factors, highlighting an urgent need for community-wide targeted interventions to promote muscle health.

High prevalence of muscle weakness and probable sarcopenia in patients with inflammatory bowel disease

BACKGROUND

This study aimed to determine the prevalence of probable sarcopenia and sarcopenia in patients with inflammatory bowel disease (IBD) by using the European Working Group on Sarcopenia in Older People (EWGSOP2) diagnostic criteria.

METHODS

Sarcopenia was assessed by using the sequential four-step algorithm. (1) Find: Sarcopenia risk by simple clinical symptom index (strength, assistance walking, rise from a chair, climb stairs, and falls [SARC-F questionnaire]). (2) Assess: Probable sarcopenia by low muscle strength on handgrip. (3) Confirm: Confirmed sarcopenia by low appendicular skeletal muscle mass on bioimpedance analysis. (4) Severity: Severe sarcopenia by low 4-m gait speed test.

RESULTS

A total of 129 adult patients with IBD younger than 65 years and 50 age- and sex-matched healthy control (HC) participants were included to the study. Handgrip strength, gait speed, and SARC-F scores were significantly lower in patients with IBD than in the HCs (P = 0.032, <0.0001, and <0.0001, respectively). Based on the EWGSOP2 definition, 17.8% of patients with IBD had probable sarcopenia, and six patients had confirmed sarcopenia. According to the ethnicity-based population thresholds, 34.9% of patients with IBD had probable sarcopenia, and two patients had confirmed sarcopenia. Corticosteroid use within the past year was identified as an independent risk factor for low muscle strength (P = 0.012; odds ratio, 4.133), along with advanced age and disease activity.

CONCLUSION

One-third of the patients younger than 65 years with IBD had probable sarcopenia, defined as low muscle strength, whereas the incidence of confirmed sarcopenia remained relatively low.

Self-Reported Sleep Duration Is a Useful Tool to Predict Sarcopenia in Chilean Older Adults: Evidence from the ALEXANDROS Longitudinal Study

Age-related sleep disorders share common pathways with sarcopenia. Prospective data from Latin American populations are scarce, and the association between sleep disorders and sarcopenia in Chileans remains unknown. Thus, we aimed to study the longitudinal association between sleep disorders and sarcopenia in a cohort study of 1116 community-dwelling Chilean older people ≥60 years old from the ALEXANDROS cohorts. After the exclusion criteria, 318 subjects were followed. Sociodemographic data, self-reported chronic diseases, sedentarism, sleep characteristics, anthropometric measurements, handgrip strength, and muscle performance were assessed. Results indicated that at baseline, the prevalence of sarcopenia was 24.10% without gender differences, and the prevalence of self-reported sleep problems was 23.3%, higher in women (26.46% versus 17.15% in men). The adjusted Cox regression models for sarcopenia showed an association between sarcopenia, sleep disorders (HR = 2.08, 95% IC 1.14-3.80), and long sleep duration (HR = 2.42, 95% IC 1.20-4.91). After 8.24 years of follow-up, there were 2.2 cases of sarcopenia per 100 person-years. This study demonstrates that sleep disorders are an independent risk factor for sarcopenia in Chilean older people. The identification of sleep disorders through self-reported data provides an opportunity for early identification of risk and cost-effective sarcopenia prevention.

Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults

Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

INTRODUCTION

Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru.

METHODS

This cross-sectional study was conducted between 2018 and 2020. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS2) guidelines. We measured muscle strength by maximum handgrip strength and muscle mass using bioelectrical impedance analyzer. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.

RESULTS

The study participants had a mean age of 66.2 years (SD 7.1), age range between 60 to 92 years old, of which 621 (53.9%) were men. Among the sample, 41.7% were classified as obese (BMI ≥30.0 kg/m²). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI: 25.2-30.4) using the AWGS2 criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS2 criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).

CONCLUSION

Our findings reveal substantial variation in the prevalence of sarcopenia and SO, underscoring the necessity for context-specific cut-off values. Although the prevalence of SO was relatively low, this result may be underestimated. Furthermore, the consistently high proportion of probable sarcopenia and sarcopenia point to a substantial public health burden.

Interaction between handgrip strength and vitamin D deficiency on all-cause mortality in community-dwelling older adults: a prospective cohort study

OBJECTIVE

Muscle strength decline and vitamin D deficiency are coexisting conditions associated with multiple adverse health outcomes. This prospective study aimed to investigate the multiplicative and additive interactions between handgrip strength (HS) and serum 25-hydroxyvitamin D [25(OH)D] on all-cause mortality in Chinese community-dwelling older adults.

STUDY DESIGN

This is a population-based cohort study.

METHODS

2635 older adults (85.15 ± 12.01 years) were recruited from the Chinese Longitudinal Healthy Longevity Survey (2012-2018). Low HS was defined according to the Asian Working Group for Sarcopenia 2019 updated consensus (<28 kg for men and <18 kg for women). Serum 25(OH)D < 50 nmol/L were defined as vitamin D deficiency. Cox proportional hazard models were used to examine the association of HS and 25(OH)D with all-cause mortality. Socio-demographics, health status, and clinical characteristics were included as covariates.

RESULTS

1715 (65.09 %) and 1885 (71.54 %) participants had low HS and vitamin D deficiency, respectively. During a median follow-up of 3.52 years, 1107 older people died. After multivariable adjustment, both HS and 25(OH)D levels were inversely associated with all-cause mortality risk (Ps < 0.001). The hazard ratios (HRs) of low HS and vitamin D deficiency for all-cause mortality were 1.73 (95 % CI: 1.41-2.13) and 1.61 (95 % CI: 1.32-1.93), respectively. Although significant multiplicative interactions were not found, the association between low HS and all-cause mortality was attenuated in the higher 25(OH)D subgroup than in the lower 25(OH)D subgroup (stratified by 50 nmol/L). The multiple-adjusted HR of mortality for combined low HS and vitamin D deficiency was 2.18 (95 % CI: 1.73-2.56), which was higher than that for these two conditions alone. Significant additive interactions between low HS and vitamin D deficiency on mortality were observed (relative excess risk due to interaction: 0.71, 95 % CI: 0.37-1.05).

CONCLUSIONS

Low HS and low 25(OH)D levels synergistically increased the risk of all-cause mortality. Our results added new insights to the priority of early detection for older adults with comorbid muscle strength decline and vitamin D deficiency.

Associations between handgrip strength and skeletal muscle mass with all-cause mortality and cardiovascular mortality in people with type 2 diabetes: A prospective cohort study of the UK Biobank

AIMS

To explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all-cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients.

MATERIALS AND METHODS

Data were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex-specific analyses were conducted.

RESULTS

A total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow-up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all-cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles (p trend <.05). A 1 SD decrease in HGS was found to both increase the all-cause risk (HR: 1.31 [95% CI: 1.24-1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22-1.50]) for men, and all-cause risk (HR: 1.26 [95% CI: 1.11-1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09-1.89]) for women. There was no statistically significant trend association between SMM/height2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height2 showed a U-shaped nonlinear relationship (pnonlinear  <.05).

CONCLUSIONS

Grip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U-shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.

Motor unit firing patterns in older adults with low skeletal muscle mass

Muscular dysfunctions involving a decline in muscle strength are often induced by loss of muscle mass in older adults. Understanding neural activation in older adults in addition to muscular characteristics may be important to prevent such age-related dysfunctions. This study aimed to investigate the difference in motor unit firing patterns between community-dwelling older individuals with normal and low skeletal muscle mass. Sixty-six older adults (62-90 years) performed muscle strength and function tests. On conducting high-density surface electromyography of the vastus lateralis, individual motor unit firing properties were assessed. Individual motor units were divided into three different recruitment threshold groups and their firing rates were compared. The skeletal muscle quantity and quality were assessed using bioimpedance methods and ultrasound images. They were divided into two groups according to sarcopenia criteria: a normal group (n = 39) and presarcopenia group with low skeletal muscle mass but normal physical functions (n = 21). Skeletal muscle mass and muscle thickness were greater and echo intensity was lower in the normal group than presarcopenia group. Motor units in normal older adults fired at different rates with a hierarchy depending on their recruitment threshold, observed as a normal phenomenon. However, motor units in the presarcopenia group fired without showing the hierarchical pattern. The results suggest that older adults with low skeletal muscle mass exhibited an abnormal neural input pattern, in addition to declines in muscle quantity and quality.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

Background

Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. However, there remains a lack of consensus on the criteria and cut-off thresholds for assessing sarcopenia and SO. Moreover, limited data are available on the prevalence of these conditions in Latin American countries. To address this evidence gap, we aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥ 55 years in Lima, Peru.

Methods

Data collection for this cross-sectional study was conducted between 2018 and 2020 in two urban low-resource settings in Lima, Peru. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS) guidelines. We measured muscle strength by maximum handgrip strength; muscle mass using a whole-body single-frequency bioelectrical impedance analyzer, and physical performance using the Short Physical Performance Battery and 4-meter gait speed. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.

Results

The study participants had a mean age of 66.2 years (SD 7.1), of which 621 (53.9%) were men, and 41.7% were classified as obese (BMI ≥ 30.0 kg/m2). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI:25.2-30.4) using the AWGS criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).

Conclusions

Our findings reveal substantial variation in the prevalence of sarcopenia and SO when using different guidelines, underscoring the necessity for context-specific cut-off values. Nevertheless, regardless of the chosen guideline, the prevalence of probable sarcopenia and sarcopenia among community-dwelling older adults in Peru remains noteworthy.

Ultrasound assessment of rectus femoris pennation angle and echogenicity. Their association with muscle functional measures and fat infiltration measured by CT scan

BACKGROUND & AIMS

Ultrasound can be used to measure the pennation angle between muscle fiver and the presumed axis of force generation and muscle echogenicity as an indicator of muscle fat infiltration. We aimed to assess the association of the rectus femoris pennation angle and echogenicity with muscle functional measures. Also, to assess the concordance of rectus femoris echogenicity with muscle fat infiltration as determined by CT scan.

METHODS

Rectus femoris ultrasound pennation angle and thickness were measured in 78 participants aged 69 (65,73) years (37 women). Also hand grip strength, gait speed in 4 m, the 12 min' walk and body composition by DEXA were measured. In a different group of 114 participants aged 44 (31,52) years (80 females), non-dominant rectus femoris echogenicity and thickness were measured by ultrasound and muscle fat infiltration was assessed by CT scan. Handgrip strength and quadriceps torque were also measured.

RESULTS

There was a weak correlation between the pennation angle and rectus femoris thickness in men (r = 0.31 p = 0.05) but not in women (r = 0.29 NS). Women, but not men with a low pennation angle covered a longer distance during the 12 min' walk. The concordance between the z scores of rectus femoris echogenicity and CT radiological density was 0.43 (p < 0.01) and 0.01 (NS) in men and women, respectively. Men and women with an echogenicity below the 25th percentile had a higher quadriceps torque. Men with an echogenicity 25th percentile below 25th percentile had also a higher handgrip strength.

CONCLUSIONS

Rectus femoris pennation angle had a weak or absent association with muscle performance. Rectus femoris echogenicity had a moderate overall concordance with radiological density by CT scan and was inversely associated with quadriceps torque. Therefore, echogenicity was associated with muscle strength, but pennation angle measurement did not contribute to the assessment of muscle function.

The association between walking pace and grip strength and all-cause mortality: A prospective analysis from the MAUCO cohort

OBJECTIVE

This study investigated the individual and combined association of walking pace and grip strength with all-cause mortality in Chilean adults.

STUDY DESIGN

8813 participants (54.6 % women) from the MAUCO population-based cohort were included in this prospective study.

MAIN OUTCOME MEASURES

Individual and combined associations of grip strength (normal or low grip) and walking pace (normal or slow walking) with all-cause mortality were investigated using Cox proportional-hazard models. Analyses were adjusted for sociodemographic, lifestyle, and health-related factors.

RESULTS

Over a median follow-up of 4.74 years, 151 and 206 participants included in the analyses of walking pace and grip strength died. Individuals with low grip strength had a risk of dying 2.40 times (95 % CI: 1.64 to 3.51) higher than their counterparts with normal grip strength. Similar results were identified for slow walkers (HR: 1.77 [95 % CI: 1.25 to 2.50]). When the two factors were combined and the associations investigated, individuals with normal walking pace but with low grip strength had a higher risk of all-cause mortality than those with normal walking pace and normal grip strength (HR: 3.56 [95 % CI: 1.99 to 6.36]). The associations remained even after including a 1- and 2-year landmark period in the analyses.

CONCLUSIONS

Slow walking pace and low grip strength were associated with a higher risk of mortality (both in isolation and combined). These factors might be early markers of all-cause mortality, and should be measured more frequently in middle-aged and older adults in clinical practice.

The Relationship between Sarcopenia and Injury Events: A Systematic Review and Meta-Analysis of 98,754 Older Adults

The main purpose of this study was to investigate the relationship between sarcopenia and injury events (falls, fractures, hospitalization, disability, and death). This study systemically searched the literature from Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library and analyzed the collected literature using the random effects model to demonstrate the relationship between sarcopenia and injury events. This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and collected a total of 38 prospective studies, and the results showed that, when compared to robust individuals, the risk of injury events for older individuals with sarcopenia was significantly higher for fractures (HR = 9.66, CI: 5.07-18.38), hospital admissions (HR = 11.80, CI: 4.86-28.65), and death (HR = 9.57, CI: 3.17-28.94). In consideration of the negative impact of sarcopenia on the subsequent health of older adults, professional nursing personnel should assess older adults for sarcopenia as early as possible and propose relevant care policies to further reduce negative health impacts.

Low muscle mass, low muscle function, and sarcopenia in the urban and rural elderly

Health outcomes of the elderly vary between rural and urban areas. Sarcopenia is diagnosed as loss of muscle strength or impaired physical performance, namely "low muscle function" and low muscle mass. Outcomes of low muscle mass and low muscle function are not equal. This study aimed to investigate the prevalence of low muscle mass, low muscle function, and sarcopenia in rural and urban populations and to determine whether regional differences were associated with each of these components. Participants aged ≥ 69 years (n = 2354) were recruited from three urban districts and one rural district in Korea. Low muscle mass was defined by appendicular lean mass using bioelectrical impedance analysis. Low muscle function was defined by handgrip strength and 5-chair stand test. Sarcopenia was defined as low muscle mass plus low muscle function. The prevalence of low muscle function (53.7% vs. 72.8%), and sarcopenia (16.3% vs. 24.4%) were higher in the rural elderly population. Rural residence was associated with low muscle function (OR 1.63; 95% CI 1.13-2.37, P = 0.009), but not with low muscle mass (OR 0.58; 95% CI 0.22-1.54, P = 0.271) or with sarcopenia (OR 1.13; 95% CI 0.63-2.00, P = 0.683). Interventions to detect and improve low muscle function in rural elderly population are needed.

Pre-sarcopenia and Mac-2 binding protein glycosylation isomer as predictors of recurrence and prognosis of early-stage hepatocellular carcinoma

BACKGROUND

The Mac-2 binding protein glycosylation isomer (M2BPGi), a fibrosis marker in various liver diseases, is reportedly a prognostic marker in patients with hepatocellular carcinoma (HCC) who underwent hepatectomy.

AIM

To evaluate whether the M2BPGi value, M2BP, and pre-sarcopenia before radiofrequency ablation (RFA) could be useful recurrence and prognostic markers in patients with early-stage HCC.

METHODS

In total, 160 patients with early-stage primary HCC treated with RFA were separately analyzed as hepatitis C virus (HCV)-positive and HCV-negative. Factors contributing to recurrence and liver-related death, including M2BP, M2BPGi, and skeletal muscle mass index, were statistically analyzed. Eighty-three patients were HCV-positive and 77 were HCV-negative.

RESULTS

In HCV-positive patients, only des-γ-carboxy-prothrombin ≥ 23 mAU/mL was a significant poor prognostic factor affecting survival after RFA. In HCV-negative patients, M2BPGi ≥ 1.86 cutoff index was significantly associated with tumor recurrence, while M2BP was not. M2BPGi ≥ 1.86 cutoff index (hazard ratio, 4.89; 95% confidence interval: 1.97-12.18; P < 0.001) and pre-sarcopenia (hazard ratio, 3.34, 95% confidence interval: 1.19-9.37; P = 0.022) were independent significant poor prognostic factors in HCV-negative patients.

CONCLUSION

In HCV-negative patients with primary HCC treated with RFA, lower M2BPGi contributed to a lower tumor recurrence rate and longer survival period. Pre-sarcopenia contributed to the poor prognosis independently in HCV-negative patients. These factors might be useful recurrence and prognostic markers for early-stage primary HCC.

Forecasting Healthy Life Expectancy Among Chilean Community-Dwelling Older Adults With and Without Sarcopenia

BACKGROUND

Sarcopenia is an important risk factor for disability and dependency at old age. The prevalence of sarcopenia among the Chilean older population is high.

OBJECTIVE

To estimate life expectancy, healthy life expectancy and unhealthy life expectancy among sarcopenic and non-sarcopenic older adults from Santiago, Chile.

METHODS

A sample of 1,897 community-dwelling older adults aged 60 years or more, living in Santiago, was observed between 5-15 years. Disability was defined as the unhealthy state, assessed through self-reported difficulties in activities of daily living. Sarcopenia was determined via HTSMayor software. Total and marginal life expectancies were estimated using the Interpolated Markov Chain method "IMaCh".

RESULTS

At 60 years, estimated life expectancy for sarcopenic and non-sarcopenic older adults was similar (22.7 and 22.5 years, respectively). The proportion of years to be lived with disability was three times greater in sarcopenic adults, compared to non-sarcopenic people. This difference was observed up to 80 years. Non-sarcopenic women had a higher proportion of years to be lived with disabilities compared to non-sarcopenic men of the same age, but this proportion was higher among sarcopenic men, compared to sarcopenic women until 70 years of age.

DISCUSSION

People with sarcopenia expect to live a higher proportion of years with disabilities. Sarcopenic men until 70 years expected to live a higher proportion of years with disability, compared to sarcopenic women. Monitoring sarcopenia among older people may help to identify individuals with higher risk of disability onset. Future research should focus on disentangling the mechanisms explaining sex differences.

Sarcopenia Index Based on Serum Creatinine and Cystatin C is Associated with Mortality, Nutritional Risk/Malnutrition and Sarcopenia in Older Patients

Purpose

To investigate the association of sarcopenia index (SI) [(serum creatinine/serum cystatin C) × 100] with mortality, nutritional risk/malnutrition and sarcopenia among hospitalized older adults.

Subjects and Methods

A prospective analysis was performed in 758 hospitalized older adults. Anthropometric measures and biochemical parameters were carried out for each patient. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) 2019 algorithm. Nutritional risk/malnutrition was defined according to the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria. The logistic regression analysis was employed for the analysis of correlation between the SI and other variables. Cox regression analysis was employed to analyze correlation between the SI and mortality.

Results

A total of 758 participants agreed to participate in this study (589 men and 169 women; mean age: 85.6±6.1 years). The median of the follow-up period was 212 days. A total of 112 patients died. A high SI (per 1-SD was 22.1) was independently associated with all-cause mortality (HR per 1-SD = 0.61, 95% CI: 0.47–0.79), nutritional risk/malnutrition (OR per 1-SD = 0.38, 95% CI: 0.29–0.49) and sarcopenia (OR per 1-SD = 0.58, 95% CI: 0.45–0.74). High SI was positively correlated with albumin (r = 0.32, P < 0.001), hemoglobin (r = 0.24, P < 0.001), body mass index (BMI) (r = 0.12, P = 0.001), waist circumference (WC) (r = 0.08, P = 0.046), calf circumference (CC) (r = 0.45, P < 0.001), hand grip strength (HGS) (r = 0.52, P < 0.001) and negatively correlated with triglyceride glucose (TyG) (r = −0.11, P = 0.007).

Conclusion

The SI based on serum cystatin C and creatinine is associated with long-term mortality, nutritional risk/malnutrition and sarcopenia in hospitalized older Chinese patients.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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