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Hämäläinen O, Tirkkonen A, Savikangas T, Alén M, Sipilä S, Hautala A. Low physical activity is a risk factor for sarcopenia: a cross-sectional analysis of two exercise trials on community-dwelling older adults. BMC Geriatr 2024; 24:212. [PMID: 38424514 PMCID: PMC10905947 DOI: 10.1186/s12877-024-04764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Physical inactivity is an important factor in the development of sarcopenia. This cross-sectional study explores the prevalence of sarcopenia and associations of physical activity (PA) with sarcopenia in two exercise trial populations. These study groups are clinically meaningful community-dwelling populations at increased risk for sarcopenia: older adults not meeting the PA guidelines and those with a recent hip fracture (HF). METHODS Data from 313 older adults who did not meet the PA guidelines (60% women; age 74.5 ± 3.8, body mass index 27.9 ± 4.7) and 77 individuals with HF diagnosed on average 70 ± 28 days earlier (75% women; age 79.3 ± 7.1, body mass index 25.3 ± 3.6) were included in this study. Grip strength and muscle mass (Dual-energy X-ray absorptiometry [DXA] in older adults not meeting the PA guidelines and bioimpedance analysis in participants with HF) were used to assess sarcopenia according to the European Working Group in Older People 2019 (EWGSOP2) criteria. The current level of PA was self-reported using a question with seven response options in both study groups and was measured with a hip-worn accelerometer for seven consecutive days in older adults not meeting the PA guidelines. RESULTS The prevalence of sarcopenia and probable sarcopenia was 3% (n = 8) and 13% (n = 41) in the older adults not meeting the PA guidelines and 3% (n = 2) and 40% (n = 31) in the HF group, respectively. In the age- and sex-adjusted logistic regression model, the lowest levels of self-reported PA were associated with increased probable sarcopenia and sarcopenia risk in older adults not meeting the PA guidelines (OR 2.8, 95% CI, 1.3-6.1, p = 0.009) and in the HF group (OR 3.9, 95% CI, 1.4-11.3, p = 0.012). No significant associations between accelerometer-measured PA and probable sarcopenia or sarcopenia were found. CONCLUSIONS Probable sarcopenia is common among community-dwelling older adults not meeting the PA guidelines and very common among individuals recovering from HF who are able to be involved in exercise interventions. In addition, since low PA is associated with higher probable sarcopenia and sarcopenia risk, it is recommended to screen for sarcopenia and promote regular physical activity to prevent sarcopenia in these populations.
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Affiliation(s)
- Onni Hämäläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Anna Tirkkonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Savikangas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Alén
- Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
| | - Sarianna Sipilä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Arto Hautala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Ooi H, Welch C. Obstacles to the Early Diagnosis and Management of Sarcopenia: Current Perspectives. Clin Interv Aging 2024; 19:323-332. [PMID: 38404480 PMCID: PMC10893890 DOI: 10.2147/cia.s438144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024] Open
Abstract
Research in sarcopenia has grown exponentially over the last 15 years in geriatrics and gerontology, as well as other specialties, including oncology and hepatology. There is now strong evidence for the role of resistance exercise to prevent declines in muscle strength and function, especially when combined with nutritional optimization with protein supplementation. However, there remains a disparity between research evidence and clinical practice. There are multiple factors for this, which relate to the current diagnostic criteria for sarcopenia, practical and logistical aspects of diagnosis of sarcopenia, clinician knowledge of both diagnosis and management, and the availability of pathways for interventions. Sarcopenia is currently defined based on the identification of muscle strength, in combination with muscle size or quality, below cut-off thresholds at a single timepoint. This defines sarcopenia as a binary process of either present or not present, thus early diagnosis can be challenging. In this article, we summarize current obstacles to early diagnosis and management of sarcopenia in clinical practice, and make recommendations to how these might be overcome. This includes our recommendation of incorporation of handgrip strength measurement into standard care, to enable dynamic assessment and identification of early declines in handgrip strength, so that interventions can be implemented to prevent disability.
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Affiliation(s)
- Hoyli Ooi
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London, UK
| | - Carly Welch
- Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London, UK
- Department of Twin Research and Genetic Epidemiology, School of Life Course and Population Sciences, St Thomas’ Campus, King’s College London, London, UK
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Kiss CM, Bertschi D, Beerli N, Berres M, Kressig RW, Fischer AM. Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients. Aging Clin Exp Res 2024; 36:25. [PMID: 38321234 PMCID: PMC10847205 DOI: 10.1007/s40520-024-02694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. METHODS In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. RESULTS In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). CONCLUSION In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults.
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Affiliation(s)
- Caroline M Kiss
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Dominic Bertschi
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadine Beerli
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Institute of Nursing Science, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas M Fischer
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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Yilmaz M, Atik-Altinok Y, Seyidoglu Yüksel D, Acarer A, Bozkurt D, Savas S, Sarac ZF, Akcicek F. Evaluation of sarcopenia and phase angle in elderly patients with Parkinson's Disease. Int J Neurosci 2024:1-8. [PMID: 38275120 DOI: 10.1080/00207454.2024.2310180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE To investigate sarcopenia and related factors and to determine the disease-specific phase angle (PhA) cut-off score in detecting sarcopenia in elderly patients with Parkinson's Disease (PD). METHODS This cross-sectional study was conducted with 89 participants. The Mini-Nutritional Assessment (MNA), the Eating Attitude Test-10 (EAT-10), the Physical Activity Scale for The Elderly (PASE) questionnaire and the Hoehn-Yahr scale have been used. Additionally, anthropometric measurements were performed. The diagnosis of sarcopenia was based on the new consensus published by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). PhA has been performed by Bioelectrical Impedance Analysis (BIA) with Tanita MC 780®. RESULTS The mean age was of the participants 68.9 ± 6.4 years, and 57.3% were male. The prevalence of sarcopenia was 12.3%. PhA, malnutrition, age, disease severity, low calf circumference (CC), low body mass index (BMI), the difference between the pre-diagnosis and current weight loss, dopaminergic treatment, and low PASE score were associated with sarcopenia. The cut-off value of the PhA in terms of the ability to identify sarcopenia was <4.5o with a sensitivity of 53.3% and a specificity of 93.2% (p = 0.001). When we grouped the PhA of the patients according to this cut-off score, it was seen that 14.6% of them were sarcopenic. Age, disease severity, PASE score and hand grip strength were significantly related to both sarcopenia and PhA. CONCLUSION It is important to be aware of sarcopenia and related factors at an early stage in Parkinson's patients. Because of disease-related symptoms, it may be more appropriate to use a disease-specific PhA cut-off score in the definition of sarcopenia.
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Affiliation(s)
- Merve Yilmaz
- Faculty of Health Science, Department of Nutrition and Dietetics, İzmir Tinaztepe University, İzmir, Turkey
| | | | | | - Ahmet Acarer
- Department of Neurology, Ege University of Medical Faculty, İzmir
| | - Devrim Bozkurt
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Sumru Savas
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Z Fulden Sarac
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Fehmi Akcicek
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
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Haigis D, Wagner S, Pomiersky R, Matting L, Hahn LS, Eschweiler GW, Thiel A, Frahsa A, Sudeck G, Nieß AM. [Sarcopenia, physical activity and sedentary behavior among nursing home residents in Germany]. Z Gerontol Geriatr 2024:10.1007/s00391-023-02275-z. [PMID: 38276995 DOI: 10.1007/s00391-023-02275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Residents in nursing homes show a high prevalence of the musculoskeletal syndrome sarcopenia and tend not to achieve current physical activity recommendations. OBJECTIVE The aim of this study is to identify differences in physical activity and sedentary behavior of sarcopenic residents compared with nonsarcopenic and presarcopenic residents. METHODS Sarcopenia assessment was performed among 63 nursing home residents in Baden-Wuerttemberg (D) using the European Working Group on Sarcopenia in Older People 2 specifications. Structured activity sessions (per week), accelerometer-based physical activity (steps/day), and sedentary behavior (percentual/day) were examined. The group comparisons were determined with Kruskal-Wallis tests and Dunn-Bonferroni post hoc tests. RESULTS Significant differences were found for number of steps (p = 0.005) and percentual sedentary behavior (p = 0.019). Moreover, steps per day presented significant results in group comparison for no sarcopenia (2824.4 [423-14275]) with probable sarcopenia (1703.9 [118-5663]) and confirmed/severe sarcopenia (1571.2 [240-2392]) (both p = 0.022; |r| = 0.34). Sedentary behavior demonstrated significant differences in groups with no sarcopenia (87.9% [69.1-94.3]) and with probable sarcopenia (91.7% [80.4-9835]) (p = 0.018; |r| = 0.35). CONCLUSION Nonsarcopenic residents demonstrated a higher number of steps and lower sedentary behavior compared with presarcopenic and sarcopenic residents. Increasing steps, reducing sedentary behavior and promoting activities of daily living can contribute to the prevention and treatment of sarcopenia in the nursing home setting.
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Affiliation(s)
- Daniel Haigis
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland.
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland.
| | - Silas Wagner
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Rebekka Pomiersky
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Leon Matting
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Lea-Sofie Hahn
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Gerhard W Eschweiler
- Geriatrisches Zentrum, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
| | - Ansgar Thiel
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Annika Frahsa
- Institut für Sozial- und Präventivmedizin, Universität Bern, 3012, Bern, Schweiz
| | - Gorden Sudeck
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Andreas M Nieß
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
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Márquez Mesa E, Suárez Llanos JP, Afonso Martín PM, Negrín CB, García Ascanio M, González González S, Llorente Gómez de Segura I. Influence of the Results of Control of Intakes, Proteins and Anthropometry Nutritional Screening, Sarcopenia and Body Composition on the Clinical Evolution of Hospitalized Patients. Nutrients 2023; 16:14. [PMID: 38201844 PMCID: PMC10780303 DOI: 10.3390/nu16010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Hospital malnutrition and sarcopenia are common in inpatients and are associated with worse prognosis. Our objective is to determine the association of the positivity of CIPA (Control of Intakes, Proteins and Anthropometry) nutrition screening tool and sarcopenia and evaluate its prognostic implications (length of stay, readmissions and mortality) as well as different components of body composition. (2) Methodology: Cross-sectional single-center study and prospective six months follow-up for prognostic variables. On admission, CIPA and EWGSOP2 criteria were assessed. (3) Results: Four hundred inpatients, a median of 65.71 years old and 83.6% with high comorbidity, were evaluated. In total, 34.8% had positive CIPA and 19.3% sarcopenia. Positive CIPA and sarcopenia had worse results in body composition (fat mass (FM), fat-free mass (FFM) and appendicular skeletal muscle mass index (ASMI)) and dynamometry. Positive CIPA is significantly associated with worse prognosis (mortality (OR = 1.99), readmissions (OR = 1.86) and length of stay (B = 0.19)). Positive CIPA and sarcopenia combined are associated with a tendency to higher mortality (OR = 2.1, p = 0.088). Low hand grip strength (HGS) is significantly related to a higher length of stay (B = -0.12). (4) Conclusions: In hospitalized patients, malnutrition independently and combined with sarcopenia is associated with a worse prognosis but not body composition. Low HGS is related to a higher length of stay.
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Affiliation(s)
- Elena Márquez Mesa
- Endocrinology and Nutrition Department, Hospital Universitario Nuestra Señora de Candelaria, Ctra. Del Rosario 145, 38010 Santa Cruz de Tenerife, Spain; (J.P.S.L.)
| | - José Pablo Suárez Llanos
- Endocrinology and Nutrition Department, Hospital Universitario Nuestra Señora de Candelaria, Ctra. Del Rosario 145, 38010 Santa Cruz de Tenerife, Spain; (J.P.S.L.)
| | | | - Carla Brito Negrín
- Faculty of Health Sciences, University of La Laguna, Calle Padre Herrera, 38200 La Laguna, Spain
| | - María García Ascanio
- Faculty of Health Sciences, University of La Laguna, Calle Padre Herrera, 38200 La Laguna, Spain
| | - Samuel González González
- Faculty of Health Sciences, University of La Laguna, Calle Padre Herrera, 38200 La Laguna, Spain
| | - Ignacio Llorente Gómez de Segura
- Endocrinology and Nutrition Department, Hospital Universitario Nuestra Señora de Candelaria, Ctra. Del Rosario 145, 38010 Santa Cruz de Tenerife, Spain; (J.P.S.L.)
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Altinkaynak M, Gurel E, Oren MM, Kilic C, Karan MA, Bahat G. Associations of EWGSOP1 and EWGSOP2 probable sarcopenia definitions with mortality: A comparative study. Clin Nutr 2023; 42:2151-2158. [PMID: 37774651 DOI: 10.1016/j.clnu.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND & AIMS Sarcopenia is a well-defined geriatric syndrome and a major cause of disability and mortality. We investigate the associations of alternative sarcopenia definitions with mortality in community-dwelling older adults. METHODS Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 probable sarcopenia criteria, with standard handgrip strength (HGS) cut-offs of 30/20 kg for an EWGSOP1 definition and 27/16 kg for an EWGSOP2 definition, or alternatively, population-specific cut-offs of 35/20 kg for a EWGSOP2 definition. The 5-year mortality rate was assessed in the accessible cases. RESULTS The prevalence of sarcopenia among 204 older adults [53.9% female; aged 74.5 ± 7.0] was 4.9% based on the EWGSOP1 criterion, 23.5% according to the EWGSOP2-suggested standard (British) HGS cut-offs and 50.0% based on the EWGSOP2 population-specific cut-offs. In the 103 accessible patients, the mortality rate was 30.1%. Cox-regression analyses adjusted for parameters determined through univariate analyses [age and sarcopenia definitions (in 3 different models)], showed that the EWGSOP1 definition (HR = 4.26, 95% CI = 1.45-12.42, p = 0.008) and EWGSOP2 probable sarcopenia definition with population-specific cut-offs (HR = 2.58, 95% CI = 1.12-5.93, p = 0.03) were associated with a greater mortality risk, while the EWGSOP2 probable sarcopenia definition with standard-cut offs was not (p = 0.09). CONCLUSIONS This is the first study to investigate the associations of EWGSOP2-defined probable sarcopenia with mortality based on standard vs. population-specific HGS cut-offs. The results suggest that population-specific cut-offs should be used when available. We suggest that conducted in community-dwelling older adults, our results have implications for most of older adults.
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Affiliation(s)
- Mustafa Altinkaynak
- Department of Internal Medicine, Division of General Internal Medicine, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
| | - Erdem Gurel
- Department of Internal Medicine, Division of General Internal Medicine, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
| | - Meryem Merve Oren
- Department of Public Health, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
| | - Cihan Kilic
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
| | - Mehmet Akif Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
| | - Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Fatih, 34390, Istanbul, Turkey.
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Muñoz-Redondo E, Morgado-Pérez A, Pérez-Sáez MJ, Pascual J, Tejero-Sánchez M, Curbelo YG, Terradellas-Fernández M, Meza-Valderrama D, Vázquez-Ibar O, Annweiler C, Sánchez-Rodríguez D, Marco E. New perspectives on frailty in light of the Global Leadership Initiative on Malnutrition, the Global Leadership Initiative on Sarcopenia, and the WHO's concept of intrinsic capacity: A narrative review. Maturitas 2023; 177:107799. [PMID: 37499428 DOI: 10.1016/j.maturitas.2023.107799] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
This review gathered the evidence on the epidemiology of frailty, as well as on screening and diagnostic tools, and new perspectives, in light of the latest global frameworks in malnutrition, sarcopenia, and the World Health Organization's concept of intrinsic capacity. Frailty is a worldwide health challenge and highly prevalent in older adults and the population with chronic diseases independent of age. Regardless of the particular concept of frailty, many screening and diagnostic tools are able to identify frailty in older people, but none of them has shown superiority in every population and healthcare setting. Physical, cognitive, and social components are part of the larger context of frailty. The latest evidence-based initiatives on frailty recommend the use of validated tools to identify frailty's different components, tailored to the needs of specific populations and healthcare systems. Unintentional weight loss is a shared criterion between physical frailty and malnutrition according to the Global Leadership Initiative on Malnutrition criteria. A new definition of sarcopenia by the Global Leadership Initiative on Sarcopenia is awaited, but at present physical frailty shares with sarcopenia the criteria of low muscle function and physical performance (severity grading) according to the revised consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2). The EWGSOP2 includes both muscle mass and function, with most scientific groups agreeing that function is a key hallmark of sarcopenia. The concept of intrinsic capacity features the reserves and positive aspects of aging, and responds to ageism by addressing the deficit model approach. Intrinsic capacity is an emerging, person-centered and public health indicator, aimed at preserving health at mid-life and beyond, to move towards a better aging process in the Decade of Healthy Aging 2020-2030.
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Affiliation(s)
- Elena Muñoz-Redondo
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Andrea Morgado-Pérez
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - María José Pérez-Sáez
- Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain
| | - Julio Pascual
- Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain; Nephrology Department, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain
| | - Marta Tejero-Sánchez
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Yulibeth G Curbelo
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marc Terradellas-Fernández
- Tecnocampus, Universitat Pompeu Fabra, Research group in Attention to Chronicity and Innovation in Health (GRACIS), Carrer d'Ernest Lluch, 32, 08302 Mataró, Barcelona, Spain
| | - Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFRE), City 0819, Panama; Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain
| | - Olga Vázquez-Ibar
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Campus Sart Tilman, Avenue Hippocrate (Bât 23), 4000 Liège, Belgium.
| | - Ester Marco
- Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Aljawini N, Habib SS. Estimation of Sarcopenia Indices in Women from Saudi Arabia in Relation to Menopause and Obesity: Cross-Sectional Comparative Study. J Clin Med 2023; 12:6642. [PMID: 37892780 PMCID: PMC10607446 DOI: 10.3390/jcm12206642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Sarcopenia prevalence depends on the definition, and ethnicity must be considered when setting reference values. However, there is no specific cut-off for sarcopenia in Saudi women. Accordingly, we aimed to establish a cut-off value for sarcopenia in Saudi women. We determined the prevalence of sarcopenia in terms of low handgrip strength (HGS) in postmenopausal women using the EWGSOP2 value, redefined a specific cut-off for low HGS derived from Saudi premenopausal women, re-determined the prevalence of low HGS using the new cut-off, and analyzed the proportion of low HGS in women with obesity compared to those without obesity. Following EWGSOP2 guidelines, we defined probable sarcopenia and set new HGS values. We assessed HGS and body composition in 134 pre/postmenopausal women. Probable sarcopenia prevalence was calculated using EWGSOP2's HGS of 16 kg and new cut-offs from young premenopausal women without obesity. HGS 10 and 8 kg cut-offs were calculated from premenopausal Saudi women's mean -2 SDs and mean -2.5 SDs. Using the HGS 16 kg cut-off, sarcopenia prevalence was 44% in postmenopausal and 33.89% in premenopausal women. Applying the new HGS 10 kg and 8 kg cut-offs, the prevalence was 9.33% and 4%, respectively, in postmenopausal and 5% and 3.40%, respectively, in premenopausal women. Women with obesity had a higher proportion of low HGS across all cut-offs. We suggest that EWGSOP2 cut-offs may not be adaptable for Saudi women. Considering body composition differences between Saudis and Caucasians, our proposed HGS cut-offs appear more relevant.
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Affiliation(s)
- Nouf Aljawini
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11416, Saudi Arabia; (N.A.)
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Syed Shahid Habib
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11416, Saudi Arabia; (N.A.)
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10
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Scott D, Blyth F, Naganathan V, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V. Sarcopenia prevalence and functional outcomes in older men with obesity: Comparing the use of the EWGSOP2 sarcopenia versus ESPEN-EASO sarcopenic obesity consensus definitions. Clin Nutr 2023; 42:1610-1618. [PMID: 37481869 DOI: 10.1016/j.clnu.2023.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND & AIMS The potential for older adults with obesity to also have sarcopenia, and the health consequences of 'sarcopenic obesity', may be underappreciated by health professionals. The primary aim of this secondary analysis of a prospective cohort study of older men was to explore the prevalence and functional outcomes of sarcopenic obesity based on different consensus definitions. METHODS 1416 community-dwelling men aged ≥70 years were classified into sarcopenia categories according to the European Working Group on Sarcopenia in Older People (EWGSOP2) definition, and sarcopenic obesity categories according to the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN-EASO) definition. Descriptive analyses determined prevalence of sarcopenia in obese and non-obese older men. Multivariable analyses compared associations with functional outcomes including activity of daily living (ADL) and instrumental activity of daily living (IADL) disability and 12-month incident falls. RESULTS According to the EWGSOP2 definition, 12.6% of men had confirmed sarcopenia but only 0.3% of men had sarcopenia and obesity (BMI ≥30 kg/m2). Conversely, 9.6% of men had sarcopenic obesity according to the ESPEN-EASO definition. Notably, no men with a BMI ≥32 kg/m2 were classified as having EWGSOP2-confirmed sarcopenia, despite the fact that 60.8% of all men with BMI ≥32 kg/m2 had low muscle strength. Due to low numbers (N = 4) of obese older men with EWGSOP2-confirmed sarcopenia, associations with functional outcomes were not assessed. Men with sarcopenic obesity according to the ESPEN-EASO definition had significantly lower hand grip strength, higher chair-stands time and slower gait speed (all P < 0.05), increased odds for ADL (odds ratio: 5.02, 95% CI: 1.85-13.58) and IADL (2.18, 1.38-3.45) disability, and higher 12-month incident falls rates (incident rate ratio: 1.59, 95% CI: 1.03-2.44) than men with neither sarcopenia nor obesity. CONCLUSION Low muscle strength is common in older men with obesity, but the prevalence of sarcopenia is likely to be underestimated when the EWGSOP2 operational definition is applied in this population. The ESPEN-EASO operational definition of sarcopenic obesity appears to provide a valid approach for identifying older men with obesity who are at risk of poor functional outcomes related to sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Fiona Blyth
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
| | - Vasi Naganathan
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia
| | - David G Le Couteur
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - David J Handelsman
- Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia
| | - Louise M Waite
- Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia
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Chowdhury SR, Chakrabarti A, Datta PK. Sarcopenia in patients with diabetes mellitus, an overlooked perioperative condition. Br J Anaesth 2023; 131:e65-e67. [PMID: 37394326 DOI: 10.1016/j.bja.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Affiliation(s)
- Sumit R Chowdhury
- Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
| | - Asmita Chakrabarti
- Department of Emergency Medicine and Staff Health, Tata Medical Center, Kolkata, India
| | - Priyankar K Datta
- Department of Anesthesiology Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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12
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Sutil DV, Parentoni AN, Da Costa Teixeira LA, de Souza Moreira B, Leopoldino AAO, Mendonça VA, Lacerda ACR, Danielewicz AL, de Avelar NCP. Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 ( EWGSOP2). BMC Musculoskelet Disord 2023; 24:182. [PMID: 36906535 PMCID: PMC10007796 DOI: 10.1186/s12891-023-06287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/02/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed the use of different diagnostic tools to assess sarcopenia. This study aimed to determine prevalence rates of sarcopenia according to the diagnostic instruments proposed by EWGSOP2 and to assess their level of agreement in older Brazilian women. METHODS A cross-sectional study with 161 community-dwelling older Brazilian women. Probable sarcopenia was assessed through Handgrip Strength (HGS) and the 5-times sit-to-stand test (5XSST). In addition to reduced strength, Appendicular Skeletal Muscle Mass (ASM) (obtained by Dual-energy X-ray absorptiometry) and ASM/height² were considered for diagnosis confirmation. Sarcopenia severity was determined by reduced muscle strength and mass and poor functional performance assessed by Gait Speed (GS), Short Physical Performance Battery (SPPB), and Timed Up and Go test (TUG). McNemar's test and Cochran's Q-test were used to compare sarcopenia prevalence. Cohen's Kappa and Fleiss's Kappa tests were used to assess the level of agreement. RESULTS The prevalence of probable sarcopenia was significantly different (p < 0.05) when using HGS (12.8%) and 5XSST (40.6%). Regarding confirmed sarcopenia, the prevalence was lower when using ASM/height² than with ASM. Regarding severity, the use of SPPB resulted in a higher prevalence in relation to GS and TUG. CONCLUSION There were differences in the prevalence rates of sarcopenia and low agreement between the diagnostic instruments proposed by the EWGSOP2. The findings suggest that these issues must be considered in the discussion on the concept and assessment of sarcopenia, which could ultimately help to better identify patients with this disease in different populations.
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Affiliation(s)
- Daiana Vieira Sutil
- Universidade Federal de Santa Catarina (Federal University of Santa Catarina), Araranguá, SC, Brazil
| | - Adriana Netto Parentoni
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (Federal University of the Jequitinhonha and Mucuri Valleys), Diamantina, MG, Brazil
| | - Leonardo Augusto Da Costa Teixeira
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (Federal University of the Jequitinhonha and Mucuri Valleys), Diamantina, MG, Brazil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento (Center for Studies in Public Health and Aging), Universidade Federal de Minas Gerais e Fundação Oswaldo Cruz - Minas Gerais (Federal University of Minas Gerais and Oswaldo Cruz Foundation - Minas Gerais), Belo Horizonte, MG, Brazil
| | | | - Vanessa Amaral Mendonça
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (Federal University of the Jequitinhonha and Mucuri Valleys), Diamantina, MG, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (Federal University of the Jequitinhonha and Mucuri Valleys), Diamantina, MG, Brazil
| | - Ana Lúcia Danielewicz
- Department of Health Sciences, Universidade Federal de Santa Catarina (Federal University of Santa Catarina), 3201 Jardim das Avenidas - Araranguá, CEP: 88.906-072, Araranguá, SC, Brazil
| | - Núbia Carelli Pereira de Avelar
- Department of Health Sciences, Universidade Federal de Santa Catarina (Federal University of Santa Catarina), 3201 Jardim das Avenidas - Araranguá, CEP: 88.906-072, Araranguá, SC, Brazil.
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Sallfeldt ES, Mallmin H, Karlsson MK, Mellström D, Hailer NP, Ribom EL. Sarcopenia prevalence and incidence in older men - a MrOs Sweden study. Geriatr Nurs 2023; 50:102-108. [PMID: 36774676 DOI: 10.1016/j.gerinurse.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 02/12/2023]
Abstract
INTRODUCTION The European Working Group on Sarcopenia in Older People (EWGSOP) published a revised definition of sarcopenia in 2018. There are few incidence studies of sarcopenia following the latest definition. OBJECTIVE To study prevalence, incidence proportion and incidence rate of sarcopenia in a simple random sample of older Swedish men using the EWGSOP2 definition. METHODS Men aged 69-81 were invited to participate in the Osteoporotic Fractures in Men (MrOs) Sweden study. Of 2,004 included participants, 1,266 participants (mean age 75.1, SD 3.1 years) completed baseline and 5-year follow-up measurements. We assessed muscle strength by measuring grip strength and chair stands test, lean mass by dual energy X-ray absorptiometry and physical performance by gait speed at baseline and follow-up. Sarcopenia prevalence and incidence were calculated according to the EWGSOP2 definition. RESULTS Sarcopenia prevalence increased from 5.6% at baseline to 12.0% at follow-up. During the mean 5.2-year follow-up period, 9.1% developed sarcopenia (incidence proportion), corresponding to an incidence rate of 1.8 per 100 person-years at risk while 39.4% of the participants with sarcopenia at baseline participating in follow-up reversed to no longer having confirmed sarcopenia at 5-year follow-up. CONCLUSION The prevalence of sarcopenia defined along EWGSOP2 criteria doubled within 5 years in older men, and more than a third of the study participants with sarcopenia at baseline did not have sarcopenia at follow-up. We conclude that sarcopenia is not a static condition.
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Affiliation(s)
- Ellen S Sallfeldt
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden.
| | - Hans Mallmin
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Institution of Clinical Sciences Malmö (IKVM), Lund University, Department of Orthopaedics, Skåne University Hospital (SUS), SE-205 02 Malmo, Sweden
| | - Dan Mellström
- Department of Internal Medicine and Geriatrics, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nils P Hailer
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
| | - Eva L Ribom
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
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Aoki Y, Furukawa K, Suzuki D, Takayashiki T, Kuboki S, Takano S, Kawasaki Y, Shiko Y, Ohtsuka M. Influence of sarcopenia as defined by EWGSOP2 on complications after pancreaticoduodenectomy and on the prognosis of pancreatic head cancer: A prospective cohort study. Nutrition 2022; 99-100:111660. [PMID: 35576875 DOI: 10.1016/j.nut.2022.111660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES It has been reported that sarcopenia is associated with higher postoperative complication rates in various surgeries and with a poorer prognosis in various carcinomas. However, many of these reports did not strictly follow the definition of sarcopenia. Therefore, we prospectively evaluated the influence of sarcopenia, as defined by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), on complications after pancreaticoduodenectomy (PD) and on the prognosis of pancreatic head carcinoma. METHODS We prospectively investigated 180 patients who underwent PD at Chiba University Hospital from January 2016 to March 2020. The skeletal muscle mass, grip strength, and gait speed of the patients were measured preoperatively. Sarcopenia was defined in accordance with the EWGSOP2 definition. We evaluated the frequency and severity of postoperative complications in infectious, non-infectious, and overall complications. We analyzed the prognosis of 83 patients with pancreatic head carcinoma who underwent PD. RESULTS There were no differences in the severity and frequency of infectious, non-infectious, and overall complications between patients with and without sarcopenia. In patients with pancreatic head carcinoma, the recurrence-free and overall survival rates were significantly lower in patients with sarcopenia than in those without sarcopenia (P = 0.017 and P = 0.011, respectively). In multivariate analysis, sarcopenia was an independent risk factor for poor recurrence-free survival and overall survival (HR, 4.48; 95% CI, 1.68-11.98; P = 0.003 and HR, 3.25; 95% CI, 1.19-8.86; P = 0.021, respectively). CONCLUSIONS Sarcopenia, as defined by EWGSOP2, did not affect complications after PD. Sarcopenia is an important prognostic factor for surgically resected pancreatic head carcinoma.
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Affiliation(s)
- Yu Aoki
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Katsunori Furukawa
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Daisuke Suzuki
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tsukasa Takayashiki
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoshi Kuboki
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shigetsugu Takano
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Data Center, Chiba University Hospital, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Data Center, Chiba University Hospital, Chiba, Japan
| | - Masayuki Ohtsuka
- Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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Escribà-Salvans A, Jerez-Roig J, Molas-Tuneu M, Farrés-Godayol P, Moreno-Martin P, Goutan-Roura E, Güell-Masramon H, Amblàs-Novellas J, de Souza DLB, Skelton DA, Torres-Moreno M, Minobes-Molina E. Sarcopenia and associated factors according to the EWGSOP2 criteria in older people living in nursing homes: a cross-sectional study. BMC Geriatr 2022; 22:350. [PMID: 35448983 PMCID: PMC9022416 DOI: 10.1186/s12877-022-02827-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 01/11/2023] Open
Abstract
Background In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality. Aim Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain). Design A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia. Results Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040. Conclusions According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population.
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Affiliation(s)
- Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.
| | - Miriam Molas-Tuneu
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Ester Goutan-Roura
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Helena Güell-Masramon
- Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, VIC, 08500, Barcelona, Spain
| | - Dyego Leandro Bezerra de Souza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.,Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miriam Torres-Moreno
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
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Vágnerová T, Michálková H, Dvořáčková O, Topinková E. Comparison between EWGSOP1 and EWGSOP2 criteria and modelling of diagnostic algorithm for sarcopenic obesity in over 70 years old patients. Eur Geriatr Med 2022; 13:641-648. [PMID: 34988910 DOI: 10.1007/s41999-021-00602-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/12/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Sarcopenic obesity (SO) as a new diagnostic entity defined by presence of obesity in combination with sarcopenia represents serious health condition negatively affecting quality of life in old age. Despite the rapidly increasing incidence of SO associated with demographic aging, clear diagnostic criteria for SO have not yet been established. We describe here the applicability of the EWGSOP2 and EWGSOP1 diagnostic criteria in identifying sarcopenia and SO and the development of a refinement algorithm for SO detection. METHODS In total 156 subjects were pre-screened, 126 had a complete dataset and were included, 20.6% (n = 26) were men and 79.4% (n = 100) women, mean age 81 ± 6.3 years in tertiary hospital, Prague, Czech Republic. Testing of physical performance (hand-grip test, 400 m walk test, chair stand test, gait speed), anthropometric measures and SARC-F, SPPB and MNA-SF were used to determine physical, functional, and nutritional status, while muscle mass and fat mass were measured by DXA scans to confirm sarcopenia and SO diagnosis. RESULTS The prevalence of sarcopenia (BMI adjusted ALM < 0.789 for men, < 0.512 for women) was 26.2% (n = 33), SO in 20.6% (n = 26). 78.8% of all sarcopenic subjects fulfilled the criteria of SO (FM > 27% for men and > 38% for women; waist circumference > 90 cm for men and > 85 cm for women). EWGSOP1 criteria for diagnosing sarcopenia showed better sensitivity of 97.0% than the EWGSOP2 66.7%, while specificity reached 100% for both criteria. According to DXA measurement, EWGSOP1 identified 3.0% cases (1 out of 33) as false negative meanwhile EWGSOP2 identified 33.3% cases as false negative and this difference was statistically significant (McNemar's test, p < 0.001). An algorithm for SO was developed (which uses sex, BMI, height, waist circumference and SPPB) with sensitivity and specificity of 88.5 and 91.0%, respectively. CONCLUSION High prevalence of obesity among elderly people and rather low sensitivity of current diagnostic criteria for SO call for ongoing research. Broader international consensus for SO diagnostic criteria, screening and diagnosis algorithm are crucial for early detection of SO in older people in clinical practice so that optimal multi-component therapy can be initiated.
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Affiliation(s)
- Tereza Vágnerová
- Department of Gerontology and Geriatrics, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic. .,Institute of Hygiene and Epidemiology, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic.
| | - Helena Michálková
- Department of Gerontology and Geriatrics, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic.,Institute of Nursing, Midwifery and Emergency Care, University of South Bohemia, Faculty of Health and Social Sciences, J. Boreckého 1167, 370 11, České Budějovice, Czech Republic
| | - Olga Dvořáčková
- Institute of Laboratory Diagnostics and Public Health, University of South Bohemia, Faculty of Health and Social Sciences, J. Boreckého 1167, 370 11, České Budějovice, Czech Republic
| | - Eva Topinková
- Department of Gerontology and Geriatrics, Charles University, 1st Faculty of Medicine, Londýnská 545/15, 128 00, Prague 2, Czech Republic.,Institute of Nursing, Midwifery and Emergency Care, University of South Bohemia, Faculty of Health and Social Sciences, J. Boreckého 1167, 370 11, České Budějovice, Czech Republic
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Anand A, Mohta S, Agarwal S, Sharma S, Gopi S, Gunjan D, Madhusudhan KS, Singh N, Saraya A. European Working Group on Sarcopenia in Older People ( EWGSOP2) Criteria With Population-Based Skeletal Muscle Index Best Predicts Mortality in Asians With Cirrhosis. J Clin Exp Hepatol 2022; 12:52-60. [PMID: 35068785 DOI: 10.1016/j.jceh.2021.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/31/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND/AIMS Multiple definitions of sarcopenia exist and the acceptable criterion that best predicts outcome is lacking. We estimated the prevalence of sarcopenia based on four criteria and assessed their utility in predicting mortality in cirrhotics. METHODS In a prospective observational study, consecutive Asian patients with cirrhosis underwent testing for handgrip strength (HGS) and estimation of skeletal muscle index (SMI) using computed tomography at the third lumbar vertebra. Sarcopenia was defined based on the Western cut-off (WC; SMI < 50 cm2/m2 for men and <39 cm2/m2 for women), Asian cut-off (AC; SMI < 36.5 cm2/m2 for men and 30.2 cm2/m2 for women), European Working Group on Sarcopenia in Older People-2nd meeting (EWGSOP2) definition incorporating low HGS (<27 kg for men and <16 kg for women) with low SMI (defined by the WC), and EWGSOP2 definition with low HGS and low SMI (defined by AC). Risk factors for mortality were assessed using multivariate Cox-proportional hazards. RESULTS We included 219 patients with cirrhosis (168 men; mean age 42.6 years) with 50.2% patients having decompensation. Alcohol was the commonest aetiology (33.3%). The prevalence of sarcopenia was highest with the WC (men: 82.1%; women: 62.7%). There was a weak concordance among all criteria (Fleiss' kappa 0.23, 95% confidence interval [CI] 0.10-0.37). Overall, 12-month survival was 86.1% (81.1-91.3%) over a median (interquartile range) follow-up of 12 (6-15) months. Ascites (hazards ratio [HR] 6.27 [95% CI 1.6-24.1]; P < 0.007) and SMI (HR 0.92 [0.85-0.98]; P = 0.021) were independent predictors of mortality. The 12-month mortality rate was higher in patients with sarcopenia, irrespective of criteria (log rank P < 0.05). Low HGS and low SMI (defined by AC) was the best for predicting mortality (HR 3.04 [1.43-6.43]; P = 0.004). CONCLUSION A weak concordance exists amongst various diagnostic definitions of sarcopenia. Sarcopenia diagnosed by a combination of low HGS and population-specific SMI cut-off (AC) best predicts mortality.
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Key Words
- 6MWD, 6-min walk distance
- AC, Asian cut-off
- ACLF, acute on chronic liver failure
- BMI, body mass index
- CI, confidence interval
- CT, computed tomography
- CTP, Child-Turcotte-Pugh
- EWGSOP2
- EWGSOP2, European Working Group on Sarcopenia in Older People—2nd meeting
- HCC, hepatocellular cancer
- HE, hepatic encephalopathy
- HGS, handgrip strength
- HR, hazards ratio
- HU, Hounsfield unit
- IQR, interquartile range
- LT, liver transplant
- MELD, model for end-stage liver disease
- SD, standard deviation
- SMA, skeletal muscle area
- SMI, skeletal muscle index
- WC, Western cut-off
- sarcopenia
- skeletal muscle index
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Kaluźniak-Szymanowska A, Krzymińska-Siemaszko R, Deskur-Śmielecka E, Lewandowicz M, Kaczmarek B, Wieczorowska-Tobis K. Malnutrition, Sarcopenia, and Malnutrition-Sarcopenia Syndrome in Older Adults with COPD. Nutrients 2021; 14:44. [PMID: 35010919 DOI: 10.3390/nu14010044] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world population. In addition to airflow obstruction, COPD is associated with multiple systemic manifestations, including impaired nutritional status or malnutrition and changes in body composition (low muscle mass, LMM). Poor nutritional status and sarcopenia in subjects with COPD leads to a worse prognosis and increases health-related costs. Data from previous studies indicate that 30–60% of subjects with COPD are malnourished, 20–40% have low muscle mass, and 15–21.6% have sarcopenia. This study aimed to assess the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in elderly subjects with COPD and investigate the relationship between COPD severity and these conditions.Patients and methods: A cross-sectional study involving 124 patients with stable COPD, aged ≥60, participating in a stationary pulmonary rehabilitation program. Nutritional status was assessed following the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia with the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The results of pulmonary function tests and exercise capacity were obtained from the hospital database. Results: 22.6% of participants had malnutrition according to the GLIM criteria. Subjects with malnutrition had lower gait speed (p = 0.0112) and worse results of the Six Minute Walk Test. Sixteen participants (12.9%) had sarcopenia; 12 subjects with sarcopenia had concomitant malnutrition. The prevalence of severe and very severe obstruction (GOLD3/GOLD4) was 91.7%. It was significantly higher in patients with malnutrition-sarcopenia syndrome. Conclusions: Malnutrition was found in nearly one out of four subjects with COPD, while sarcopenia was one out of seven patients. About 10% of our study sample had malnutrition-sarcopenia syndrome. The prevalence of severe and very severe obstruction was significantly higher in patients with malnutrition-sarcopenia syndrome.
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Lampignano L, Bortone I, Castellana F, Donghia R, Guerra V, Zupo R, De Pergola G, Di Masi M, Giannelli G, Lozupone M, Panza F, Boeing H, Sardone R. Impact of Different Operational Definitions of Sarcopenia on Prevalence in a Population-Based Sample: The Salus in Apulia Study. Int J Environ Res Public Health 2021; 18:ijerph182412979. [PMID: 34948590 PMCID: PMC8700814 DOI: 10.3390/ijerph182412979] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 12/25/2022]
Abstract
Background: In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP1) issued its first operational definition to diagnose sarcopenia. This was updated in 2019 with a revised sequence of muscle mass and muscle strength (EWGSOP2). The aim of the study was to investigate the impact of these different operational definitions on sarcopenia prevalence in a representative population-based sample. Methods: For each algorithm, the prevalence of sarcopenia-related categories was calculated and related to sociodemographic and lifestyle variables, anthropometric parameters, and laboratory biomarkers. The present analysis used data from the Salus in Apulia Study (Italy, 740 subjects, mean age 75.5 ± 5.9 years, 54% women). Results: The application of the EWGSOP1 adapted algorithm resulted in 85% [95% confidence intervals (CI): 82–88%] non-sarcopenic subjects, 10% (95% CI: 8–12%) pre-sarcopenic subjects, and 5% (95% CI: 3–7%) sarcopenic/severe sarcopenic subjects. The sarcopenia-related categories were inversely related to weight and body mass index (BMI), particularly in overweight/obese subjects, and these categories showed favorable metabolic biomarkers. The EWGSOP2 algorithm yielded 73% (95% CI: 69–76%) non-sarcopenic subjects, 24% (95% CI: 21–27%) probably sarcopenic subjects, and 4% (95% CI: 2–5%) sarcopenic subjects. Conclusions: The present study identified BMI as a potential confounder of the prevalence estimates of sarcopenia-related categories in population-based settings with different EWGSOP operational definitions.
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Affiliation(s)
- Luisa Lampignano
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Correspondence: (L.L.); (R.S.)
| | - Ilaria Bortone
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Fabio Castellana
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Rossella Donghia
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Vito Guerra
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Roberta Zupo
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Giovanni De Pergola
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari Aldo Moro, 70100 Bari, Italy
| | - Marta Di Masi
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Madia Lozupone
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70100 Bari, Italy;
| | - Francesco Panza
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
| | - Heiner Boeing
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Rodolfo Sardone
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (I.B.); (F.C.); (R.D.); (V.G.); (R.Z.); (G.D.P.); (M.D.M.); (G.G.); (F.P.); (H.B.)
- Correspondence: (L.L.); (R.S.)
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Lu JL, Xu Q, Zhu SQ, Chen L, Ding LY, Hua HX, Xu XY, Hu JM. Comparison of five sarcopenia screening tools in preoperative patients with gastric cancer using the diagnostic criteria of the European Working Group on Sarcopenia in Older People 2. Nutrition 2021; 95:111553. [PMID: 34999385 DOI: 10.1016/j.nut.2021.111553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this study was to compare the performance of five sarcopenia screening tools in preoperative patients with gastric cancer, including strength, assistance with walking, rise from a chair, climb stairs, and falls; strength, assistance with walking, rise from a chair, climb stairs, falls, and calf circumference (SARC-CalF); Ishii score chart; short version of the mini sarcopenia risk assessment; and full version of the mini sarcopenia risk assessment. METHODS We conducted a cross-sectional study of consecutive patients undergoing a gastrectomy between May 2020 and October 2020. Sarcopenia was diagnosed per the diagnostic criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Data on the five sarcopenia screening tools, patient characteristics, nutrition risk screening 2002, and diagnostic indicators of sarcopenia were collected preoperatively, and pathological characteristics of the tumor were collected postoperatively. Based on the EWGSOP2 criteria, the clinical validity of the sarcopenia tools was measured using sensitivity, specificity, and predictive value. A receiver operator characteristic curve and area under curve were applied to compare the overall screening accuracy, and a Youden index was calculated to determine the optimal cutoff value of each tool. RESULTS We included 260 participants age 62.38 ± 11.21 y. Based on the EWGSOP2 criteria, the prevalence of sarcopenia and severe sarcopenia were 8.46% and 4.62%, respectively. Moreover, the prevalence of sarcopenia risk ranged from 3.46% to 73.85% based on the five screening tools. Of these tools, SARC-CalF had the largest area under the curve (0.896) with moderate-to-high sensitivity (86.36%) and high specificity (92.86%). For SARC-CalF, the cutoff value of 10 reached the highest Youden index, and the corresponding sensitivity and specificity were 81.82% and 93.44%, respectively. CONCLUSION Among the above five screening tools, SARC-CalF appeared to be the optimal choice to screen sarcopenia in preoperative patients with gastric cancer.
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Ramirez E, Salas R, Bouzas C, Pastor R, Tur JA. Comparison between Original and Reviewed Consensus of European Working Group on Sarcopenia in Older People: A Probabilistic Cross-Sectional Survey among Community-Dwelling Older People. Gerontology 2021; 68:869-876. [PMID: 34592734 DOI: 10.1159/000519304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/29/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The European Working Group on Sarcopenia in Older People (EWGSOP) published a consensus on sarcopenia in 2010 and updated it in 2019 (EWGSOP2) which included the use of specific cut-off points. The aim was to assess how much prevalence of sarcopenia differed between EWGSOP2 and EWGSOP, as well as the use of specific cut-off points to assess differences in presarcopenia versus probable sarcopenia. METHODS Observational, transversal, and comparative study (n = 1,283 older adults; 57% women). Anthropometrics and handgrip strength were measured, and appendicular skeletal muscle mass equation was defined. Conceptual and methodological definitions of EWGSOP and EWGSOP2 consensus were applied to calculate prevalence of presarcopenia, probable sarcopenia, and sarcopenia. RESULTS Using cut-off points recommended for European population, prevalence of sarcopenia with EWGSOP2 was lower (-6.6%; p < 0.001) than EWGSOP. The prevalence of probable sarcopenia (EWGSOP2) was higher (+7.8%; p < 0.001) than EWGSOP presarcopenia. The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.45; IC = 0.40-0.51). Using specific-population cut-off points for muscle strength and appendicular muscle mass, the prevalence of probable sarcopenia with EWGSOP2 was higher (46.5%; p < 0.001) than EWGSOP (1.8%). The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.48; IC = 0.42-0.52). CONCLUSION The new EWGSOP2 consensus underestimates the prevalence of sarcopenia, compared with EWGSOP using conventional cut-off points. The prevalence of presarcopenia with EWGSOP (low muscle mass) was lower than probable sarcopenia (low muscle strength) with the new EWGSOP2. In both cases, agreements between EWGSOP2 and EWGSOP were moderated. Discrepancies between the original and new consensus have implications on the primary health setting for identifying old and new cases for prevention and treatment.
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Affiliation(s)
- Erik Ramirez
- Body Composition Lab, Faculty of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey, Mexico
| | - Rogelio Salas
- Population Nutrition Laboratory, Faculty of Public Health and Nutrition, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Cristina Bouzas
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), Madrid, Spain.,Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, & IDISBA, Palma de Mallorca, Spain
| | - Rosario Pastor
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, & IDISBA, Palma de Mallorca, Spain.,Department of Human Nutrition & Dietetics, Faculty of Health Sciences, Catholic University of Avila, Avila, Spain
| | - Josep A Tur
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), Madrid, Spain.,Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, & IDISBA, Palma de Mallorca, Spain
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Ballesteros-Pomar MD, Gajete-Martín LM, Pintor-de-la-Maza B, González-Arnáiz E, González-Roza L, García-Pérez MP, González-Alonso V, García-González MA, de Prado-Espinosa R, Cuevas MJ, Fernández-Perez E, Mostaza-Fernández JL, Cano-Rodríguez I. Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study. Nutrients 2021; 13:nu13092937. [PMID: 34578815 PMCID: PMC8465264 DOI: 10.3390/nu13092937] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death, readmissions at three months, and quality of life). (2) Methodology: Prospective cohort study in medical inpatients. On admission, MM and hand grip strength (HGS) were assessed. The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose DRM and EWGSOP2 for sarcopenia. Assessment was repeated after one week and at discharge. Quality of life (EuroQoL-5D), length of stay (LoS), readmissions and mortality are reported. (3) Results: Two hundred medical inpatients, median 76.0 years-old and 68% with high comorbidity. 27.5% met GLIM criteria and 33% sarcopenia on admission, increasing to 38.1% and 52.3% on discharge. Both DRM and sarcopenia were associated with worse QoL. 6.5% died and 32% readmission in 3 months. The odds ratio (OR) of mortality for DRM was 4.36 and for sarcopenia 8.16. Readmissions were significantly associated with sarcopenia (OR = 2.25) but not with DRM. A higher HGS, but not MM, was related to better QoL, less readmissions (OR = 0.947) and lower mortality (OR = 0.848) after adjusting for age, sex, and comorbidity. (4) Conclusions: In medical inpatients, mostly polymorbid, both DRM but specially sarcopenia are associated with poorer quality of life, more readmissions, and higher mortality. Low HGS proved to be a stronger predictor of worse outcomes than MM.
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Affiliation(s)
- María D. Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
- Correspondence: ; Tel.: +34-987237400 (ext. 43044)
| | - Luisa Mercedes Gajete-Martín
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
| | - Begoña Pintor-de-la-Maza
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
| | - Elena González-Arnáiz
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
| | - Lucía González-Roza
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
| | - María Pilar García-Pérez
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
| | - Verónica González-Alonso
- Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (V.G.-A.); (M.A.G.-G.); (R.d.P.-E.); (E.F.-P.); (J.L.M.-F.)
| | - María Ascensión García-González
- Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (V.G.-A.); (M.A.G.-G.); (R.d.P.-E.); (E.F.-P.); (J.L.M.-F.)
| | - Rocío de Prado-Espinosa
- Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (V.G.-A.); (M.A.G.-G.); (R.d.P.-E.); (E.F.-P.); (J.L.M.-F.)
| | - María José Cuevas
- Departament of Biomedical Sciences, Institute of Biomedicine, University of León, Campus de Vegazana, 24071 León, Spain;
| | - Esther Fernández-Perez
- Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (V.G.-A.); (M.A.G.-G.); (R.d.P.-E.); (E.F.-P.); (J.L.M.-F.)
| | - José Luis Mostaza-Fernández
- Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (V.G.-A.); (M.A.G.-G.); (R.d.P.-E.); (E.F.-P.); (J.L.M.-F.)
| | - Isidoro Cano-Rodríguez
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain; (L.M.G.-M.); (B.P.-d.-l.-M.); (E.G.-A.); (L.G.-R.); (M.P.G.-P.); (I.C.-R.)
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Piotrowicz K, Głuszewska A, Czesak J, Fedyk-Łukasik M, Klimek E, Sánchez-Rodríguez D, Skalska A, Gryglewska B, Grodzicki T, Gąsowski J. SARC-F as a case-finding tool for sarcopenia according to the EWGSOP2. National validation and comparison with other diagnostic standards. Aging Clin Exp Res 2021; 33:1821-1829. [PMID: 33506313 PMCID: PMC8249283 DOI: 10.1007/s40520-020-01782-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sarcopenia is a potentially reversible condition, which requires proper screening and diagnosis. AIMS To validate a Polish version of sarcopenia screening questionnaire (SARC-F), and assess its clinical performance. METHODS Cross-sectional validation study in community-dwelling subjects ≥ 65 years of age. Diagnosis of sarcopenia was based on the 2018 2nd European Working Group on Sarcopenia in Older People (EWGSOP2) consensus. Hand grip and 4-m gait speed were measured, and the Polish version of SARC-F was administered. RESULTS The mean (SD) age of 73 participants (21.9% men) was 77.8 (7.3) years. Seventeen participants (23.3%) fulfilled the EWGSOP2 criteria of sarcopenia, and 9 (12.3%) criteria for severe sarcopenia. Fourteen (19.2%) participants fulfilled the SARC-F criteria for clinical suspicion of sarcopenia. The Cronbach's alpha coefficient for internal was 0.84. With EWGSOP2 sarcopenia as a gold standard, the sensitivity of SARC-F was 35.3% (95% CI 14.2-61.7, p = 0.33), specificity was 85.7% (95% CI 73.8-93.6, p < 0.0001). The corresponding positive and negative predictive values were 42.9% (p = 0.79) and 81.4% (p < 0.0001), respectively. The probability of false-positive result was 14.3% (95% CI 6.4-26.2, p < 0.0001) and the probability of false-negative result was 64.7% (95% CI 38.3-85.8, p = 0.33). Overall the predictive power of SARC-F was low (c-statistic 0.64). DISCUSSION SARC-F is currently recommended for sarcopenia case finding in general population of older adults. However, its sensitivity is low, despite high specificity. CONCLUSIONS At present SARC-F is better suited to rule out sarcopenia then to case-finding. Further refinement of screening for sarcopenia with the use of SARC-F seems needed.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Anna Głuszewska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Joanna Czesak
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
- Department of Clinical Rehabilitation, University School of Physical Education, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Ewa Klimek
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Dolores Sánchez-Rodríguez
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
- Geriatrics Department, Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland.
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland.
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Wu WY, Dong JJ, Huang XC, Chen ZJ, Chen XL, Dong QT, Bai YY. AWGS2019 vs EWGSOP2 for diagnosing sarcopenia to predict long-term prognosis in Chinese patients with gastric cancer after radical gastrectomy. World J Clin Cases 2021; 9:4668-4680. [PMID: 34222433 PMCID: PMC8223822 DOI: 10.12998/wjcc.v9.i18.4668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/23/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the long-term overall survival (OS) of patients with gastric cancer. Its diagnostic criterion is critical to clinical diagnosis and treatment. However, previous research reported widely differing sarcopenia prevalence due to different criteria. AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.
AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.
METHODS An observational study was conducted from July 2014 to January 2017, which included 648 consecutive gastric cancer patients who underwent radical gastrectomy. The sarcopenia elements (skeletal muscle index, handgrip strength, and gait speed) were measured within 1 mo or 7 d before surgery. The patients were followed at fixed intervals to gain the outcomes. Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately. The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index (C-index) and area under the time-dependent receiver operating characteristic curve (AUC). The Akaike information criterion (AIC) was applied to compare model fits.
RESULTS The prevalence of sarcopenia was 20.5% and 11.3% according to AWGS2019 and EWGSOP2, respectively. Sarcopenia was an independent risk factor for the long-term OS no matter based on AWGS2019 or EWGSOP2, but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio (HR) [2.150 (1.547-2.988)] than EWGSOP2-sarcopenia [HR 1.599 (1.092-2.339)]. Meanwhile, the model with AWGS2019-sarcopenia [C-index 0.773 (0.742-0.804); AIC 2193.7; time-dependent AUC 0.812 (0.756-0.867) for 1-year OS, 0.815 (0.778-0.852) for 3-year OS, and 0.809 (0.759-0.859) for 5-year OS] had better predictive power and model fits than the model with EWGSOP2-sarcopenia [C-index 0.762 (0.729-0.795); AIC 2215.2; time-dependent AUC 0.797 (0.741-0.854) for 1-year OS, 0.804 (0.767-0.842) for 3-year OS, and 0.799 (0.748-0.850) for 5-year OS].
CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy. The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia. AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
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Affiliation(s)
- Wen-Yi Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jiao-Jiao Dong
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xin-Ce Huang
- Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Zhe-Jing Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xiao-Lei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Qian-Tong Dong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Yong-Yu Bai
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Lengelé L, Bruyère O, Beaudart C, Reginster JY, Locquet M. Malnutrition, assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria but not by the mini nutritional assessment (MNA), predicts the incidence of sarcopenia over a 5-year in the SarcoPhAge cohort. Aging Clin Exp Res 2021; 33:1507-1517. [PMID: 33991331 DOI: 10.1007/s40520-021-01880-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The capacity of malnutrition screening to predict the onset of sarcopenia is unknown. AIM Our first objective is to explore the association between the screening of malnutrition and the incidence of sarcopenia and then, to assess the added value of the diagnosis of malnutrition to predict sarcopenia over a 5-year follow-up. METHODS Malnutrition was screened at baseline according to the MNA short-form (MNA-SF) and long-form (MNA-LF) and was diagnosed by the GLIM definition. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Kaplan-Meier analysis and adjusted Cox regression were performed to explore the association between nutritional status and the incidence of sarcopenia. RESULTS A total of 418 participants were analyzed (median age 71.7 years (67.7 - 76.8), 60% women) for our first objective. Among them, 64 (15.3%) became sarcopenic during the follow-up period. In the adjusted model, the incidence of sarcopenia was nonsignificantly associated with the risk of malnutrition for both forms of the MNA (MNA-SF: HR of 1.68 (95% CI 0.95 - 2.99); MNA-LF: HR of 1.67 (95% CI 0.86 - 3.26)). However, among the 337 participants for which a GLIM assessment was possible and in which 46 participants became sarcopenic, malnourished subjects had a higher risk than well-nourished participants of developing sarcopenia after 5 years, with an adjusted HR of 3.19 (95% CI 1.56 - 6.50). CONCLUSION A full diagnosis of malnutrition seems more useful than a simple malnutrition screening to predict the incidence of sarcopenia over 5 years.
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Affiliation(s)
- Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium.
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Department of Sport Rehabilitation Sciences, University of Liège, 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, University Hospital of Liège, SportS2, 4000, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000, Liège, Belgium
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Bahat G, Kilic C, Ozkok S, Ozturk S, Karan MA. Associations of sarcopenic obesity versus sarcopenia alone with functionality. Clin Nutr 2021; 40:2851-2859. [PMID: 33940398 DOI: 10.1016/j.clnu.2021.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/18/2021] [Accepted: 04/07/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS There have been several attempts to come up with a global operational definition of sarcopenia (S), and consequently, a definition of S has been established, to some extent. That said, the definition of sarcopenic obesity (SO), which is defined as the presence of obesity + sarcopenia, remains obscure, hindering evaluations of the prevalence and relevance of SO. It has yet to be elucidated whether SO is associated with worse functionality when compared to S alone (S without obesity). In the present study, we compare SO and S alone in terms of their associations with functional measures through the application of alternative definitions of SO. As a secondary output, we document the prevalence of SO based on alternative definitions. METHODS This retrospective cross-sectional study included community-dwelling adults over 60 years of age who presented as outpatients to a university hospital between 2012 and 2020. All were evaluated for body composition (bioimpedance analysis), handgrip strength (Jamar hand dynamometer) and functional health status [activities of daily living (ADL), instrumental activities of daily living (IADL)]. The fat percentile method was used to define the obesity component of SO. Low muscle mass (LMM) was defined using two different adjustment methods of skeletal muscle mass (LMM adjusted by height2 or LMM adjusted by BMI). S was defined based on the EWGSOP2 definition, as probable S (low muscle strength) or confirmed S (low muscle strength + LMM). Accordingly, three alternative definitions of SO were applied based on three alternative definitions of S, i.e., "obesity + sarcopenia (probable)", "obesity + sarcopenia (confirmed, LMM adjusted by height2)" and "obesity + sarcopenia (confirmed, LMM adjusted by BMI)". The associations of SO and S alone with functional measures were examined with univariate analyses and adjusted multivariate analyses. RESULTS Included in the study were 1468 older adults (median age 75; 68.8% female). The prevalence of SO was very low (0.2%) based on the SO definition "obesity + sarcopenia (confirmed, LMM adjusted by height2), but it was present at a considerable and comparable rate based on SO definition "obesity + sarcopenia (probable)" and SO definition "obesity + sarcopenia (confirmed, LMM adjusted by BMI)" (4.1%, 4.0%; respectively). As SO by "obesity + sarcopenia (confirmed, LMM adjusted by height2)" had an ignorable prevalence, this definition of SO was excluded from further analyses. Multivariate analyses revealed that, when compared to the Non-S Non-Obese group, S alone definitions had odds ratio (OR) of 5.4 and 3.4 while SO definitions had an OR of 3.2 and 2.7 for impaired ADL, and an OR of 7.9 and 6.4, while SO definitions had an OR of 3.0 and 2.7 for impaired IADL. SO was thus found to be associated with a lower prevalence of impaired functional measures than that of S alone. CONCLUSIONS Our results suggest that the SO definition confirmed, LMM adjusted by height2 has an ignorable prevalence in populations in which underweight or malnutrition is uncommon. Among sarcopenic older individuals, obesity may have a protective effect against the limitations of some functional measures, providing evidence of the possible protective effect of obesity in sarcopenic individuals.
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Affiliation(s)
- Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Cihan Kilic
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Serdar Ozkok
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Savas Ozturk
- Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Mehmet Akif Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
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Abstract
BACKGROUND/OBJECTIVE While assessment of sarcopenia has drawn much attention, assessment of low muscle power has not been studied widely. This is, to a large extend, due to a more difficult assessment of power in practice. We aimed to compare the associations of low power and sarcopenia with functional and performance measures. MATERIAL AND METHODS We designed a retrospective and cross-sectional study. Community-dwelling outpatient older adults applied to a university hospital between 2012 and 2020 composed the population. We estimated body composition by bioimpedance analysis. Other measures were handgrip strength, timed-up-and-go-test (TUG), usual gait speed (UGS), activities of daily living (ADL) and instrumental activities of daily living (IADL) tests. We assessed muscle power by a practical equation using a 5-repetition sit-to-stand power test. We adjusted the power by body weight and defined low muscle power threshold as the lowest sex-specific tertile. We noted demographic characteristics, number of medications, and diseases. We defined sarcopenia by EWGSOP2 definition. RESULTS Cut points for low relative muscle power were <2.684 and <1.962 W/kg in males and females, respectively. Low muscle power was related with both measures of disability (impaired ADL and IADL) (OR=2.4, 95% CI= 1.4-4.0, p=0.001; OR=2.4, 95% CI= 1.4-4.1, p=0.001; respectively). Low muscle strength (i.e. probable sarcopenia) was only related with disability in IADL (OR=3.6, 95% CI= 1.6-8.; p=0.002); confirmed sarcopenia was related with neither measures. Low muscle power was not related with impaired TUG (p=1) but with impaired UGS (OR=6.6, 95% CI= 3.6-11.0; p<0.001). Probable sarcopenia was not related with impaired TUG (p=0.08) but with impaired UGS (OR=2.4, 95% CI= 1.1-5.3; p=0.03) and confirmed sarcopenia was related with neither measures (p=1, p=0.3; respectively). CONCLUSION Low muscle power detected by simple and practically applicable CSST (Chair Sit To-Stand Test) power test was a convenient measure associated with functional and performance measures. It was related to functionality and performance measures more than sarcopenia. Future longitudinal studies are needed to examine whether it predicts future impairment in ADL, IADL, and performance measures.
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Affiliation(s)
- G Bahat
- Gulistan Bahat, Istanbul University, Istanbul Medical School, Department of Internal Medicine, Capa, 34390, Istanbul, Turkey, Telephone: + 90 212 414 20 00-33204, Fax: + 90 212 532 42 08, E-mail address:
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Landi F, Calvani R, Martone AM, Salini S, Zazzara MB, Candeloro M, Coelho-Junior HJ, Tosato M, Picca A, Marzetti E. Normative values of muscle strength across ages in a 'real world' population: results from the longevity check-up 7+ project. J Cachexia Sarcopenia Muscle 2020; 11:1562-1569. [PMID: 33147374 PMCID: PMC7749608 DOI: 10.1002/jcsm.12610] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/07/2020] [Accepted: 07/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Low muscle strength is a powerful predictor of negative health-related events and a key component of sarcopenia. The lack of normative values for muscle strength across ages hampers the practical appraisal of this parameter. The aim of the present study was to produce normative values for upper and lower extremity muscle strength across a wide spectrum of ages, in a large sample of community-dwellers recruited in the Longevity check-up (Lookup) 7+ project. METHODS Lookup 7+ is an ongoing project that started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy with the aim of fostering the adoption of healthy lifestyles in the general population. Candidate participants are eligible for enrolment if they are 18+ years and provide written informed consent. Upper and lower extremity muscle strength is assessed by handgrip strength and five-repetition chair-stand [5 × sit-to-stand (STS)] tests, respectively. Cross-sectional centile and normative values for handgrip strength and 5 × STS tests from age 18 to 80+ years were generated for the two genders. Smoothed normative curves for the two tests were constructed for men and women using the lambda-mu-sigma method. RESULTS From 1 June 2015 to 30 May 2019, 11 448 participants were enrolled. The mean age of participants was 55.6 years (standard deviation: 11.5 years; range: 18-98 years), and 6382 (56%) were women. Normative values for handgrip strength and the 5 × STS test, both absolute and normalized by body mass index, were obtained for men and women, stratified by age groups. Values of upper and lower extremity muscle strength across ages identified three periods in life: an increase to peak in young age and early adulthood (18-24 years), preservation through midlife (25-44 years), and a decline from midlife onwards (45+ years). CONCLUSIONS Our study established age-specific and gender-specific percentile reference values for handgrip strength and the 5 × STS test. The normative curves generated can be used to interpret the assessment of muscle strength in everyday practice for the early detection of individuals with or at risk of sarcopenia.
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Affiliation(s)
- Francesco Landi
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
| | - Riccardo Calvani
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Anna Maria Martone
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Sara Salini
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Maria Beatrice Zazzara
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Matteo Candeloro
- Dipartimento di Medicina e Scienze dell'Invecchiamento, Università G. D'Annunzio, Chieti, Italy
| | - Hélio José Coelho-Junior
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
| | - Matteo Tosato
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Anna Picca
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Center for Geriatric Medicine (CEMI), Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
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Johansson J, Strand BH, Morseth B, Hopstock LA, Grimsgaard S. Differences in sarcopenia prevalence between upper-body and lower-body based EWGSOP2 muscle strength criteria: the Tromsø study 2015-2016. BMC Geriatr 2020; 20:461. [PMID: 33172391 DOI: 10.1186/s12877-020-01860-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023] Open
Abstract
Background The European Working Group on Sarcopenia in Older People (EWGSOP2) recommends grip strength and chair stand tests to be used as primary defining measures. It is unclear how either test affects prevalence estimates. Methods This cross-sectional study involved 3498 community-dwelling participants (40–84 years) from the 7th Tromsø Study survey (2015–2016). We used grip strength, five-repetition chair stands, four-meter Walk Speed Test, Timed-Up-and-Go (TUG) and Dual-Energy X-ray Absorptiometry measurements. Data were analyzed using multiple linear regression models and ROC-curves. Results Probable and confirmed sarcopenia prevalence was 1.3 and 4.4% based on grip strength and chair stands, respectively. There was very low agreement between grip strength and chair stand cut-offs (κ = 0.07), with only 4.3% of participants defined as having probable sarcopenia overlapping in the two criteria. Participants with grip strength-based sarcopenia had lower mean height, weight, waist circumference, and appendicular lean mass relative to body height (ALMheight2) than non-sarcopenic participants (all p < 0.001), after adjusting for multiple covariates. Conversely, participants with chair stand-based sarcopenia had similar height, higher weight, waist circumference and body fat% compared to non-sarcopenic participants (all p < 0.05). Area-under-curves (AUCs) for TUG-time were significantly larger when using chair stand instead of grip strength cut-offs (0.86, 95% CI 0.84–0.89 vs. 0.75, 95% CI 0.69–0.83). Conclusions Using chair stands instead of grip strength more than doubled probable sarcopenia prevalence across all ages. The two measures defined individuals of contradictory anthropometrics, body composition, and dissimilar physical function to have probable sarcopenia. Researchers should further evaluate the consequences of using different strength measures in the EWGSOP2 definition to classify sarcopenia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01860-w.
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Moreno-Gonzalez R, Corbella X, Mattace-Raso F, Tap L, Sieber C, Freiberger E, Kostka T, Guligowska A, Melzer I, Melzer Y, Carlsson AC, Ärnlöv J, Roller-Wirnsberger R, Wirnsberger G, Gil P, Martinez SL, Fabbietti P, Corsonello A, Lattanzio F, Formiga F. Prevalence of sarcopenia in community-dwelling older adults using the updated EWGSOP2 definition according to kidney function and albuminuria : The Screening for CKD among Older People across Europe (SCOPE) study. BMC Geriatr 2020; 20:327. [PMID: 33008317 PMCID: PMC7531109 DOI: 10.1186/s12877-020-01700-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Background Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR). Methods A cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines. Results Median age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, (p = 0.019). Conclusions Sarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of eGFR; as well as among those with higher albuminuria categories.
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Affiliation(s)
- Rafael Moreno-Gonzalez
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Corbella
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Catalunya International University, Barcelona, Spain
| | - Francesco Mattace-Raso
- Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lisanne Tap
- Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Cornel Sieber
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Ellen Freiberger
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel
| | - Yehudit Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel.,Maccabi Health Organization, Tel Aviv-Yafo, Israel
| | - Axel C Carlsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan Ärnlöv
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,School of Health and Social Studies, Dalarna University, Falun, Sweden
| | | | | | - Pedro Gil
- Geriatric Department, Hospital Clínico San Carlos, Martín Lagos S/N, 28040, Madrid, Spain
| | - Sara Lainez Martinez
- Geriatric Department, Hospital Clínico San Carlos, Martín Lagos S/N, 28040, Madrid, Spain
| | - Paolo Fabbietti
- Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124, Ancona, Italy
| | - Andrea Corsonello
- Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124, Ancona, Italy. .,, Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy.
| | - Fabrizia Lattanzio
- , Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Wearing J, Konings P, de Bie RA, Stokes M, de Bruin ED. Prevalence of probable sarcopenia in community-dwelling older Swiss people - a cross-sectional study. BMC Geriatr 2020; 20:307. [PMID: 32847545 PMCID: PMC7448475 DOI: 10.1186/s12877-020-01718-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/18/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People has recently defined new criteria for identifying "(probable) sarcopenia" (EWGSOP2). However, the prevalence of probable sarcopenia, defined by these guidelines, has not been determined extensively, especially in the oldest old. This study aims to determine the prevalence of probable sarcopenia in older, community-living people and its association with strength-related determinants. METHODS Handgrip strength and reported determinants (age, height, weight, osteoarthritis of hands, medications, fall history, physical activity, activities of daily living (ADL) and global cognitive function) were collected in a cross-sectional study of 219 community-living Swiss people (75 years and over). Probable sarcopenia was estimated based on cut-off values for handgrip strength as recommended by EWGSOP2. Spearman correlations, binary-regression analyses and contingency tables were used to explore relationships between variables. RESULTS The prevalence of probable sarcopenia in women (n = 137, age 84.1 ± 5.7 years) and men (n = 82, age 82.6 ± 5.2 years) was 26.3 and 28.0%, respectively. In women, probable sarcopenia correlated positively with age and falls (rs range 0.332-0.195, p < .05), and negatively with weight, cognition, physical activity, using stairs regularly, participating in sports activities and ADL performance (rs range = - 0.141 - -0.409, p < .05). The only significant predictor of probable sarcopenia at the multivariate level was ADL performance (Wald(1) = 5.51, p = .019). In men, probable sarcopenia was positively correlated with age (rs = 0.33, p < .05) and negatively with physical activity, participation in sports and ADL performance (rs range - 0.221 - - 0.353, p < .05). ADL performance and age (Wald(1) = 4.46, p = .035 and Wald(1) = 6.30, p = .012) were the only significant predictors at the multivariate level. Men and women with probable sarcopenia were 2.8 times more likely to be dependent in ADL than those without. CONCLUSION Probable sarcopenia affected one in every four community-living, oldest old people and was independently associated with impaired ADL performance in both sexes. This highlights the importance of detection of handgrip strength in this age group in clinical practice. Although prospective studies are required, independence in ADL might help to protect against probable sarcopenia.
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Affiliation(s)
- Julia Wearing
- Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, Maastricht University, Minderbroedersberg 4-6, 6211, LK, Maastricht, The Netherlands.,Adullam Stiftung, Mittlere Strasse 15, 4056, Basel, Switzerland
| | - Peter Konings
- Geriatrische Klinik St. Gallen, Rorschacher Strasse 94, 9000, St. Gallen, Switzerland
| | - Rob A de Bie
- Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, Maastricht University, Minderbroedersberg 4-6, 6211, LK, Maastricht, The Netherlands
| | - Maria Stokes
- School of Health Sciences, University of Southampton, Building 67, Highfield Campus, Southampton, SO17 1BJ, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nottingham, UK
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Insitute of Human Movement Sciences and Sport (IBWS) ETH, ETH Zurich, HCP H 25.1, Leopold-Ruzicka-Weg 4, 8093, Zürich, Switzerland. .,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Mazocco L, Chagas P, Barbosa-Silva TG, Gonzalez MC, Schwanke CHA. Accuracy of SARC-F and SARC-CalF for sarcopenia screening in older women from southern Brazil. Nutrition 2020; 79-80:110955. [PMID: 32919183 DOI: 10.1016/j.nut.2020.110955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to verify the accuracy of the SARC-F and the SARC-CalF as screening tools for sarcopenia in community-dwelling older women ≥60 y of age. METHODS This was a cross-sectional study evaluating a convenience sample of women ≥60 y of age, living in Southern Brazil. Sarcopenia was defined according to the criteria proposed in the latest European Working Group on Sarcopenia in Older People consensus (EWGSOP2). Appendicular muscle mass was assessed by dual-energy x-ray absorptiometry. Muscle strength was measured by handheld dynamometry, and physical performance through the 4-m gait speed test. The SARC-F questionnaire and SARC-CalF score for sarcopenia screening were also applied. RESULTS We evaluated 288 participants, with a mean age of 67.6 ± 5.8 y. The frequency of probable and confirmed sarcopenia in the sample was 7.3% and 2.1%, respectively. The frequency of risk for sarcopenia assessed by the SARC-F was 4.5% and SARC-CalF 22.2%. Despite the excellent specificity (95.4%) demonstrated by the SARC-F, its sensitivity in identifying confirmed cases was null, whereas the SARC-CalF showed high sensitivity (83.3%) and good specificity (79%). CONCLUSION The present study findings suggested that SARC-CalF may be able to outperform SARC-F as a sarcopenia screening tool in women ≥60 y of age even under the new EWGSOP2 criteria, the main determinant of which is strength as observed in studies based on the previous definition.
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Affiliation(s)
- Letícia Mazocco
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Patrícia Chagas
- Postgraduate Program in Gerontology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil; Department of Food and Nutrition, Federal University of Santa Maria (UFSM), Palmeira das Missões, Brazil
| | - Thiago G Barbosa-Silva
- Faculty of Medicine, Catholic University of Pelotas (UCPel), Pelotas, Brazil; Faculty of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil
| | - Carla Helena Augustin Schwanke
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
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von Berens Å, Obling SR, Nydahl M, Koochek A, Lissner L, Skoog I, Frändin K, Skoglund E, Rothenberg E, Cederholm T. Sarcopenic obesity and associations with mortality in older women and men - a prospective observational study. BMC Geriatr 2020; 20:199. [PMID: 32517653 PMCID: PMC7285448 DOI: 10.1186/s12877-020-01578-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 05/07/2020] [Indexed: 01/06/2023] Open
Abstract
Background The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components. Methods Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass > 30%/ > 42% or waist circumference ≥ 88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively. Results SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2–8.9)) of dying within 10 years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival. Conclusions SO was observed in 4–11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within 10 years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
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Affiliation(s)
- Å von Berens
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.
| | - S R Obling
- Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark
| | - M Nydahl
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - A Koochek
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - L Lissner
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden
| | - I Skoog
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg, SU Sahlgrenska, 41345, Gothenburg, Sweden
| | - K Frändin
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg, SU Sahlgrenska, 41345, Gothenburg, Sweden
| | - E Skoglund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden
| | - E Rothenberg
- Kristianstad University, Food and Meal Science, Högskolan Kristianstad, 291 88, Kristianstad, Sweden
| | - T Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.,Theme Ageing, Karolinska University Hospital, 14157, Huddinge, Sweden
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Petermann-Rocha F, Ho FK, Welsh P, Mackay D, Brown R, Gill JMR, Sattar N, Gray SR, Pell JP, Celis-Morales CA. Physical capability markers used to define sarcopenia and their association with cardiovascular and respiratory outcomes and all-cause mortality: A prospective study from UK Biobank. Maturitas 2020; 138:69-75. [PMID: 32471663 DOI: 10.1016/j.maturitas.2020.04.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/13/2020] [Accepted: 04/24/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION It is unclear what combinations of physical capability markers used to define sarcopenia have the strongest associations with health outcomes. AIM To compare the associations between different combinations of physical capability markers of sarcopenia with cardiovascular and respiratory outcomes and all-cause mortality. STUDY DESIGN 469,830 UK Biobank participants were included in this prospective study. Four groups were derived based on combinations of three physical capability markers used to define sarcopenia or severe sarcopenia: gait speed, grip strength and muscle mass. Outcomes studied were all-cause mortality, as well as incidence and mortality from cardiovascular disease (CVD), respiratory disease and chronic obstructive pulmonary disease (COPD). RESULTS All combinations of physical capability markers used to define sarcopenia or severe sarcopenia identified individuals at increased risk of respiratory disease and all-cause mortality. However, the definition most strongly associated with a wide range of adverse health outcomes was the combination of slow gait speed plus low muscle mass, followed by severe sarcopenia, and the combination of slow gait speed plus low grip strength. The current definition of sarcopenia (low grip strength plus low muscle mass) had the weakest associations with all-cause (HR: 1.35 [95% CI: 1.07 to 1.71]) and respiratory mortality (HR: 1.88 [95% CI: 1.15 to 3.10]), as well as respiratory disease (HR: 1.38 [95% CI: 1.11 to 1.73]) and COPD incidence (HR: 2.08 [95% CI: 1.14 to 3.79]). CONCLUSIONS Associations of sarcopenia with adverse outcomes were strongest when sarcopenia was defined as slow gait speed plus low muscle mass, followed by severe sarcopenia, suggesting that this combination of physical capability markers should be still considered in the diagnosis of sarcopenia.
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Affiliation(s)
- Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Daniel Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rosemary Brown
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos A Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Centre of Exercise Physiology Research (CIFE), Universidad Mayor, Chile; Research Group in Education, Physical Activity and Health (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
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Villani A, McClure R, Barrett M, Scott D. Diagnostic differences and agreement between the original and revised European Working Group (EWGSOP) consensus definition for sarcopenia in community-dwelling older adults with type 2 diabetes mellitus. Arch Gerontol Geriatr 2020; 89:104081. [PMID: 32485520 DOI: 10.1016/j.archger.2020.104081] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
Abstract
AIM We aimed to compare diagnostic differences for identification of sarcopenia using the original operational definition developed by the European Working Group on Sarcopenia in Older People (EWGSOP1) and the most recently revised EWGSOP2 definition in community dwelling older adults with type 2 diabetes mellitus (T2DM). METHODS Appendicular Lean Mass (ALM) corrected for height (ALM/m2) was assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength (HGS) or chair stands, and the Short Physical Performance Battery (SPPB) and gait speed were used to evaluate lower extremity physical function. Cohen's kappa (κ) statistic was applied to determine the degree of agreement between the two definitions. Chi-square analysis with Bonferroni post hoc corrections were applied to determine differences in the prevalence of sarcopenic case-findings. RESULTS A total of n = 87 older adults (71.2 ± 8.2 years; 66.7% males; BMI: 29.5 ± 5.8 kg/m2) were included. Agreement between the two definitions was low and non-significant (κ value = 0.118; P = 0.144). Significantly more cases of sarcopenia were identified when applying the EWGSOP1 definition (EWGSOP1: n = 6 (7%); EWGSOP2: n = 2 (2%); P = 0.004). No sex specific differences were observed. Only 2 of the 6 (33.3%) cases of sarcopenia identified by EWGSOP1 were also identified as sarcopenic when applying the EWGSOP2 diagnostic criteria. CONCLUSIONS We showed significant discordance and limited overlap in the number of sarcopenic case-findings when applying both EWGSOP definitions. It is unknown as to whether the new diagnostic criteria are better at identifying adverse clinical outcomes in patients with T2DM. Future investigation is therefore warranted.
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Affiliation(s)
- Anthony Villani
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
| | - Rebecca McClure
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - Michelle Barrett
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria 3168, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, 3021, Australia
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Dodds RM, Murray JC, Robinson SM, Sayer AA. The identification of probable sarcopenia in early old age based on the SARC-F tool and clinical suspicion: findings from the 1946 British birth cohort. Eur Geriatr Med 2020; 11:433-41. [PMID: 32297269 DOI: 10.1007/s41999-020-00310-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/10/2020] [Indexed: 11/25/2022]
Abstract
Aim To describe the prevalence of probable sarcopenia in a sample of older adults and to investigate (1) the SARC-F tool and (2) clinical risk factors in the identification of probable sarcopenia. Findings The prevalence of probable sarcopenia at age 69 was 19%, and a SARC-F score of ≥ 1 had a reasonable balance of sensitivity (65%) and specificity (72%) for probable sarcopenia. Three clinical risk factors were independently associated with probable sarcopenia: polypharmacy, lower body osteoarthritis and physical inactivity. Message Those with any positive responses to the questions in the SARC-F tool, a history of polypharmacy, lower body osteoarthritis or physical inactivity should be prioritised for the assessment of muscle strength. Electronic supplementary material The online version of this article (10.1007/s41999-020-00310-5) contains supplementary material, which is available to authorized users. Purpose The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus definition introduced the concept of probable sarcopenia as a basis on which to begin treatment. Our aims were to describe the prevalence of probable sarcopenia in older adults and to investigate the utility of (1) the SARC-F tool and (2) clinical risk factors for the identification of those likely to have probable sarcopenia. Methods We used data from the 1946 British birth cohort at age 69, with 1686 participants included in the analyses. We used the EWGSOP2 cut points for weak grip strength and slow chair rise time, with the presence of one or both indicating probable sarcopenia. We examined the sensitivity and specificity of the SARC-F tool for probable sarcopenia. We also examined associations between clinical risk factors and probable sarcopenia. Results The prevalence of probable sarcopenia was 19%. A SARC-F score of ≥ 4 had low sensitivity (15%) and high specificity (99%) for probable sarcopenia, whereas a score of ≥ 1 had higher sensitivity (65%) and reasonable specificity (72%). Three clinical risk factors were independently associated with probable sarcopenia: polypharmacy [OR 2.7 (95% CI 1.7, 4.2)], lower body osteoarthritis [OR 1.8 (95% CI 1.3, 2.6)] and physical inactivity [OR of 2.1 (95% CI 1.5, 2.8)]. Conclusion We have shown that EWGSOP2 probable sarcopenia is common in community-dwelling adults in early old age. Those with any positive responses to the questions in the SARC-F tool, a history of polypharmacy, lower body osteoarthritis or physical inactivity should be prioritised for the assessment of muscle strength. Electronic supplementary material The online version of this article (10.1007/s41999-020-00310-5) contains supplementary material, which is available to authorized users.
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Petermann-Rocha F, Chen M, Gray SR, Ho FK, Pell JP, Celis-Morales C. Factors associated with sarcopenia: A cross-sectional analysis using UK Biobank. Maturitas 2020; 133:60-7. [PMID: 32005425 DOI: 10.1016/j.maturitas.2020.01.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/03/2019] [Accepted: 01/06/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The critical sociodemographic, lifestyle and diseases factors influencing sarcopenia, defined by the current European Working Group on Sarcopenia 2 (EWGSOP2) classification and cut-off points, have not yet been fully elucidated. This study aimed, therefore, to determine sociodemographic, anthropometric, lifestyle and health-related factors associated with sarcopenia using the new EWGSOP2 definition. STUDY DESIGN 396,283 participants (52.8 % women, age 38-73 years) were included in this cross-sectional study. The potential factors associated with sarcopenia were allocated to four categories: sociodemographic (sex, age, education, income and professional qualification), anthropometric (nutritional status, abdominal obesity, body fat and birth weight), lifestyle (physical activity, smoking, sleeping, sitting time, TV viewing, alcohol, and dietary intakes) and health status (self-reported prevalent diseases). P-values were corrected for multiple testing using the Bonferroni method. RESULTS Age, women, lower education, higher deprivation, underweight, lower birth weight, and chronic diseases such as rheumatoid arthritis, chronic bronchitis and osteoporosis were associated with a higher likelihood of sarcopenia. Conversely, overweight, obesity, as well as a self-reported higher intake of energy, protein, vitamins (B12 and B9) and minerals (potassium, calcium and magnesium) were associated with lower odds of sarcopenia. CONCLUSION Women, people aged over 65 years, underweight people and those with rheumatoid arthritis were most likely to have sarcopenia. Considering the increase in the ageing population, sarcopenia is likely to become more prevalent. Identifying factors associated with sarcopenia could inform future strategies for early identification of individuals at high risk of sarcopenia and therefore the implementation of preventive strategies against the disease.
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Beaudart C, Sanchez-Rodriguez D, Locquet M, Reginster JY, Lengelé L, Bruyère O. Malnutrition as a Strong Predictor of the Onset of Sarcopenia. Nutrients 2019; 11:nu11122883. [PMID: 31783482 PMCID: PMC6950107 DOI: 10.3390/nu11122883] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/14/2019] [Accepted: 11/20/2019] [Indexed: 01/01/2023] Open
Abstract
This study aims to explore the association between malnutrition diagnosed according to both the Global Leadership Initiative of Malnutrition (GLIM) and the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria and the onset of sarcopenia/severe sarcopenia, diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criterion, in the sarcopenia and physical impairment with advancing age (SarcoPhAge) cohort during a four-year follow-up. Adjusted Cox-regression and Kaplan-Meier curves were performed. Among the 534 community-dwelling participants recruited in the SarcoPhAge study, 510 were free from sarcopenia at baseline, of whom 336 had complete data (186 women and 150 men, mean age of 72.5 ± 5.8 years) to apply the GLIM and ESPEN criteria. A significantly higher risk of developing sarcopenia/severe sarcopenia during the four-year follow-up based on the GLIM [sarcopenia: Adjusted hazard ratio (HR) = 3.23 (95% confidence interval (CI) 1.73–6.05); severe sarcopenia: Adjusted HR = 2.87 (95% CI 1.25–6.56)] and ESPEN [sarcopenia: Adjusted HR = 4.28 (95% CI 1.86–9.86); severe sarcopenia: Adjusted HR = 3.86 (95% CI 1.29–11.54)] criteria was observed. Kaplan-Meier curves confirmed this relationship (log rank p < 0.001 for all). These results highlighted the importance of malnutrition since it has been shown to be associated with an approximately fourfold higher risk of developing sarcopenia/severe sarcopenia during a four-year follow-up.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
- Correspondence: ; Tel.: +32-43-66-3230
| | - Dolores Sanchez-Rodriguez
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
- Geriatrics Department, Parc de Salut Mar Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU—Sart Tilman, Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium; (D.S.-R.); (M.L.); (J.-Y.R.); (L.L.); (O.B.)
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Beaudart C, Sanchez-Rodriguez D, Locquet M, Reginster JY, Lengelé L, Bruyère O. Malnutrition as a Strong Predictor of the Onset of Sarcopenia. Nutrients 2019; 11:E2883. [PMID: 31783482 DOI: 10.3390/nu11122883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aims to explore the association between malnutrition diagnosed according to both the Global Leadership Initiative of Malnutrition (GLIM) and the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria and the onset of sarcopenia/severe sarcopenia, diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criterion, in the sarcopenia and physical impairment with advancing age (SarcoPhAge) cohort during a four-year follow-up. Adjusted Cox-regression and Kaplan-Meier curves were performed. Among the 534 community-dwelling participants recruited in the SarcoPhAge study, 510 were free from sarcopenia at baseline, of whom 336 had complete data (186 women and 150 men, mean age of 72.5 ± 5.8 years) to apply the GLIM and ESPEN criteria. A significantly higher risk of developing sarcopenia/severe sarcopenia during the four-year follow-up based on the GLIM [sarcopenia: Adjusted hazard ratio (HR) = 3.23 (95% confidence interval (CI) 1.73-6.05); severe sarcopenia: Adjusted HR = 2.87 (95% CI 1.25-6.56)] and ESPEN [sarcopenia: Adjusted HR = 4.28 (95% CI 1.86-9.86); severe sarcopenia: Adjusted HR = 3.86 (95% CI 1.29-11.54)] criteria was observed. Kaplan-Meier curves confirmed this relationship (log rank p < 0.001 for all). These results highlighted the importance of malnutrition since it has been shown to be associated with an approximately fourfold higher risk of developing sarcopenia/severe sarcopenia during a four-year follow-up.
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Zhuang CL, Shen X, Zou HB, Dong QT, Cai HY, Chen XL, Yu Z, Wang SL. EWGSOP2 versus EWGSOP1 for sarcopenia to predict prognosis in patients with gastric cancer after radical gastrectomy: Analysis from a large-scale prospective study. Clin Nutr 2019; 39:2301-2310. [PMID: 31732287 DOI: 10.1016/j.clnu.2019.10.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/08/2019] [Accepted: 10/17/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) reached a consensus on sarcopenia (EWGSOP1). In 2018, the EWGSOP met again (EWGSOP2) to update original definition of sarcopenia. This study aimed to investigate the association of sarcopenia and survival and compare the prognostic effects of sarcopenia as defined by EWGSOP1 and EWGSOP2 after gastrectomy. METHODS We conducted a prospective study including patients who underwent curative gastrectomy for gastric cancer from August 2014 to February 2018. The sarcopenia elements, including skeletal muscle index, muscle attenuation, handgrip strength, and gait speed were measured before surgery. Patients were followed up after gastrectomy to gain the actual clinical outcomes. RESULTS The prevalence of sarcopenia was 17.0% and 18.9% according to the EWGSOP1 and EWGSOP2 respectively. Sarcopenia was independent risk factor for postoperative complications. Compared with EWGSOP1-sarcopenia, EWGSOP2-sarcopenia and had a higher odds ratio (OR) (2.453 vs. 1.550) in multivariate model. Area under the ROC curve of model including EWGSOP2-sarcopenia was larger than that of the model including EWGSOP1-sarcopenia (AUC 0.653 vs. 0.634, P = 0.021). For both of EWGSOP1 and EWGSOP2, sarcopenia was an independent risk factor for overall survival (OS) and disease-free survival (DFS), but EWGSOP2-sarcopenia seemed to have a higher hazard ratio (OS, 1.667 vs. 1.449; DFS, 1.603 vs. 1.563). In addition, severe sarcopenia, as defined by either EWGSOP2 or EWGSOP1, had a strong predictive power (OR 4.909 vs. 3.827) for postoperative complications. Both versions of severe sarcopenia were significantly predictive of OS and DFS in Cox analysis. CONCLUSION Sarcopenia at uniform diagnosis standard was an independent risk factor for survival in patients undergoing radical gastrectomy for gastric cancer. Sarcopenia defined by EWGSOP2 criteria better predicts clinical outcomes than that defined by EWGSOP1 criteria in patients with gastric cancer after gastrectomy.
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Affiliation(s)
- Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hong-Bo Zou
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qian-Tong Dong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hui-Yang Cai
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Lei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
| | - Su-Lin Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
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Kera T, Kawai H, Hirano H, Kojima M, Watanabe Y, Motokawa K, Fujiwara Y, Osuka Y, Kojima N, Kim H, Ihara K, Obuchi S. Limitations of SARC-F in the diagnosis of sarcopenia in community-dwelling older adults. Arch Gerontol Geriatr 2019; 87:103959. [PMID: 31945638 DOI: 10.1016/j.archger.2019.103959] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE The SARC-F is a recommended screening tool for sarcopenia; however, its sensitivity is reported to be very low. This study aimed to confirm the diagnostic efficacy of the SARC-F and whether it is affected by population characteristics. METHODS In this study, 2 cohorts of 1060 community-dwelling older adults, who were monitored by the Tokyo Metropolitan Institute of Gerontology, were included. In addition to the overall dataset, receiver operating characteristic curve analysis was performed to obtain the SARC-F results for sarcopenia among the datasets for only those older in age (over 75 years), those with higher frailty points (above the median total score for the Kihon Checklist points), those with lower grip strength (below the median), lower gait speed (below the median), and those with comorbidities (hypertension, cerebral vascular disease, heart disease, and diabetes mellitus). RESULTS In the overall dataset, sensitivity and specificity were 3.9% and 97.3%, respectively. In analyzing the area under the curve, sensitivity and specificity for older age and low physical function datasets were significant, but had low values. The diabetes dataset had higher values but did not effectively diagnose sarcopenia at a cutoff value of 4. CONCLUSION The SARC-F had high specificity for the diagnosis of sarcopenia in community-dwelling older adults with low physical function. However, its sensitivity was low. Despite these limitations, it may be used as a screening tool for sarcopenia in selected populations, such as adults in hospitals or nursing homes.
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Affiliation(s)
- Takeshi Kera
- Takasaki University of Health and Welfare, Gunma, Japan; Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | | | | | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | - Yosuke Osuka
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Narumi Kojima
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | | | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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Reiss J, Iglseder B, Alzner R, Mayr-Pirker B, Pirich C, Kässmann H, Kreutzer M, Dovjak P, Reiter R. Consequences of applying the new EWGSOP2 guideline instead of the former EWGSOP guideline for sarcopenia case finding in older patients. Age Ageing 2019; 48:719-724. [PMID: 31112221 DOI: 10.1093/ageing/afz035] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/27/2019] [Accepted: 03/18/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION we examined the consequences of applying the new EWGSOP2 algorithm for sarcopenia screening instead of the former EWGSOP algorithm (EWGSOP1) in geriatric inpatients. METHODS the dataset of our formerly published Sarcopenia in Geriatric Elderly (SAGE) study includes 144 geriatric inpatients (86 women, 58 men, mean age 80.7±5.6 years) with measurements of gait speed, handgrip strength and appendicular muscle mass by dual x-ray absorptiometry (DXA). We analysed the agreement between EWGSOP and EWGSOP2 algorithms in identifying patients as sarcopenic/non-sarcopenic. Differences in the distribution sarcopenic vs. non-sarcopenic were assessed by Chi²-test. RESULTS sarcopenia prevalence according to EWGSOP1 (41 (27.7%)) was significantly higher than with EWGSOP2 (26(18.1%), p<0.05). The sex-specific sarcopenia prevalence was 22.1% (EWGSOP1) and 17.4% (EWGSOP2), respectively, for women (difference not significant) and 37.9% vs. 19.4% for men (p<0.05%). The overall agreement in classifying subjects as sarcopenic/non-sarcopenic was 81.25% (81.4% for women, 81.0% for men). However, among the 41 sarcopenia cases identified by EWGSOP1, only 20 (48.8%) were diagnosed with sarcopenia by EWGSOP2 (9/19 w (47.4%), 11/22 m (50.0%)). Ten of 19 women (52.6%) and 11 of 22 men (50.0%) diagnosed with sarcopenia by EWGSOP1 were missed by EWGSOP2, while 6 of 15 women (40.0%) and 0 of 11 men (0.0%) were newly diagnosed. DISCUSSION there is a substantial mismatch in sarcopenia case finding according to EWGSOP1 and EWGSOP2. The overall prevalence and the number of men diagnosed with sarcopenia are significantly lower in EWGSOP2. While the absolute number of women identified as sarcopenic remains relatively constant, the overlap of individual cases between the two definitions is low.
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Affiliation(s)
- J Reiss
- Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
| | - B Iglseder
- Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
| | - R Alzner
- Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
| | - B Mayr-Pirker
- Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
| | - C Pirich
- Department of Endocrinology and Nuclear Medicine, Landeskrankenhaus, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, Salzburg, Austria
| | - H Kässmann
- Department of Endocrinology and Nuclear Medicine, Landeskrankenhaus, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, Salzburg, Austria
| | - M Kreutzer
- Department of Clinical Nutrition, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
| | - P Dovjak
- Salzkammergut-Klinikum Gmunden, Miller-von-Aichholz-Straße 49, Gmunden, Austria
| | - R Reiter
- Department of Geriatric Medicine, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, Salzburg, Austria
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Özsürekci C, Arslan SS, Demir N, Çalışkan H, Şengül Ayçiçek G, Kılınç HE, Yaşaroğlu ÖF, Kızılarslanoğlu C, Tuna Doğrul R, Balcı C, Sümer F, Karaduman A, Yavuz BB, Cankurtaran M, Halil MG. Timing of Dysphagia Screening in Alzheimer's Dementia. JPEN J Parenter Enteral Nutr 2019; 44:516-524. [PMID: 31172554 DOI: 10.1002/jpen.1664] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/18/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dysphagia is an important and frequent symptom in Alzheimer's dementia (AD). We hypothesized that dysphagia could be seen in the early stages of AD and sarcopenia presence rather than the severity of the AD affecting dysphagia. The main aim of this study was to investigate swallowing functions in AD patients according to stages. The second aim was to investigate the correlation between sarcopenia and dysphagia in AD. METHODS This study involved 76 probable AD patients. For all participants, diagnosis of sarcopenia was based on definitions from the revised version of European Working Group on Sarcopenia in Older People at 2018. Dysphagia symptom severity was evaluated by the Turkish version of the Eating Assessment Tool, a videofluoroscopic swallowing study (VFSS) was performed for instrumental evaluation of swallowing. The patients were divided into 3 groups according to the clinical dementia rating (CDR) scale as CDR 1 (mild dementia), CDR 2 (moderate dementia), and CDR 3 (severe dementia). Swallowing evaluation parameters were analyzed between these groups. RESULTS Mean age was 78.9 ± 6.4 years, and 56.4% were female. Twenty-six patients had mild dementia, 31 patients had moderate dementia, 19 patients had severe dementia (CDR 3). We found that sarcopenia rates were similar between AD stages according to CDR in our study population and dysphagia could be seen in every stage of AD. In a multivariate analysis, polypharmacy and sarcopenia were found to be independently associated factors for dysphagia, irrespective of stage of AD (OR: 6.1, CI: 1.57-23.9, P = 0.009; OR: 4.9, CI: 1.24-19.6, P = 0.023, respectively). CONCLUSION Aspirations may be subtle so that AD patients and caregivers may not be aware of swallowing difficulties. Therefore, all AD patients, especially those who have polypharmacy and/or sarcopenia (probable-sarcopenia-severe sarcopenia), should be screened for dysphagia in every stage.
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Affiliation(s)
- Cemile Özsürekci
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Selen Serel Arslan
- Department of Physiotherapy and Rehabilitation, Division of Swallowing Disorders, Hacettepe University Medical Science Faculty, Ankara, Turkey
| | - Numan Demir
- Department of Physiotherapy and Rehabilitation, Division of Swallowing Disorders, Hacettepe University Medical Science Faculty, Ankara, Turkey
| | - Hatice Çalışkan
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Gözde Şengül Ayçiçek
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Hasan Erkan Kılınç
- Department of Physiotherapy and Rehabilitation, Division of Swallowing Disorders, Hacettepe University Medical Science Faculty, Ankara, Turkey
| | - Ömer Faruk Yaşaroğlu
- Department of Physiotherapy and Rehabilitation, Division of Swallowing Disorders, Hacettepe University Medical Science Faculty, Ankara, Turkey
| | - Cemal Kızılarslanoğlu
- Internal Medicine Department, Division of Geriatrics, Gazi University Medical Faculty, Ankara, Turkey
| | - Rana Tuna Doğrul
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Cafer Balcı
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Fatih Sümer
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Ayşe Karaduman
- Department of Physiotherapy and Rehabilitation, Division of Swallowing Disorders, Hacettepe University Medical Science Faculty, Ankara, Turkey
| | - Burcu Balam Yavuz
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Mustafa Cankurtaran
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Meltem Gülhan Halil
- Internal Medicine Department, Division of Geriatrics, Hacettepe University Medical Faculty, Ankara, Turkey
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Franzon K, Zethelius B, Cederholm T, Kilander L. The impact of muscle function, muscle mass and sarcopenia on independent ageing in very old Swedish men. BMC Geriatr 2019; 19:153. [PMID: 31142271 PMCID: PMC6542054 DOI: 10.1186/s12877-019-1142-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background Preserved functions of daily life and cognition are cornerstones of independent aging, which is crucial for maintaining a high quality of life. The aim of this study was to examine the impact of sarcopenia, and its underlying components, on independent ageing in a cohort study of very old men. Methods The presence of sarcopenia and independent ageing at a mean age of 87 was investigated in 287 men from the Uppsala Longitudinal Study of Adult Men. Five years later 127 men were re-evaluated for independent ageing. Sarcopenia was defined by two different definitions from the European Working Group on Sarcopenia in Older People. In the first definition sarcopenia was defined as skeletal muscle index < 7.26 kg/m2 and either gait speed ≤0.8 m/s or hand grip strength < 30 kg. In the later up-dated definition, HGS < 27 kg and/or chair stand test > 15 s defines probable sarcopenia, which is confirmed by SMI < 7.0 kg/m2. Independent ageing was defined as a Mini-Mental State Examination score of ≥25 points, absence of diagnosed dementia, community-dwelling, independency in personal care and ability to walk outdoors alone. Results Sarcopenia at baseline was observed in 21% (60/287) and 20% (58/287), respectively, due to definition. The prevalence of independent ageing was 83% (239/288) at baseline and 69% (87/127) five years later. None of the sarcopenia diagnoses were associated with independent ageing. In contrast, gait speed was both in cross-sectional (odds ratio (OR) per one standard deviation increase 2.15, 95% confidence interval (CI) 1.47–3.15), and in longitudinal multivariate analyses (OR 1.84, 95% CI 1.19–2.82). In the cross-sectional analysis also higher hand grip strength was associated with independent ageing (OR 1.58, 95% CI 1.12–2.22), while a slower chair stand test was inversely associated (OR 0.61, 95% CI 0.43–0.86). Muscle mass; i.e. skeletal muscle index, was not associated with independent ageing. Conclusions For very old men, especially a higher gait speed, but also a higher hand grip strength and a faster chair stand test, were associated with independent ageing, while skeletal muscle index alone, and the composite sarcopenia phenotype measured with two different definitions, were not.
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Affiliation(s)
- Kristin Franzon
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
| | - Björn Zethelius
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
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Su Y, Hirayama K, Han TF, Izutsu M, Yuki M. Sarcopenia Prevalence and Risk Factors among Japanese Community Dwelling Older Adults Living in a Snow-Covered City According to EWGSOP2. J Clin Med 2019; 8:E291. [PMID: 30823497 PMCID: PMC6463161 DOI: 10.3390/jcm8030291] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia is a common problem among the elderly worldwide. Muscle mass can decrease with aging and decreased physical activity may occur. However, the sarcopenia prevalence among community dwelling older adults living in snow-covered cities remains largely unknown. Therefore, we evaluated the prevalence of and risk factors for sarcopenia in this population aged 65 years or older according to the definitions and diagnoses of the European Working Group on Sarcopenia in Older People-2 from two welfare centers in Sapporo, Hokkaido, Japan. The demographic characteristics, nutrition, and depression status of 310 participants were assessed using a standardized questionnaire. All participants were assessed for grip strength. Skeletal muscle index, body mass index (BMI), and total body water (TBW) were measured using bioelectrical impedance analysis. The overall sarcopenia prevalence in the study population was 8.1%. Multivariate analysis revealed that diabetes and taking more than four drugs per day were independently associated with sarcopenia (adjusted odds ratio (OR) = 3.66, 95% confidence interval (CI) = 1.06⁻12.61; OR = 2.66, CI = 1.05⁻6.77, respectively). BMI and TBW were negatively associated with sarcopenia. Sarcopenia prevalence was low in community dwelling older adults living in the snow-covered city. It is indicated that welfare center exercise may be a good intervention for the prevention of sarcopenia. Moreover, the management of diabetes, medication, and nutrition is necessary for sarcopenia prevention in community dwelling older adults.
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Affiliation(s)
- Ya Su
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Kengo Hirayama
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Tian-Fang Han
- Graduate School of Education, Hokkaido University, Sapporo 060-0812, Japan.
| | - Miku Izutsu
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.
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