|
1
|
Mitsunaga S, Naito T, Imai H, Kimura M, Miura S, Tanaka H, Mizukami T, Imoto A, Kondoh C, Okuyama H, Ueno M, Shiotsu S, Inano T, Chitose H, Tatematsu N, Okayama T, Mouri T, Sugiyama M, Omae K, Kawabata T, Mori K, Takayama K. A Randomized Trial of Nutrition and Exercise Treatment in Patients With Pancreatic and Non-Small Cell Lung Cancer (NEXTAC-TWO). J Cachexia Sarcopenia Muscle 2025; 16:e13871. [PMID: 40522817 PMCID: PMC12169190 DOI: 10.1002/jcsm.13871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 05/14/2025] [Accepted: 05/20/2025] [Indexed: 06/19/2025] Open
Abstract
BACKGROUND In our previous study (NEXTAC-ONE), the Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) program (including home-based exercise and branched-chain amino acid-containing supplements combined with nutritional counselling) was shown to potentially prevent low muscle mass-related disability in elderly cancer patients. This randomized controlled trial (NEXTAC-TWO) was conducted to elucidate whether the NEXTAC program prolongs disability-free survival in elderly patients with advanced pancreatic or non-small cell lung cancer. METHODS This open-label, multicentre, randomized phase II study was conducted at 15 Japanese hospitals. Patients aged ≥ 70 years, with pathologically proven advanced pancreatic or non-small cell lung cancer, who were scheduled to undergo systemic chemotherapy for treatment-naïve tumours were randomly assigned (1:1) to undergo observation or receive the NEXTAC program for 12 weeks. Randomization was performed by the minimization method, using performance status and types with cancer diagnosis and anticancer treatment as adjustment factors. The primary endpoint was disability-free survival (period from randomization to the date patients were evaluated as needing care or death due to any cause). Key secondary endpoints were change in weight, muscle mass, physical activity, nutritional assessment, safety and survival. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000028801). RESULTS From 2017 to 2019, 131 patients were enrolled and randomly assigned to NEXTAC (n = 66) or control arms (n = 65, median age 76.0 years). After randomization, two patients in the NEXTAC arm declined further participation. As a result, 64 patients (median age 75.5 years) received at least one session of the NEXTAC program. The completion rate of the planned exercise and nutrition consultation sessions was 98.4% in the NEXTAC arm. Of the 129 patients, 91 (71%) had a disability (44 in the NEXTAC arm; 47 in the control arm). In the primary analysis, median disability-free survival periods were 478 days (95% confidence interval [CI], 358-576) in the NEXTAC arm and 499 days in the control arm (95% CI, 363-604), with no significant differences between them (p = 0.884). The hazard ratio for disability-free survival in the NEXTAC arm compared with the control arm was 0.970 (95% CI 0.642-1.465). There were no differences in the secondary endpoints between the two arms. CONCLUSIONS The patients had good compliance with the 12-week NEXTAC program but failed to show significant improvements in disability-free survival as compared to observation alone. Further study on the progression of low muscle mass in the NEXTAC arm is needed.
Collapse
Affiliation(s)
- Shuichi Mitsunaga
- Department of Hepatobiliary and Pancreatic OncologyNational Cancer Center Hospital EastKashiwaJapan
- Division of Biomarker Discovery, Exploratory Oncology Research and Clinical Trial CenterNational Cancer CenterKashiwaJapan
| | - Tateaki Naito
- Cancer Supportive Care CenterShizuoka Cancer CenterShizuokaJapan
| | - Hisao Imai
- Division of Respiratory MedicineGunma Prefectural Cancer CenterGunmaJapan
- Department of Respiratory Medicine, International Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Madoka Kimura
- Department of Thoracic OncologyOsaka International Cancer InstituteOsakaJapan
| | - Satoru Miura
- Department of Internal MedicineNiigata Cancer Center HospitalNiigataJapan
| | - Hisashi Tanaka
- Department of Respiratory MedicineHirosaki UniversityHirosakiJapan
| | - Takuro Mizukami
- Department of Clinical OncologySt. Marianna University School of MedicineKawasakiJapan
- Department of Medical OncologyNTT Medical CenterTokyoJapan
| | - Akira Imoto
- Second Department of Internal MedicineOsaka Medical and Pharmaceutical UniversityOsakaJapan
- Department of Internal MedicineAoyama HospitalOsakaJapan
| | - Chihiro Kondoh
- Department of Medical OncologyToranomon HospitalTokyoJapan
| | - Hiroyuki Okuyama
- Department of Medical OncologyKagawa University HospitalKagawaJapan
| | - Makoto Ueno
- Department of GastroenterologyKanagawa Cancer CenterYokohamaJapan
| | - Shinsuke Shiotsu
- Department of Respiratory MedicineJapanese red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Toshimi Inano
- Division of NutritionShizuoka Cancer CenterShizuokaJapan
| | - Haruka Chitose
- Nutrition Management OfficeNational Cancer Center HospitalTokyoJapan
| | - Noriatsu Tatematsu
- Department of Integrated Health SciencesNagoya UniversityNagoyaAichiJapan
| | - Taro Okayama
- Division of Rehabilitation MedicineShizuoka Cancer CenterShizuokaJapan
| | - Takako Mouri
- Graduate School of NursingKyoto Prefectural University of MedicineKyotoJapan
| | - Miwa Sugiyama
- Division of NursingShizuoka Cancer CenterShizuokaJapan
| | - Katsuhiro Omae
- Department of Data ScienceNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Takanori Kawabata
- Department of Data ScienceNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Keita Mori
- Department of Biostatistics, Clinical Research Support CenterShizuoka Cancer CenterShizuokaJapan
| | - Koichi Takayama
- Department of Pulmonary MedicineKyoto Prefectural University of MedicineKyotoJapan
| |
Collapse
|
|
2
|
Xiao Q, Jiang J, Han S, Xiong Y, Chen Y, Yan F, Yue J. A study on the balance ability and plantar pressure of sarcopenia patients in different standing postures. Gait Posture 2025; 118:51-60. [PMID: 39891964 DOI: 10.1016/j.gaitpost.2025.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 01/24/2025] [Accepted: 01/28/2025] [Indexed: 02/03/2025]
Abstract
BACKGROUND Sarcopenia usually manifests as a decrease in muscle mass and strength, seriously affecting the quality of life and independent living ability of elderly people. Moreover, sarcopenia is associated with various adverse outcomes such as mortality, postoperative infections, and severe complications, as well as affecting the balance and plantar pressure of the elderly. RESEARCH QUESTION What are the characteristics of balance ability and plantar pressure in sarcopenia population across different standing postures? METHODS A plantar pressure measurement system was used to measure the COP parameters and plantar pressure of 70 individuals in four standing postures: Feet 10 cm apart (FA), Feet together (FT), Feet Semi Tandem (FST), and Feet Full Tandem (FFT). The plantar area was divided into ten regions based on the anatomical structure of the foot. An independent samples t-test was conducted for significance testing, and developed sarcopenia screening models based on binary logistic regression. RESULTS Research has found that there are significant differences in the center of plantar pressure (COP) speed, 95 % elliptical region, COP length, and short axis length between populations with and without sarcopenia in the FST stance. The analysis of plantar pressure showed that the main differences between the two groups were located in the metatarsal and heel regions, and the accuracy of the binary logistic regression model constructed based on the FFT stance plantar pressure data without weight-adjusted for screening sarcopenia was as high as 94.3 %, which was superior to other standing postures. SIGNIFICANCE The difference in balance ability between sarcopenia population and non-sarcopenia population is reflected in standing posture with a relatively narrower base of support on the plantar surface (FST), and FFT stance plantar pressure can be used as a new method for screening sarcopenia.
Collapse
Affiliation(s)
- Qing Xiao
- School of Mechanical and Electrical Engineering, Chengdu University of Technology, Chengdu, Sichuan 610059, China
| | - Jie Jiang
- School of Mechanical and Electrical Engineering, Chengdu University of Technology, Chengdu, Sichuan 610059, China.
| | - Shulang Han
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China
| | - Yan Xiong
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China
| | - Yu Chen
- Department of Applied Mechanics, Sichuan University, Chengdu 610065, China
| | - Fei Yan
- Chongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing University Three Gorges Hospital, School of Medicine, Chongqing University, Chongqing 404000, China
| | - Jirong Yue
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
|
3
|
Montalvão-Sousa TM, Ferreira PDA, Colombelli NL, de Carvalho KMB, Blazevich AJ, Lima RM. Sarcopenic obesity defined by the ESPEN and EASO consensus statement in older women: Risk of falls and bone mineral density implications. Arch Gerontol Geriatr 2024; 124:105444. [PMID: 38643667 DOI: 10.1016/j.archger.2024.105444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To apply the ESPEN-EASO diagnostic criteria for Sarcopenic Obesity (SO) in older women and to assess its association with the risk of falls, fear of falls (FOF), and bone mineral density (BMD). METHODS After exclusion criteria, 232 women aged ≥60 years (68.2 ± 6.1) were enrolled in the study. Volunteers had handgrip strength (HGS; dynamometer) and body composition assessed by DXA before risk of falls was evaluated using the QuickScreen and FOF evaluated by the Falls Efficiency Scale. SO was defined according to the ESPEN-EASO algorithm, which includes reduced HGS and fat-free mass, and elevated fat mass. RESULTS The prevalence of SO was 6.5 %, which was associated with a higher proportion of fallers in the previous year (X2 6.2, P = 0.04), reduced reaction time (X2 6.2, P = 0.04), reduced sit-to-stand performance (X2 6.2, P = 0.04), and a higher probability of falls [ꭓ2(6) = 17.689, p = 0.004]. FOF was lower in the eutrophic group (ꭓ2(2) = 15,662, p < 0,001) than both the obesity (p = 0.001) and SO (p = 0.05) groups. For total and femoral neck BMD, the eutrophic group presented significantly lower values (1.05 and 0.79 g/cm2) than the obesity group (1.10 and 0.87 g/cm2), but similar to the SO group (1.02 and 0.83 g/cm2). These results remained significant after adjustments for potential confounders. CONCLUSIONS SO specified by the ESPEN-EASO framework was associated with a higher risk of falls but not with increased FOF than obesity alone. The favorable influence of overweight and obesity on BMD seems to be attenuated in individuals with SO. Our findings support the clinical significance of the ESPEN-EASO definition.
Collapse
Affiliation(s)
| | | | | | | | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
| |
Collapse
|
|
4
|
Hu P, Jiang Z, Ma S, Cheng R, Tsai TY, Wang H. Sarcopenia in older adults is associated with static postural control, fear of falling and fall risk: A study of Romberg test. Gait Posture 2024; 112:147-153. [PMID: 38795475 DOI: 10.1016/j.gaitpost.2024.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/27/2024] [Accepted: 04/30/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND As a geriatric syndrome, sarcopenia may exacerbate static postural control and increase fall risk among older adults. The Romberg test, a simple method to assess static postural control, has the potential to predict fall, but has rarely been used to assess static postural control and fall risk in sarcopenic older adults. RESEARCH QUESTION How does sarcopenia increase fall risk by affecting static postural control? METHODS Forty-four older adults performed the Romberg test and were included for analyses. Romberg parameters, including Center of Pressure (CoP), Center of Mass (CoM) and Displacement Angle (DA), were collected under eyes-open/eyes-closed conditions. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Fall risk was assessed using the Morse Elderly Fall Risk Assessment Scale (MFS), and fear of falling was evaluated using the Falls Efficacy Scale-International (FES-I). Multivariate linear regression models were conducted to examine the associations of sarcopenia with Romberg test parameters, fear of falling, and fall risk. RESULTS Sarcopenic older adults had higher scores of both fear of falling and fall risk (P<0.001 and =0.006, respectively), and worse static postural control parameters (P values ranging from <0.001-0.043) than healthy controls, demonstrated by the multivariate linear regression models. Most of the Romberg test parameters were significantly associated with fear of falling score, especially under eyes-closed condition, and fear of falling was further associated with higher fall risk score (β=0.90, P=0.001). Meanwhile, the presence of sarcopenia also significantly increased fall risk score (β=10.0, P<0.001). SIGNIFICANCE Sarcopenia may increase fall risk in older adults via worsen static postural control ability and increase fear of falling. Paying attention and making efforts to prevent sarcopenia may help to alleviate postural control dysfunction, decrease fear of falling, so as to reduce fall risk and prevent severe injuries caused by fall accidents.
Collapse
Affiliation(s)
- Ping Hu
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Ziang Jiang
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Shaojun Ma
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Rongshan Cheng
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| | - Haiya Wang
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| |
Collapse
|
|
5
|
Sales WB, Mâcedo SGGF, Gonçalves RSDSA, Andrade LELD, Ramalho CST, de Souza GF, Maciel ÁCC. Use of electrical bioimpedance in the assessment of sarcopenia in the older aldults: A scoping review. J Bodyw Mov Ther 2024; 39:373-381. [PMID: 38876654 DOI: 10.1016/j.jbmt.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/14/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE to map and synthesize the main evidence on the use of bioelectrical impedance (BIA) and its variables in the assessment of sarcopenia in community-dwelling older adults. METHODS This is a scoping review carried out by searching for articles available in four databases: PUBMED, LILACS, Web of Science and CINAHL, with the following search strategy: Body Composition AND Sarcopenia AND ″electric impedance'' OR ″bioelectrical impedance analysis'' AND Aged. RESULTS A total of 27,660 older adults made up the sum of the samples of the included studies. Most studies included participants of both sexes (75.6%), used the variable skeletal and/or appendicular skeletal muscle mass (ASMM) (75.6%), followed by body fat (8.1%), and phase angle (8.1%) in the assessment of the body composition of subjects with sarcopenia. CONCLUSION The data from this research show that ASMM and phase angle are the main variables related to sarcopenia screening in community-dwelling older adults. Whereas total extracellular water/body water is still considered a confounding variable in the screening of sarcopenia in the elderly, but it can be considered useful regarding the health conditions of the elderly in the community.
Collapse
Affiliation(s)
- Weslley Barbosa Sales
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | | | | | - Luiz Eduardo Lima de Andrade
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | - Caroline Sousa Truta Ramalho
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | - Gérson Fonseca de Souza
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | | |
Collapse
|
|
6
|
Ong RHS, Nurjono M, Oh HC, Lien CTC, Jumala J, Teo RCC, Gan P, Kan KLM, Rosle LF, Wee MK, Low SL. Factors Influencing the Implementation of a Fall Prevention Exercise Program for Community-Dwelling Older Adults: A Qualitative Study Guided by the PRECEDE-PROCEED Model. Clin Interv Aging 2024; 19:857-871. [PMID: 38770185 PMCID: PMC11104366 DOI: 10.2147/cia.s454043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/27/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of "Steady Feet" (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore. Material and Methods This study utilized purposive sampling to recruit two participant groups: (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors. Results Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation. Conclusion Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers' capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.
Collapse
Affiliation(s)
| | | | - Hong Choon Oh
- Health Services Research, Changi General Hospital, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore
- Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | | - Junisha Jumala
- Rehabilitative Services, Changi General Hospital, Singapore
| | | | - Peiying Gan
- Community Nursing, Changi General Hospital, Singapore
| | | | | | - Moi Kim Wee
- Community and Mental Health, Changi General Hospital, Singapore
| | - Shou Lin Low
- Geriatric Medicine, Changi General Hospital, Singapore
| |
Collapse
|
|
7
|
Ishimoto R, Mutsuzaki H, Shimizu Y, Takeuchi R, Matsumoto S, Hada Y. Association between Sarcopenia and Balance in Patients Undergoing Inpatient Rehabilitation after Hip Fractures: A Retrospective Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:742. [PMID: 38792925 PMCID: PMC11123061 DOI: 10.3390/medicina60050742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Sarcopenia is characterized by a decline in skeletal muscle mass, strength, and function and is associated with advancing age. This condition has been suggested as a factor that negatively influences the functional outcomes of patients with hip fractures. However, the association between sarcopenia and balance impairment in patients undergoing inpatient rehabilitation after hip fractures remains unclear. In this retrospective cohort study, we aimed to investigate the impact of sarcopenia on balance outcomes in patients undergoing inpatient rehabilitation following hip fractures. Materials and Methods: Baseline sarcopenia was diagnosed using skeletal muscle mass index and handgrip strength, with cut-off values recommended by the Asian Working Group for Sarcopenia. The primary outcome was balance, which was assessed using the Berg Balance Scale (BBS) at the time of discharge. A multiple linear regression model analyzed the association between sarcopenia and balance. The model was adjusted for age, sex, comorbidities, and cognitive function. Results: Among the 62 patients (mean age: 78.2; sex: 75.8% women), 24.2% had sarcopenia. Patients with sarcopenia had significantly lower BBS scores than did those without sarcopenia (41 vs. 49 points, p = 0.004). Multiple linear regression analysis revealed that baseline sarcopenia was independently associated with BBS scores at discharge (β = -0.282, p = 0.038). Conclusions: Following inpatient rehabilitation, patients with baseline sarcopenia had inferior balance outcomes than did those without sarcopenia at discharge. Sarcopenia should be assessed on admission to consider and provide additional care for those with a higher risk of poor functional outcomes. More studies are needed to investigate the association between sarcopenia and functional outcomes, examine the impact of sarcopenia treatment on these outcomes, and reduce the risk of recurrent falls and fractures in patients with hip fractures.
Collapse
Affiliation(s)
- Ryu Ishimoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan;
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Ryoko Takeuchi
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Shuji Matsumoto
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| |
Collapse
|
|
8
|
Yeh PC, Syu DK, Ho CC, Lee TS. Associations of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Front Public Health 2024; 12:1226239. [PMID: 38414890 PMCID: PMC10896829 DOI: 10.3389/fpubh.2024.1226239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
Background Aging is an inevitable process of life development. These physical changes can cause a decline in the functional adaptability and health status of older adult individuals. Aims The purpose of this study was to investigate the association of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Methods We conducted a cross-sectional study and reviewed data derived from the National Physical Fitness Survey in Taiwan 2015-2016. A total of 20,846 Taiwanese older adult individuals aged 65 years old or older were recruited as study participants. Demographic characteristics, anthropometric assessments, lifestyle habits, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and linear regression analysis. Lower-limb muscle strength performance was classified into 4 groups based on quartile (Quartile 1 [Q1], Quartile 2 [Q2], Quartile 3 [Q3], and Quartile 4 [Q4]) values. Results Increased lower-limb muscle strength levels were significantly associated with static balance in men (Q2: β = 2.539, p < 0.0001; Q3: β = 4.590, p < 0.0001; Q4: β = 7.700, p < 0.0001) and women (Q2: β = 2.022, p < 0.0001; Q3: β = 4.179, p < 0.0001; Q4: β = 6.920, p < 0.0001) after adjusting for potential confounders. In addition, we observed that increased lower-limb muscle strength levels were significantly associated with dynamic balance in men (Q2: β = -1.661, p < 0.0001; Q3: β = -2.434, p < 0.0001; Q4: β = -3.091, p < 0.0001) and women (Q2: β = -1.660, p < 0.0001; Q3: β = -2.548, p < 0.0001; Q4: β = -3.196, p < 0.0001) after adjusting for potential confounders. Conclusion Lower-limb muscle strength was the most important factor, as it was an improved method for static and dynamic balance control in both genders.
Collapse
Affiliation(s)
- Ping-Chun Yeh
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - De-Kai Syu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - Chien-Chang Ho
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tian-Shyug Lee
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, Taiwan
| |
Collapse
|
|
9
|
Heo SJ, Park S, Jee YS. Navigating the nexus among thigh volume, myokine, and immunocytes in older adults with sarcopenia: A retrospective analysis in a male cohort. Arch Gerontol Geriatr 2024; 117:105273. [PMID: 37979337 DOI: 10.1016/j.archger.2023.105273] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND This study investigated the association among thigh volume features, interleukin (IL)-6, and immunocytes in the context of the older people with sarcopenia. MATERIALS AND METHODS This study comprised a cohort of 437 older males diagnosed with sarcopenia, and their average age of 70.41 ± 4.86 years. This study involved conducting correlation and multiple linear regression analyses to investigate the connections between thigh volume, IL-6, and immunocytes. RESULTS Total thigh volume (TTV) showed positive connections with thigh muscle volume (TMV), natural killer (NK) cells, and CD8 + T cells. TMV had negative associations with thigh fat volume (TFV) and IL6 but displayed positive connections with other factors. IL-6 had adverse associations with all the other variables except for TFV. NK cells showed significant positive relations with all adaptive immune cells, though showing not TFV and IL-6. The CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD19+ B cells exhibited positive correlations with each other including NK cells, though showing not TFV and IL-6. In the regression analysis, TMV exhibited significant positive effects on NK cells (β = 0.304), CD3+ T cells (β = 0.182), CD4+ T cells (β = 0.109), CD8+ T cells (β = 0.226), and CD19+ B cells (β = 0.197). On the other hand, IL-6 had significant negative effects on NK cells (β = -0.292), CD3+ T cells (β = -0.352), CD4+ T cells (β = -0.184), CD8+ T cells (β = -0.387), and CD19+ B cells (β = -0.366). CONCLUSIONS This study found that there existed a direct association among thigh muscle with sarcopenia, myokine, and immunocytes. SIMPLE SUMMARY The aging process involves the immune system playing a vital role in sarcopenia development, and it is thought that myokines released by skeletal myocytes. However, the exact relationship between TMV, myokines, and immunocytes in older male adults affected by sarcopenia remains unclear. This study found that myokines observed in sarcopenia showed a negative correlation with immunocytes, while muscle mass had a positive correlation with immunocytes. In the meantime, this research delved into the use of a regression model to examine how TMV and myokines individually contribute to explaining the presence of innate and adaptive immunocytes in older individuals with sarcopenia.
Collapse
Affiliation(s)
- Seung-Jae Heo
- Department of Physical Education, Chungnam National University, Daehak-ro, Yuseong-gu, Daejeon 34134, South Korea
| | - Sihwa Park
- Research Institute of Sports and Industry Science, Hanseo University, #1 Hanseo-ro, Haemi-myeon, Seosan, 31962, South Korea.
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, #1 Hanseo-ro, Haemi-myeon, Seosan, 31962, South Korea.
| |
Collapse
|
|
10
|
Chen R, Armamento-Villareal R. Obesity and Skeletal Fragility. J Clin Endocrinol Metab 2024; 109:e466-e477. [PMID: 37440585 PMCID: PMC10795939 DOI: 10.1210/clinem/dgad415] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/15/2023]
Abstract
Skeletal fracture has recently emerged as a complication of obesity. Given the normal or better than normal bone mineral density (BMD), the skeletal fragility of these patients appears to be a problem of bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), the incidence of which increases with increasing body mass index, is also associated with an increased risk for fractures despite a normal or high BMD. With the additional bone pathology from diabetes itself, patients with both obesity and T2DM could have a worse skeletal profile. Clinically, however, there are no available methods for identifying those who are at higher risk for fractures or preventing fractures in this subgroup of patients. Weight loss, which is the cornerstone in the management of obesity (with or without T2DM), is also associated with an increased risk of bone loss. This review of the literature will focus on the skeletal manifestations associated with obesity, its interrelationship with the bone defects associated with T2DM, and the available approach to the bone health of patients suffering from obesity.
Collapse
Affiliation(s)
- Rui Chen
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| |
Collapse
|
|
11
|
Eitmann S, Matrai P, Hegyi P, Balasko M, Eross B, Dorogi K, Petervari E. Obesity paradox in older sarcopenic adults - a delay in aging: A systematic review and meta-analysis. Ageing Res Rev 2024; 93:102164. [PMID: 38103840 DOI: 10.1016/j.arr.2023.102164] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
The prognostic significance of obesity in sarcopenic adults is controversial. This systematic review and meta-analysis aimed to investigate the effect of additional obesity on health outcomes in sarcopenia. MEDLINE, EMBASE, Scopus and CENTRAL were systematically searched for studies to compare health outcomes of adults with sarcopenic obesity (SO) to those of sarcopenic non-obese (SNO) adults. We also considered the methods of assessing obesity. Of 15060 records screened, 65 papers were included (100612 participants). Older community-dwelling SO adults had 15% lower mortality risk than the SNO group (hazard ratio, HR: 0.85, 95% confidence interval 0.76, 0.94) even when obesity was assessed by measurement of body composition. Additionally, meta-regression analysis revealed a significant negative linear correlation between the age and the HR of all-cause mortality in SO vs. SNO community-dwelling adults, but not in severely ill patients. Compared with SNO, SO patients presented lower physical performance, higher risk for metabolic syndrome, but similar cognitive function, risk of falls and cardiovascular diseases. Age-related obesity, SO and later fat loss leading to SNO represent consecutive phases of biological aging. Additional obesity could worsen the health state in sarcopenia, but above 65 years SO represents a biologically earlier phase with longer life expectancy than SNO.
Collapse
Affiliation(s)
- Szimonetta Eitmann
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Matrai
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Balint Eross
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary; Centre for Translational Medicine, Semmelweis University, 26 Ulloi street, H-1085 Budapest, Hungary; Division of Pancreatic Diseases, Semmelweis University, 23-26 Baross street, H-1085 Budapest, Hungary
| | - Kira Dorogi
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary
| | - Erika Petervari
- Institute for Translational Medicine, Medical School, University of Pecs, 12 Szigeti street, H-7624 Pecs, Hungary.
| |
Collapse
|
|
12
|
Xia X, Xiang S, Hua L, Sun Q, Wang R. The relationship between lifestyles and sarcopenia-related traits: A two-sample Mendelian randomization study. Arch Gerontol Geriatr 2024; 116:105169. [PMID: 37657206 DOI: 10.1016/j.archger.2023.105169] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To investigate the causal association between lifestyles (smoking, drinking consumption and physical activity) and sarcopenia-related traits by Mendelian randomized analysis. METHODS Instrumental variables from the genome-wide association study were used for analysis. The exposure factors were lifestyle factors, including smoking, alcohol consumption, moderate physical activity and vigorous physical activity, and the outcome variables were low hand grip strength and appendicular lean mass. The inverse variance weighted (IVW) method and other MR methods were used for analysis. Heterogeneity test, sensitivity analysis and pleiotropy analysis were performed. RESULTS According to a primary causal effects model with MR analyses by the IVW method, smoking was a decreased risk of low hand grip strength (odds ratio (OR) = 0.899, 95% confidence interval (CI) = 0.829-0.974, P = 0.010), while alcohol consumption was a significant correlation with low hand grip strength (OR = 1.137, 95% CI = 1.020-1.267, P = 0.020). There was no significant relationship between smoking, alcohol, and appendicular lean mass. In addition, moderate or vigorous physical showed no significant correlation with low hand grip strength and appendicular lean mass. CONCLUSION This study demonstrated that smoking may be causally related to a lower risk of low hand grip strength, while alcohol may increase the risk of low hand grip strength. There was no causal relationship between physical activity and sarcopenia-related traits.
Collapse
Affiliation(s)
- Xiaoting Xia
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shate Xiang
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lijiangshan Hua
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiuhua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China; College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
| |
Collapse
|
|
13
|
Liang C, Shi L, Li B, He Z. The Mediating Role of Sarcopenia in the Association between Physical Activity and Falls among Chinese Older Adults: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:3146. [PMID: 38132036 PMCID: PMC10743279 DOI: 10.3390/healthcare11243146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
Physical inactivity and sarcopenia are potentially modifiable risk factors for falls in older adults, but the strength of the association between physical activity (PA), sarcopenia, and falls in Chinese older adults is unclear. This study sought to investigate the potential mediation mechanism relationship in the connection between PA, sarcopenia, including its elements (muscle strength, physical performance, and skeletal muscle mass), and falls among Chinese older people. The subjects were 3592 community-dwelling Chinese aged 60 or over, selected from the China Health and Retirement Longitudinal Study (CHARLS). PA was evaluated through the International Physical Activity Questionnaire (IPAQ), and sarcopenia was determined through the Asian Working Group on Sarcopenia (AWGS) 2019 guidelines. We employed logistic regression to explore the link between physical activity, sarcopenia, and falls. Additionally, we applied Karlson, Holm and Breen's (KHB) method to estimate two different mediation models. The results demonstrated that PA lowers the risk of falls [odds ratio (OR) 0.54, 95% confidence interval (CI) 0.48-0.61], whereas sarcopenia increases the risk of falls (OR 1.34, 95% CI 1.16-1.55). Sarcopenia mediated the association between PA and falls, explaining a total of 2.69% of the association (indirect effect = -0.02). PA also had a significant mediating effect on the association between sarcopenia and falls, explaining a total of 20.12% of the association (indirect effect = 0.06). The proportion mediated by sarcopenia was 2.69% for PA and falls (indirect effect = -0.02). Our findings suggest that PA and sarcopenia have a direct effect on falls as well as an indirect effect through each other. Enhancing PA levels and preventing sarcopenia may help prevent falls in older adults.
Collapse
Affiliation(s)
| | - Lei Shi
- Sports Centre, Xi’an Jiaotong University, Xi’an 710049, China; (C.L.); (B.L.); (Z.H.)
| | | | | |
Collapse
|
|
14
|
Shin HE, Won CW, Kim M. Development of multiple biomarker panels for prediction of sarcopenia in community-dwelling older adults. Arch Gerontol Geriatr 2023; 115:105115. [PMID: 37422966 DOI: 10.1016/j.archger.2023.105115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND It is required to consider multiple biomarkers simultaneously to predict sarcopenia and to understand its complex pathological mechanisms. This study aimed to develop multiple biomarker panels for predicting sarcopenia in older adults and to further examine its association with the incidence of sarcopenia. METHODS A total of 1,021 older adults were selected from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019 criteria. Among the 14 biomarker candidates at baseline, eight biomarkers that could optimally detect individuals with sarcopenia were selected to develop a multi-biomarker risk score (range from 0 to 10). The utility of developed multi-biomarker risk score in discriminating sarcopenia was investigated using receiver operating characteristic (ROC) analysis. RESULTS The multi-biomarker risk score had an area under the ROC curve (AUC) of 0.71 with an optimal cut-off of 1.76 score, which was significantly higher than all single biomarkers with AUC of <0.7 (all, p<0.01). During the two-year follow-up, the incidence of sarcopenia was 11.1%. Continuous multi-biomarker risk score was positively associated with incidence of sarcopenia after adjusting confounders (odds ratio [OR]=1.63; 95% confidence interval [CI]=1.23-2.17). Participants with a high risk score had higher odds of sarcopenia than those with a low risk score (OR=1.82; 95% CI=1.04-3.19). CONCLUSIONS Multi-biomarker risk score, which was a combination of eight biomarkers with different pathophysiologies, better discriminated the presence of sarcopenia than a single biomarker, and it could further predict the incidence of sarcopenia over two years in older adults.
Collapse
Affiliation(s)
- Hyung Eun Shin
- Department of Biomedical Science and Technology, College of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea.
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Korea.
| |
Collapse
|
|
15
|
Caprariu R, Oprea MD, Poenaru DV, Andrei D. Correlation between Preoperative MRI Parameters and Oswestry Disability Index in Patients with Lumbar Spinal Stenosis: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2000. [PMID: 38004049 PMCID: PMC10672893 DOI: 10.3390/medicina59112000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Lumbar spinal stenosis (LSS) is a degenerative condition posing significant challenges in clinical management. Despite the use of radiological parameters and patient-reported outcome measures like the Oswestry Disability Index (ODI) for evaluation, there is limited understanding of their interrelationship. This study aimed to investigate the correlation between preoperative MRI parameters and ODI scores in patients with LSS undergoing surgical treatment. Materials and Methods: A retrospective analysis was conducted on 86 patients diagnosed with LSS over a 5-year period. Preoperative MRI measurements, including the cross-sectional area of the psoas muscle, lumbar canal stenosis, neural foramina area, and facet joint osteoarthritis, were assessed. ODI scores were collected preoperatively and at a 1-year follow-up. Statistical analyses were performed using IBM SPSS Statistics software (version 26). Results: Weak to moderate correlations were observed between certain MRI parameters and ODI scores. The initial ODI score had a weak positive correlation with the severity of lumbar canal stenosis according to Schizas criteria (rho = 0.327, p = 0.010) and a moderate negative correlation with the relative cross-sectional area of the psoas muscle (rho = -0.498, p = 0.000). At 1-year follow-up, the ODI had a weak negative correlation with the relative cross-sectional area of the psoas muscle (rho = -0.284, p = 0.026). Conclusions: While the severity of LSS showed a weak correlation with initial ODI, it was not a predictor of 1-year postoperative ODI. Furthermore, although the cross-sectional area of the thecal sac, the sagittal area of the neural foramen, and the grade of facet joint osteoarthritis influence the imagistic severity, none of them correlate with ODI. These findings underscore the need for a comprehensive model that integrates multiple imaging and clinical parameters for a holistic understanding of LSS and its functional outcomes.
Collapse
Affiliation(s)
- Radu Caprariu
- Department of Radiology and Medical Imaging, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania;
| | - Manuel D. Oprea
- Department of Traumatology and Orthopedics, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania;
| | - Dan V. Poenaru
- Department of Traumatology and Orthopedics, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania;
| | - Diana Andrei
- Department of Balneology, Medical Rehabilitation and Rheumatology, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania;
| |
Collapse
|
|
16
|
Milic J, Calza S, Cantergiani S, Albertini M, Gallerani A, Menozzi M, Barp N, Todisco V, Renzetti S, Motta F, Mussini C, Sebastiani G, Raggi P, Guaraldi G. Sarcopenic Obesity Phenotypes in Patients With HIV: Implications for Cardiovascular Prevention and Rehabilitation. Can J Cardiol 2023; 39:S359-S367. [PMID: 37659756 DOI: 10.1016/j.cjca.2023.08.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND We aimed to describe prevalence, incidence, and risk factors for sarcopenic obesity (SO) phenotypes in people living with HIV (PWH) and their association with subclinical cardiovascular disease (CVD). METHODS Observational, longitudinal study of PWH. A minimum of 1 criterion was necessary to diagnose sarcopenia: weak hand grip (HG), low appendicular skeletal muscle index (ASMI), short physical performance battery (SPPB < 11). Obesity was defined as body mass index (BMI) ≥ 30 kg/m2 or visceral adipose tissue (VAT) ≥ 160 cm2. These variables combined generated 5 SO phenotypes: severe SO: low HG + low ASMI + low SPPB + high BMI; SO1: weak HG + high VAT; SO2: weak HG + high BMI; SO3: low ASMI + high VAT; SO4: low ASMI + high BMI. Subclinical CVD was defined as carotid intima-media thickness (IMT) ≥ 1 mm, presence of carotid plaque, or coronary artery calcification (CAC) score > 10. RESULTS Among 2379 male PWH 72%, median age was 52 years, median HIV vintage 21 years, and median BMI 24 kg/m2. Two PWH had severe SO. The prevalence of SO1-SO4 was 19.7%, 3.6%, 20.8% and 0.8%, respectively. Incidence of SO1-SO4 was 6.90, 1.2, 5.6, and 0.29 × 100 person-years, respectively. SO1 was associated with risk of IMT ≥ 1, and SO3 with risk of CAC score > 10. CONCLUSIONS There was a large variability in incidence and prevalence of SO phenotypes. The presence of SO may have important implications for cardiovascular prevention and cardiac rehabilitation of PWH who suffered events.
Collapse
Affiliation(s)
- Jovana Milic
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Samuele Cantergiani
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Maddalena Albertini
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Altea Gallerani
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Marianna Menozzi
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Nicole Barp
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Vera Todisco
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Federico Motta
- Department of Physical, Computer and Mathematical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Giada Sebastiani
- Division of Gastroenterology and Hepatology and Division of Infectious Diseases, McGill University Health Centre, Montréal, Québec, Canada
| | - Paolo Raggi
- Department of Medicine, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Giovanni Guaraldi
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy.
| |
Collapse
|
|
17
|
Wakaba K, Osuka Y, Kojima N, Sasai H. Predictive Capability of 5 Sarcopenia Diagnostic Criteria for Fall Incidents in Older Japanese Women: The Otassha Study. J Am Med Dir Assoc 2023; 24:1549-1554. [PMID: 37579925 DOI: 10.1016/j.jamda.2023.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES The association between sarcopenia diagnosis according to various diagnostic criteria and falls is unclear. We examined the association between sarcopenia defined by 5 different international criteria, and fall and injurious fall numbers among older community-dwelling Japanese women. DESIGN Prospective observational study. SETTING AND PARTICIPANTS Two population-based cohort studies in Itabashi, Japan, were integrated, including 552 community-dwelling Japanese women >75 years of age. METHODS Muscle mass, muscle strength, and physical performance were assessed by bioimpedance analysis, handgrip strength, and gait speed, respectively. We recorded the fall and injurious fall numbers for 1 year using a diary. The association between sarcopenia diagnosis defined by the Asian Working Group for Sarcopenia (AWGS) 2019, European Working Group on Sarcopenia in Older People 2, Foundation for the National Institutes of Health (FNIH), International Working Group on Sarcopenia, and Society on Sarcopenia, Cachexia, and Wasting Disorders, and fall numbers was assessed by Poisson regression analysis to estimate the incidence rate ratio (IRR) and 95% CI for the presence or absence of sarcopenia. RESULTS Of 470 participants (mean age 77.1 ± 8.1 years), 144 reported a combined 352 falls. Overall, 80 individuals experienced a single fall, 64 experienced multiple falls, and 91 experienced injurious falls. Sarcopenia defined by the AWGS 2019 (IRR 1.39, 95% CI 1.10-1.76) and FNIH (IRR 2.55, 95% CI 1.99-3.26) was significantly associated with the number of falls. In addition, sarcopenia defined by the FNIH (IRR 2.72, 95% CI 1.84-4.03) was significantly associated also with the number of injurious falls. No significant association was observed between sarcopenia diagnosis based on the other definitions and fall outcomes. CONCLUSIONS AND IMPLICATIONS The AWGS 2019 and FNIH sarcopenia definitions were associated with the fall and injurious fall numbers in older Japanese women, indicating they can help in predicting falls in this population.
Collapse
Affiliation(s)
| | - Yosuke Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan; Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
|
18
|
Yun J, Kwon RJ, Kim T. Prevalence and clinical characteristics of low skeletal muscle index among adults visiting a health promotion center: Cross-sectional study. Medicine (Baltimore) 2023; 102:e34404. [PMID: 37478219 PMCID: PMC10662807 DOI: 10.1097/md.0000000000034404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023] Open
Abstract
Sarcopenia causes a variety of functional impairments and is associated with all-cause mortality, but once it occurs, it is difficult to treat and reverse. However, the prevalence of sarcopenia in healthy people has never been investigated due to the low awareness of sarcopenia in healthy people. This cross-sectional study was conducted in a single health promotion center from the January 1st 2020 to the December 31st 2021. Adults aged 18 years and older with an Inbody as part of their health checkup were included, and all data was collected from the EMR. Obesity was defined as a body mass index (BMI) of 23 (kg/m2) or more by Korean standards, and low skeletal muscle mass was defined as a skeletal muscle index (SMI) of <0.789 for men and <0.512 for women. 60.5% of the total participants (n = 5993) had low skeletal muscle mass. The low SMI group had lower BMI, waist circumference, and abdominal skinfold than the normal SMI group (low SMI group vs normal SMI: BMI; 25.47 ± 2.96 vs 22.98 ± 3.05, P < .001, waist circumference; 90.31 ± 8.80 cm vs 82.69 ± 9.71 cm, P < .001, abdominal skinfold; 18.78 ± 2.44 mm vs 15.99 ± 2.12 mm, P < .001). The body fat percentage was higher in the low SMI group than in the normal SMI group 25.30 ± 6.23% versus 29.82 ± 7.07%, P < .001. Triglyceride and uric acid levels were low in the low SMI group (TG; 147.69 ± 97.27 vs 115.86 ± 68.31, P < .001, uric acid level; 6.30 ± 1.38 vs 5.23 ± 1.30, P < .001) and high-density lipid (HDL) was high (HDL; 53.17 ± 11.41 vs 59.89 ± 14.72, P < .001). The odds ratio of low SMI prevalence for age, sex, BMI, fat body percent, and triglycerides relative to normal SMI was 1.05 (P = .031), 0.14 (P < .001), 0.12 (P < .001), 2.05 (P < .001), and 0.99 (P = .003), respectively. Of those who visited the Health Promotion Center, more than 60% had low SMI identified through Inbody. Low BMI and high body fat percentage increase the risk of low SMI. Compared to normal and low SMI based on obesity, Sex, height, BW, abdominal skinfold, and waist circumflex showed significant P values in both groups. The factors related to low SMI were TG, HDL, and uric acid levels.
Collapse
Affiliation(s)
- Jungmi Yun
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Ryuk Jun Kwon
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Taehwa Kim
- Division of Pulmonology, Allergy, and Critical Care Medicine, Research Institute for Convergence of Biomedical Science and Technology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
| |
Collapse
|
|
19
|
Batsis JA, Haudenschild C, Crow RS, Gilliam M, Mackenzie TA. Sarcopenia Definition Outcome Consortium - defined Weakness and Risk of Falls: The National Health and Aging Trends Survey. Geriatr Gerontol Int 2023; 23:213-220. [PMID: 36752357 PMCID: PMC9992327 DOI: 10.1111/ggi.14548] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/02/2023] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
AIM The prevalence of obesity continues to rise, as does that of weakness. However, it is unclear how this impacts the risk of falling. We aimed to ascertain the risk of falls using new definitions of clinically defined weakness. METHODS We applied clinically defined weakness definitions to the National Health and Aging Trends Survey using the Sarcopenia Definitions Outcomes Consortium cutpoints. Three exposure variables were created: grip-strength-defined weakness and body mass index [GS/BMI]-defined obesity; weakness and obesity, weakness and waist circumference-derived obesity (GS/WC); and weakness defined by a ratio of GS÷BMI. Proportional hazards modeled incident falls as a function of weakness with/without obesity (hazard ratio [HR] [95% confidence intervals]). RESULTS Of 4906 respondents aged ≥ 65 years (54.5% female), the mean ± SD grip strength, BMI, and WC were 26.7 ± 10.6 kg, 27.4 ± 5.4 kg/m2 , and 99.5 ± 16.3 cm, respectively. Using the neither weakness/obesity as the referent, weakness was associated with incident falls across all definitions (GS/BMI: HR 1.19 [1.07, 1.33]; GS/WC: HR 1.39 [1.19, 1.62]; GS ÷ BMI: HR 1.16 [1.05, 1.28]). Weakness with obesity was associated with falls using GS/WC (HR 1.28 [1.11, 1.48]). Obesity status was associated with falls in both the BMI and the WC definition (1.17 [1.02-1.35], 1.16 [1.05-1.28]). CONCLUSION Our findings further evaluate the definitions of clinically defined weakness with and without obesity in older adults. As falls are an important patient outcome, establishing this relationship is critical for both clinicians and researchers. Future study should identify high-risk individuals in order to direct specific interventions to them. Geriatr Gerontol Int 2023; 23: 213-220.
Collapse
Affiliation(s)
- John A. Batsis
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Rebecca S. Crow
- Department of Medicine, Veterans Affairs, White River Junction, Vermont, USA
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Meredith Gilliam
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Todd A. Mackenzie
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth College, Hanover, New Hampshire, USA
| |
Collapse
|
|
20
|
The role of comprehensive geriatric assessment in predicting fall risk. Ir J Med Sci 2023; 192:303-310. [PMID: 35296974 DOI: 10.1007/s11845-022-02978-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevention of falls among older adults is one of the most important public health issues in today's aging society. There are many factors significantly affecting the risk of falls. AIMS This study aimed to investigate the factors on fall risk in older adults. METHODS A total of 335 elderly outpatients aged 65 and over were included in this cross-sectional study. Comprehensive geriatric assessment was performed on the participants. Tinetti Balance and Gait Assessment Tool (TBGA) and Mini-Mental State Examination (MMSE) were used to assess fall risk and cognitive functions, respectively. RESULTS The mean age of 335 participants was 72.1 ± 6.0 years and 55.2% was female. Of the participants, 40.6% had a moderate-high fall risk according to TBGA and 31.6% had a history of falls within the last year. Although there was no significant difference in MMSE results between the medium-high fall risk group and the low fall risk group, higher MMSE attention and calculation domain score was found to be an independent variable for decreased fall risk and sarcopenia for increased fall risk (p = 0.039, OR = 0.70 and p = 0.037, OR = 3.43, respectively). CONCLUSION The role of sarcopenia in fall risk is well established. In this study, we also showed that attention and calculation play important roles in fall risk. Elderly individuals with low scores in attention and calculation domains need a more detailed assessment in terms of fall risk, even if cognitive functions are considered normal according to the MMSE.
Collapse
|
|
21
|
Lin HY, Lin YC, Chen LK, Hsiao FY. Untangling the Complex Interplay between Social Isolation, Anorexia, Sarcopenia, and Mortality: Insights from a Longitudinal Study. J Nutr Health Aging 2023; 27:797-805. [PMID: 37960901 DOI: 10.1007/s12603-023-1993-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Social isolation is a pervasive and debilitating condition that has adverse prognostic impacts. This condition often co-occurs with other geriatric syndromes, further exacerbating negative health outcomes. Given these considerations, the present study aims to elucidate the roles of social isolation in older adults with anorexia of aging and/or sarcopenia with respect to long-term mortality using a nationally representative cohort study. METHODS Data were obtained from the Taiwan Longitudinal Study on Aging (TLSA), with a sample size of 3,762 study participants aged 50 years and older. Data from 1999 (wave 4) to 2015 (wave 9) were analyzed. The TLSA questionnaire was used to define social isolation, anorexia, and sarcopenia. Logistic regressions were employed to explore the associations between social isolation, anorexia, and sarcopenia. The Cox proportional hazard model was utilized to examine the synergistic effects of social isolation and anorexia or sarcopenia on 16-year all-cause mortality. RESULTS After controlling for demographic information and comorbidities, older adults with social isolation were significantly associated with anorexia (adjusted odds ratio [aOR] 1.46 [95% confidence interval: 1.00-2.12, p=0.0475]) and sarcopenia (aOR 1.35 [95% CI: 1.12-1.64, p=0.0021]). Furthermore, the synergistic effects of social isolation with anorexia (aOR 1.65 [95% CI: 1.25-2.18, p=0.0004]) or sarcopenia (aOR 1.65 [95% CI: 1.42-1.92, p<0.0001]) were both significantly associated with higher risks of all-cause mortality, while social isolation alone revealed borderline statistical significance. CONCLUSIONS Our findings indicate that social isolation is closely linked to anorexia and sarcopenia among middle-aged and older adults. Additionally, social isolation significantly exacerbates the long-term mortality risk associated with anorexia of aging and sarcopenia. However, social isolation alone appears to have borderline long-term mortality risk in this cohort. These findings underscore the importance of addressing social isolation in older adults with anorexia and/or sarcopenia to optimize their health outcomes and mitigate long-term mortality risk.
Collapse
Affiliation(s)
- H-Y Lin
- Fei-Yuan Hsiao, Ph.D., Professor and Director, Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Linsen S. Rd, Taipei 10050, Taiwan. Tel.: 886-2-33668787, E-mail: ; Liang-Kung Chen, Professor, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei 11217, Taiwan. Tel: +886-2-28757830; Fax: +886-2-28757711; E-mail:
| | | | | | | |
Collapse
|
|
22
|
Gait Characteristics of Dynapenia, Sarcopenia, and Presarcopenia in Community-Dwelling Japanese Older Women: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10101905. [PMID: 36292352 PMCID: PMC9601983 DOI: 10.3390/healthcare10101905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022] Open
Abstract
Age-related decline in skeletal muscle mass and function are risk factors for reduced walking ability. This study aimed to understand the characteristic gait parameters of presarcopenia (low muscle mass only), dynapenia (low muscle function only), and sarcopenia (low muscle mass and function), which have differing skeletal muscle characteristics. Skeletal muscle mass, grip strength, and gait parameters (walking speed, cadence, step length, step width, gait angle, foot angle, stance time, swing time, and double stance time) were evaluated in 307 older Japanese women. Low muscle function was determined by grip strength and normal walking speed. Participants were assessed and divided into the normal (60.9%, n = 187), presarcopenia (25.7%, n = 79), dynapenia (5.2%, n = 16), and sarcopenia (8.1%, n = 25) groups. When compared to the normal group, the sarcopenia group had significantly slower walking speed and shorter step length (p < 0.05); the dynapenia group had significantly slower walking speed, smaller cadence, shorter step length, wider step width, and longer stance time (p < 0.05); and the presarcopenia group showed no differences. Skeletal muscle function may therefore be more strongly related to reduced walking function in older adults than body composition factors. The decrease in walking function was most pronounced in older women with dynapenia.
Collapse
|
|
23
|
Fan Y, Zhang B, Huang G, Zhang G, Ding Z, Li Z, Sinclair J, Fan Y. Sarcopenia: Body Composition and Gait Analysis. Front Aging Neurosci 2022; 14:909551. [PMID: 35912078 PMCID: PMC9326397 DOI: 10.3389/fnagi.2022.909551] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/20/2022] [Indexed: 12/30/2022] Open
Abstract
BackgroundAge-induced sarcopenia negatively affects walking stability and increases the risk of falls, which is the leading cause of accidental death in the elderly.ObjectiveThis study aimed to analyze and contrast body composition and gait characteristics in those with sarcopenia in relation to healthy controls to shed some light on the prevention of falls in elderly patients with sarcopenia.Materials and MethodsIn this study, 68 community dwellers were scanned by the Hologic QDR-4500A Dual-energy X-ray absorptiometry (DXA). The appendicular lean mass index (ALMI) results were used to distinguish the normal participants from those with sarcopenia: 24 in the sarcopenia group, and 44 into the normal group. The participants were asked to undergo gait analysis on a plantar pressure measurement system. Statistical analysis was conducted to contrast both groups' gait and butterfly parameters from their gait test, and then a gait forward dynamics method was performed to quantify the analysis for both groups.ResultsThe ALMI of the female was not related to their age (r = 0.06) while that of the male was weakly related (r = 0.17). Body mass index (BMI) from both groups was normal, although with a statistically greater BMI from the normal group compared with sarcopenia (p < 0.001). Greater values and significant differences were found in step length and stride length from the normal elderly group (p < 0.01), and so was the length of the gait line and single support line (p < 0.05). Gait forward dynamics analysis results showed no motor neural or musculoskeletal disorders in their gait performance from the sarcopenia group.ConclusionFor the elderly, age did not largely affect the ALMI, BMI, or T-score, but BMI and ALMI were strongly correlated. In this study, significant differences were found in certain gait parameters between the elderly with sarcopenia and the normal elderly, which were related to absolute muscle strength, suggesting that sarcopenia was a disease mainly caused by decreased muscle mass. In addition, when abnormities were identified in step length, stride length, length of gait line, or length of single support line, it is proposed to take a DXA scan to confirm whether the elderly suffer from sarcopenia.
Collapse
Affiliation(s)
- Yuxuan Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Bo Zhang
- College of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Guohao Huang
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Guoying Zhang
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Zhiyuan Ding
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Zhiyu Li
- College of Foreign Studies, Jinan University, Guangzhou, China
| | - Jonathan Sinclair
- Research Centre for Applied Sport, Physical Activity and Performance, School of Sport and Health Sciences, University of Central Lancashire, Preston, United Kingdom
| | - Yifang Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
- *Correspondence: Yifang Fan
| |
Collapse
|
|
24
|
Lim SK, Kong S. Prevalence, physical characteristics, and fall risk in older adults with and without possible sarcopenia. Aging Clin Exp Res 2022; 34:1365-1371. [PMID: 35133613 DOI: 10.1007/s40520-022-02078-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/13/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recently, the Asian Working Group for Sarcopenia (AWGS) 2019 consensus redefined the sarcopenia including possible sarcopenia, sarcopenia and severe sarcopenia and grip strength cutoff value by sex. AIMS This study aimed to assess the prevalence, physical characteristics, physical fitness, and fall risk in older adults living in local communities, with possible sarcopenia using the diagnostic criteria suggested by the AWGS 2WG. METHODS A total of 431 participants (123 men and 308 women) aged 65-97 years were enrolled in this study. Based on the diagnostic criteria of possible sarcopenia suggested by AWGS 2, study participants were divided into normal and possible sarcopenia (grip strength: < 28 kg and < 18 kg for men and women, respectively) groups. Independent t-tests and logistic regression analyses were conducted to compare the differences between the two groups. RESULTS The possible prevalence of sarcopenia was 23.7%. Possible sarcopenia was present in older adults with lower weight, body mass index (BMI), skeletal muscle mass, and fat-free mass (P < 0.05) than those in the normal group. Older men with possible sarcopenia had poorer upper and lower body strength, aerobic endurance, lower body flexibility, agility and dynamic balance, and a higher fall risk than those in the normal group (P < 0.05). Older women with possible sarcopenia had a 2.5-fold and 3.3-fold higher fall risk than women in the normal group in both an unadjusted model (P = 0.001) and in a model adjusted for age and BMI (P < 0.001). However, there were no significant differences in fall risk among older men. CONCLUSION The diagnostic criteria suggested by AWGS 2 may be highly useful for screening for declining physical function.
Collapse
|
|
25
|
Chen L, Wu L, Li Q, Hu Y, Ma H, Lin H, Gao X. Hyperuricemia Associated with Low Skeletal Muscle in the Middle-Aged and Elderly Population in China. Exp Clin Endocrinol Diabetes 2022; 130:546-553. [PMID: 35609819 DOI: 10.1055/a-1785-3729] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population. METHODS We performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women. RESULTS Compared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association. CONCLUSIONS In a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.
Collapse
Affiliation(s)
- Lingyan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Li Wu
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Qian Li
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Huandong Lin
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Xin Gao
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| |
Collapse
|
|
26
|
Kato T, Ikezoe T, Tabara Y, Matsuda F, Tsuboyama T, Ichihashi N. Differences in lower limb muscle strength and balance ability between sarcopenia stages depend on sex in community-dwelling older adults. Aging Clin Exp Res 2022; 34:527-534. [PMID: 34417732 DOI: 10.1007/s40520-021-01952-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM This study aimed to compare motor function between sarcopenia stages with respect to sex in community-dwelling older adults. METHODS The participants, comprising 2107 community-dwelling older adults (738 men and 1369 women), were classified into 4 groups and the groups were operationally defined-normal, low muscle mass, low physical function, and sarcopenia groups. Lower limb muscle strength and balance ability were assessed for evaluating motor function. To compare motor function between sarcopenia stages, an analysis of covariance adjusted for age and body mass index was performed. RESULTS Lower limb muscle strengths were significantly lower not only in the sarcopenia group but also in the low muscle mass and low physical function groups than that in the normal group in both men and women. Low hip abductor muscle strength was observed in the low physical function group compared to the low muscle mass group in women, but not in men. Timed Up and Go test results in the sarcopenia and low function groups was lower than in the normal and low muscle mass groups for men and women. One-leg standing in the low physical function group was lower than that in the normal group, only for women. CONCLUSIONS Reduced motor function was observed not only in older people with sarcopenia but also in older people with only low muscle mass or low physical function, and the decline in lower limb muscle strength and balance ability in the low function group were greater in older women than in older men.
Collapse
Affiliation(s)
- Takehiro Kato
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tome Ikezoe
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tadao Tsuboyama
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- School of Health Sciences, Bukkyo University, 7 Higashitoganoo-cho, Nishinokyo, Nakagyo-ku, Kyoto, 606-8418, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
|
27
|
Hsu WB, Lin SJ, Hung JS, Chen MH, Lin CY, Hsu WH, Hsu WWR. Effect of resistance training on satellite cells in old mice - a transcriptome study : implications for sarcopenia. Bone Joint Res 2022; 11:121-133. [PMID: 35188421 PMCID: PMC8882320 DOI: 10.1302/2046-3758.112.bjr-2021-0079.r2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims The decrease in the number of satellite cells (SCs), contributing to myofibre formation and reconstitution, and their proliferative capacity, leads to muscle loss, a condition known as sarcopenia. Resistance training can prevent muscle loss; however, the underlying mechanisms of resistance training effects on SCs are not well understood. We therefore conducted a comprehensive transcriptome analysis of SCs in a mouse model. Methods We compared the differentially expressed genes of SCs in young mice (eight weeks old), middle-aged (48-week-old) mice with resistance training intervention (MID+ T), and mice without exercise (MID) using next-generation sequencing and bioinformatics. Results After the bioinformatic analysis, the PI3K-Akt signalling pathway and the regulation of actin cytoskeleton in particular were highlighted among the top ten pathways with the most differentially expressed genes involved in the young/MID and MID+ T/MID groups. The expression of Gng5, Atf2, and Rtor in the PI3K-Akt signalling pathway was higher in the young and MID+ T groups compared with the MID group. Similarly, Limk1, Arhgef12, and Araf in the regulation of the actin cytoskeleton pathway had a similar bias. Moreover, the protein expression profiles of Atf2, Rptor, and Ccnd3 in each group were paralleled with the results of NGS. Conclusion Our results revealed that age-induced muscle loss might result from age-influenced genes that contribute to muscle development in SCs. After resistance training, age-impaired genes were reactivated, and age-induced genes were depressed. The change fold in these genes in the young/MID mice resembled those in the MID + T/MID group, suggesting that resistance training can rejuvenate the self-renewing ability of SCs by recovering age-influenced genes to prevent sarcopenia. Cite this article: Bone Joint Res 2022;11(2):121–133.
Collapse
Affiliation(s)
- Wei-Bin Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan
| | - Shih-Jie Lin
- Department of Orthopaedic Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ji-Shiuan Hung
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
| | - Mei-Hsin Chen
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Che-Yi Lin
- Institute of Cellular and Organismic Biology Academia Sinica, Taipei, Taiwan
| | - Wei-Hsiu Hsu
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Wen-Wei Robert Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital Chiayi Branch, Puzi, Taiwan.,Department of Orthopaedic Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
|
28
|
Hörauf JA, Nau C, Mühlenfeld N, Verboket RD, Marzi I, Störmann P. Injury Patterns after Falling down Stairs-High Ratio of Traumatic Brain Injury under Alcohol Influence. J Clin Med 2022; 11:jcm11030697. [PMID: 35160145 PMCID: PMC8836855 DOI: 10.3390/jcm11030697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
Falling down a staircase is a common mechanism of injury in patients with severe trauma, but the effect of varying fall height according to the number of steps on injury patterns in these patients has been little studied. In this retrospective study, prospectively collected data from a Level 1 Trauma Center in Germany were analyzed regarding the injury patterns of patients admitted through the trauma room with suspicion of multiple injuries following a fall down a flight of stairs between January 2016 and December 2019. In total 118 patients were examined which where consecutively included in this study. More than 80% of patients suffered a traumatic brain injury, which increased as a function of the number of stairs fallen. Therefore, the likelihood of intracranial hemorrhage increased with higher numbers of fallen stairs. Fall-associated bony injuries were predominantly to the face, skull and the spine. In addition, there was a high coincidence of staircase falls and alcohol intake. Due to a frequent coincidence of staircase falls and alcohol, the (pre-)clinical neurological assessment is complicated. As the height of the fall increases, severe traumatic brain injury should be anticipated and diagnostics to exclude intracranial hemorrhage and spinal injuries should be performed promptly to ensure the best possible patient outcome.
Collapse
|
|
29
|
Maeda K, Imatani J, Moritani S, Kondo H. Effects of eldecalcitol alone or a bone resorption inhibitor with eldecalcitol on bone mineral density, muscle mass, and exercise capacity for postmenopausal women with distal radius fractures. J Orthop Sci 2022; 27:139-145. [PMID: 33349543 DOI: 10.1016/j.jos.2020.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/11/2020] [Accepted: 11/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Distal radius fractures are often the first fractures experienced by adults with osteoporosis, and such fractures provide an opportunity for treatment to prevent a domino effect of future fractures. Most of these fractures result from falls, which may be related to the individual's limb muscle mass, strength, and exercise capacity. Active vitamin D3 positively affects muscle and bone mass. However, the effect of a bone resorption inhibitor is unknown. This study aimed to determine the effects of eldecalcitol alone or a bone resorption inhibitor with eldecalcitol on bone mass, limb muscle mass, and exercise capacity of osteoporotic patients with distal radius fractures and to identify the preventive effects against future fractures. METHODS Participants were postmenopausal women(n = 99) with distal radius fractures who visited the orthopedics outpatient department in a city general hospital from April 2015 to October 2017. Bone mass, limb muscle mass, skeletal muscle mass index, and muscle strength (grip strength and quadriceps muscle strength), walking speed, 2-step results, and timed up and go tests results were evaluated before and after 1 year of treatment. The instances of fall recurrence and refracture were investigated using a questionnaire. RESULTS Eighty-five patients completed follow-up assessments for 1 year. After treatment, bone mass and bone mineral density were significantly improved in the lumbar spine and total proximal femur compared to before treatment. Furthermore, skeletal muscle mass index, grip strength on the unaffected side, quadriceps muscle strength, walking speed and 2-step test results after 1 year of treatment were significantly improved. Nineteen and 4 patients experienced fall recurrence and refracture, respectively. CONCLUSIONS Eldecalcitol alone or a bone resorption inhibitor with eldecalcitol improved bone mass and bone mineral density, and maintained skeletal muscle mass index, muscle strength, and exercise capacity of osteoporotic patients with distal radius fractures.
Collapse
Affiliation(s)
| | - Junya Imatani
- Department of Orthopedic Surgery, Okayama Saiseikai General Hospital, Japan
| | - Shiro Moritani
- Department of Orthopedic Surgery, Okayama Saiseikai General Hospital, Japan
| | - Hidenori Kondo
- Department of Orthopedic Surgery, Okayama Saiseikai General Hospital, Japan
| |
Collapse
|
|
30
|
Pachołek K, Sobieszczańska M. Sarcopenia Identification during Comprehensive Geriatric Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:32. [PMID: 35010295 PMCID: PMC8751172 DOI: 10.3390/ijerph19010032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/12/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
Comprehensive geriatric assessment (CGA) is a multidimensional diagnostic process enabling evaluation of elderly patients' physical and mental health status that implies implementation of the management targeted on the preservation of functional independence. Sarcopenia is a common but often underdiagnosed geriatric syndrome associated with increased likelihood of functional dependence and mortality risk. The main objectives of the study were the evaluation of sarcopenia prevalence in the patient group subjected to CGA with the upgraded EWGSOP2 algorithm considering muscle strength as the key criterion and usage of bioimpedance (BIA) muscle mass assessment. The study group consisted of 101 patients (76 women and 25 men) admitted for planned CGA to the Geriatrics Department of Wroclaw University Hospital. A diagnosis of sarcopenia was made according to the EWGSOP2 protocol. Body composition was determined with the bioimpedance technique. Functional status was assessed with ADLs from the VES-13 scale and additional questions. Sarcopenia was diagnosed in 16.8% of the study participants. Sarcopenic individuals presented worse functional status and impaired social activity. Muscle strength, gait speed and muscle mass below cut-off values were associated with dependence found in ADLs. Results showed that sarcopenia is a common impairment correlated with worse functional status and vulnerability to adverse outcomes. BIA can be treated as an accessible and accurate technique for muscle mass measurement in screening for sarcopenia, and the EWGSOP2 algorithm should be an essential part of the routine CGA procedure.
Collapse
|
|
31
|
Nishimura T, Hagio A, Hamaguchi K, Kurihara T, Iemitsu M, Sanada K. Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: a cross-sectional study. J Physiol Anthropol 2021; 40:18. [PMID: 34736515 PMCID: PMC8570009 DOI: 10.1186/s40101-021-00268-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.
Collapse
Affiliation(s)
- Tomohiro Nishimura
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.,Osaka College of Rehabilitation, Osaka, 530-0043, Japan
| | - Atsushi Hagio
- Department of Public Health Care and Welfare of Yawata City, Kyoto, 614-8501, Japan
| | - Kanako Hamaguchi
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, 525-8577, Japan
| | - Toshiyuki Kurihara
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, 525-8577, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.
| |
Collapse
|
|
32
|
Pérez-Ros P, Sanchis-Aguado MA, Durá-Gil JV, Martínez-Arnau FM, Belda-Lois JM. FallSkip device is a useful tool for fall risk assessment in sarcopenic older community people. Int J Older People Nurs 2021; 17:e12431. [PMID: 34652070 DOI: 10.1111/opn.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Fall prevention is a major health concern for the ageing population. Sarcopenia is considered a risk factor for falls. Some instruments, such as Time Up and Go (TUG), are used for screening risk. The use of sensors has also been shown to be a viable tool that can provide accurate, cost-effective, and easy to manage assessment of fall risk. One novel sensor for assessing fall risk in older people is the Fallskip device. The present study evaluates the performance of the FallSkip device against the TUG method in fall risk screening and assesses its measurement properties in sarcopenic older people. METHODS A cross-sectional study was made in a sample of community-dwelling sarcopenic and non-sarcopenic older people aged 70 years or over. RESULTS The study sample consisted of 34 older people with a mean age of 77.03 (6.58) years, of which 79.4% (n = 27) were females, and 41.2% (n = 14) were sarcopenic. The Pearson correlation coefficient between TUG time and FallSkip time was 0.70 (p < 0.001). The sarcopenic individuals took longer in performing both TUG and FallSkip. They also presented poorer reaction time, gait and sit-to-stand - though no statistically significant differences were observed. The results in terms of feasibility, acceptability, reliability and validity in sarcopenic older people with FallSkip were acceptable. CONCLUSIONS The FallSkip device has suitable metric properties for the assessment of fall risk in sarcopenic community-dwelling older people. FallSkip analyses more parameters than TUG in assessing fall risk and has greater discriminatory power in evaluating the risk of falls.
Collapse
Affiliation(s)
- Pilar Pérez-Ros
- Department of Nursing, University of Valencia, Valencia, Spain.,Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, Valencia, Spain
| | | | - Juan V Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Juan M Belda-Lois
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain
| |
Collapse
|
|
33
|
Abstract
OBJECTIVE Sarcopenia is associated with high morbidity and mortality in older women. Early detection and intervention during the postmenopausal period were hypothesized to help maintain muscle mass and performance. Although the Asian Working Group has developed guidelines for sarcopenia management, the condition has not been sufficiently investigated in the middle-aged cohort of the Asian population. This study aimed to measure the prevalence of pre-sarcopenia and sarcopenia in middle-aged postmenopausal women and to determine the factors associated with low muscle mass. METHODS In this cross-sectional study conducted in the Menopause Clinic, King Chulalongkorn Memorial Hospital, we used the bioelectrical impedance analysis method to determine the appendicular muscle mass using a body composition analyzer (TANITA MC980 Plus). Appendicular muscle mass index, handgrip strength, and 6-m gait speed were measured in 340 women aged 45 to 65 years. Hormonal profiles, anthropometric data, and relevant history were recorded. RESULTS The mean age of the study participants and time since menopause were 57.8 ± 4.5 years and 9.4 ± 5.5 years, respectively. The proportion of pre-sarcopenic, sarcopenic, and nonsarcopenic women were 11.8%, 2.7%, and 85.6%, respectively. A body mass index ≤ 20 kg/m2 had the strongest correlation with low muscle mass (odds ratio 7.1; 95% confidence interval 3.0-16.8, P < 0.001). CONCLUSION Nearly 12% of Thai middle-aged postmenopausal women were pre-sarcopenic. Early detection of symptoms of pre-sarcopenia and maintenance of a healthy body mass index may reduce the burden of this condition for middle-aged and older women.
Collapse
|
|
34
|
Rathnayake N, Lekamwasam S. Prevalence and factors associated with recurrent falls among middle-aged community-dwelling women. J Frailty Sarcopenia Falls 2021; 6:92-97. [PMID: 34557608 PMCID: PMC8419846 DOI: 10.22540/jfsf-06-092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 11/03/2022] Open
Abstract
Objective This community-based study evaluated the prevalence and associated risk factors of recurrent falls among middle-aged community-dwelling women in Southern-Sri Lanka. Methods Randomly selected 285 middle-aged women (40-60years, Mean±SD;51.7±6.1years) participated. History of falls within the previous 12-months was inquired and those who reported two or more falls within 6-month period were considered as recurrent fallers. Age, menopausal status, weight (kg), height (m), waist-circumference (WC, cm), appendicular-skeletal-muscle-mass (ASMM, kg by DXA), hand-grip-strength (HGS, kg) and gait-speed (GS, m/s) were evaluated. Body-mass-index (BMI, kg/m2) and relative-ASMM-index (RSMI, kg/m2) were calculated. Results The prevalence of recurrent falls was 13% (95%CI; 9.4%-17.5%) (n=37). Recurrent falls were higher among postmenopausal women compared to premenopausal women, older middle-aged women (51-60years) compared to young middle-aged women (40-50years), those with low RSMI compared to normal RSMI, low HGS compared to normal HGS and low GS compared to normal GS (p<0.01). BMI and WC did not show significant associations with recurrent falls. Risk factors associated with recurrent falls were age (OR;7.41, 95%CI; 1.23-44.43, p=0.02), RSMI (OR;3.21, 95%CI; 1.00-10.32, p=0.04) and HGS (OR;3.19, 95%CI; 1.26-8.09, p=0.01). Conclusions The prevalence of falls among middle-aged women was considerably high. Falls were associated with advanced age, low muscle mass and muscle strength.
Collapse
Affiliation(s)
- Nirmala Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Sri Lanka
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka
| |
Collapse
|
|
35
|
Endo T, Akai K, Kijima T, Kitahara S, Abe T, Takeda M, Nabika T, Yano S, Isomura M. An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: A cross-sectional analysis. PLoS One 2021; 16:e0252784. [PMID: 34292967 PMCID: PMC8297796 DOI: 10.1371/journal.pone.0252784] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/23/2021] [Indexed: 12/12/2022] Open
Abstract
Sarcopenia is intricately related to aging associated diseases, such as neuropsychiatric disorders, oral status, and chronic diseases. Dementia and depression are interconnected and also related to sarcopenia. The preliminary shift from robust to sarcopenia (i.e., pre-sarcopenia) is an important albeit underdiscussed stage and is the focus of this study. Identifying factors associated with pre-sarcopenia may lead to sarcopenia prevention. To separately examine the effects of dementia and depression on pre-sarcopenia/sarcopenia, we conducted multiple analyses. This cross-sectional study used health checkup data from a rural Japanese island. The participants were aged 60 years and above, and the data included muscle mass, gait speed, handgrip strength, oral status (teeth and denture), chronic diseases (e.g., hypertension), dementia (cognitive assessment for dementia, iPad Version), and depression (self-rating depression scale). A total of 753 older adult participants were divided into the sarcopenia (n = 30), pre-sarcopenia (n = 125), and robust (n = 598) groups. An ordered logit regression analysis indicated that age and depression were positively correlated with sarcopenia, while hypertension was negatively associated with it. A multiple logistic regression analysis between the robust and pre-sarcopenia groups showed significant associations between the same three variables. Depression was associated with pre-sarcopenia, but not dementia. There was also a significant association between hypertension and pre-sarcopenia. Further research is needed to reveal whether the management of these factors can prevent sarcopenia.
Collapse
Affiliation(s)
- Takeshi Endo
- Division of Internal Medicine, Unnan City Hospital, Shimane, Japan
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- * E-mail:
| | - Kenju Akai
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Tsunetaka Kijima
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of General Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | | | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of Functional Pathology Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Department of Laboratory Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Shimane, Japan
- Shimane University Faculty of Human Sciences, Shimane, Japan
| |
Collapse
|
|
36
|
Lai RM, Chen TB, Hu YH, Wu G, Zheng Q. Effect of type 2 diabetic mellitus in the prognosis of acute-on-chronic liver failure patients in China. World J Gastroenterol 2021; 27:3372-3385. [PMID: 34163118 PMCID: PMC8218358 DOI: 10.3748/wjg.v27.i23.3372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/14/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute-on-chronic liver failure (ACLF) patients have a high short-term mortality rate, and the severity evaluation of ACLF is necessary for prognostication. Therefore, it was meaningful to evaluate the association between type 2 diabetic mellitus (DM) and ACLF and further explore the feasibility of using DM as a prognostic indicator in ACLF patients. The association between type 2 DM and the prognosis of patients with severe liver disease remains unclear.
AIM To examine the effect of type 2 DM on the prognosis of patients with ACLF.
METHODS Clinical data from 222 ACLF patients were collected and analyzed. The patients were categorized into two groups depending on whether they had DM or not, and the clinical data of ACLF patients were measured within 48 h after admission. Complications of ACLF were documented during treatment, such as hepatic encephalopathy, hepatorenal syndrome, acute upper gastrointestinal hemorrhage, and spontaneous peritonitis (SBP). Values of laboratory parameters, complication rates, and hospital mortality rates were compared between two groups.
RESULTS Among 222 ACLF patients, 38 cases were categorized into DM groups, the mean age was 56.32 years and 73.68% were male. The prognosis of ACLF patients was significantly correlated with DM in univariate [hazard ratio (HR) = 2.4, 95% confidence interval (CI) =1.5-3.7, P < 0.001] and multivariable analysis (HR = 3.17, 95%CI =1.82-5.523, P < 0.001). The incident of SBP (34.21% vs 13.59%, P = 0.038) and other infections like lung, urinary, blood, and cholecyst (44.74% vs 28.26%, P = 0.046) were higher in DM patients than non-DM counterparts. In addition, the ACLF patients with DM tended to have a high mortality rate (P < 0.001). Cumulative survival time was also significantly shorter in the ACLF patients with DM than non-DM.
CONCLUSION A significant association between DM and the prognosis of ACLF patients was found in China. The ACLF patients with DM had higher incidence of hospital mortality and infection than those without DM.
Collapse
Affiliation(s)
- Rui-Min Lai
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Tian-Bin Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Yu-Hai Hu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Gui Wu
- Department of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Qi Zheng
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| |
Collapse
|
|
37
|
Gao Q, Mei F, Shang Y, Hu K, Chen F, Zhao L, Ma B. Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis. Clin Nutr 2021; 40:4633-4641. [PMID: 34229269 DOI: 10.1016/j.clnu.2021.06.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/15/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS Sarcopenic obesity (SO), which refers to the coexistence of sarcopenia and obesity. It can lead to physical disability, morbidity, and even mortality. This systematic review and meta-analysis aimed to estimate the global prevalence of SO in older adults. METHODS We searched PubMed, Embase, and Web of Science for studies reporting the prevalence of SO from inception to December 2020. Two researchers independently screened the literature, evaluated study quality, and extracted data. A random-effects model was used to pool the estimates for the prevalence of SO. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed using a funnel plot and the Egger test. All statistical analyses were performed using Stata 15.0 software. RESULTS This review included 50 studies, we found that the global prevalence of SO in older adults was 11%. Subgroup analyses showed that the prevalence of SO was higher among studies using diagnostic criteria of muscle mass alone (15%) to diagnose sarcopenia, using dual-energy X-ray absorptiometry (15%) to assess muscle mass, and those focused on age ≥ 75 years old (23%), hospitalized (16%), South Americans (21%) and North Americans (19%). There were no significant differences in the prevalence of SO among studies using body fat percentage (10%), body mass index (13%), waist circumference (16%) to diagnose obesity and in female (14%), male (10%) patients. Sensitivity analysis showed that none of the studies affected the overall pooled results. Meta-regression analysis found that publication year, geographical region, study setting, and the diagnostic criteria of sarcopenia were sources of heterogeneity. CONCLUSION This meta-analysis indicated SO affects more than one in ten older adults globally. Therefore, we should attach importance to the screening and early diagnosis of SO in older adults, then selecting appropriate interventions to reduce the occurrence of it and various adverse outcomes in this demographic.
Collapse
Affiliation(s)
- Qianqian Gao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Fan Mei
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yi Shang
- The Second Hospital, Lanzhou University, Lanzhou, China
| | - Kaiyan Hu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Fei Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Li Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Bin Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| |
Collapse
|
|
38
|
López-Teros MT, Rosas-Carrasco O, Sánchez-García S, Castro-Porras L, Luna-López A, Agudelo-Botero M. The Association of Osteosarcopenia With Functional Disability in Community-Dwelling Mexican Adults 50 and Older. Front Med (Lausanne) 2021; 8:674724. [PMID: 34164416 PMCID: PMC8215205 DOI: 10.3389/fmed.2021.674724] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Osteosarcopenia (OS) has recently been described as a predictor of negative outcomes in older adults. However, this alteration in body composition has not been widely studied. In Mexico and Latin America, no information is available on its frequency or associated factors. Objective: To analyze the association between OS with FD in community-dwelling Mexican adults 50 and older. Design: Cross-sectional secondary data analysis was performed using primary data from a prospective study Frailty, Dynapenia and Sarcopenia Study in Mexican Adults (FraDySMex). Setting and Participants: Eight hundred and twenty-five people were included, 77.1% women, aged 70.3 ± 10.8 years old. Methods: OS was defined as when the person was diagnosed with sarcopenia (SP) plus osteopenia/osteoporosis. The SP diagnosis was evaluated in accordance with the criteria of the European Working Group for the Definition and Diagnosis of Sarcopenia (EWGSOP), and the osteoporosis diagnosis using World Health Organization (WHO) criteria. Muscle mass and bone mass were evaluated using dual-energy X-ray absorptiometry (DXA). FD was evaluated using the basic activities of daily living (BADL) and the instrumental activities of daily living (IADL). Additional sociodemographic and health co-variables were also included, such as sex, age, education, cognitive status, depression, comorbidity, hospitalization, polypharmacy, urinary incontinence, and nutrition variables such as risk of malnutrition and obesity. Associations between OS with FD were evaluated using multiple logistic regression. Results: The prevalence of OS was 8.9% and that of FD was 8.9%. OS was associated with FD [odds ratio (OR): 1.92; CI 95%: 1.11–3.33]. Conclusions and Implications: Comprehensive OS assessment could help clinicians identify risk factors early, and thus mitigate the impact on FD in older people.
Collapse
Affiliation(s)
- Miriam T López-Teros
- Medical, Dental and Health Sciences Program, National Autonomous University of Mexico, Mexico City, Mexico.,Health Department, Iberoamerican University, Mexico City, Mexico
| | | | - Sergio Sánchez-García
- Epidemiological Research Unit and Health Services, Aging Area, XXI Century National Medical Center, Mexican Social Security Institute, Mexico City, Mexico
| | - Lilia Castro-Porras
- Politics, Population and Health Research Center, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Armando Luna-López
- Sub-directorate for Biomedical Research, Basic Research Department, National Institute of Geriatrics, Mexico City, Mexico
| | - Marcela Agudelo-Botero
- Politics, Population and Health Research Center, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| |
Collapse
|
|
39
|
Mori H, Kuroda A, Yoshida S, Yasuda T, Umayahara Y, Shimizu S, Ryomoto K, Yoshiuchi K, Yamamoto T, Matsuoka T, Shimomura I, Matsuhisa M. High prevalence and clinical impact of dynapenia and sarcopenia in Japanese patients with type 1 and type 2 diabetes: Findings from the Impact of Diabetes Mellitus on Dynapenia study. J Diabetes Investig 2021; 12:1050-1059. [PMID: 33063949 PMCID: PMC8169345 DOI: 10.1111/jdi.13436] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/31/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION The present study aimed to clarify the prevalence and clinical characteristics of sarcopenia and dynapenia, which are muscle weakness with and without low muscle mass, respectively, in Japanese patients with type 1 diabetes mellitus and type 2 diabetes mellitus. MATERIALS AND METHODS This cross-sectional study enrolled 1,328 participants with type 1 diabetes (n = 177), type 2 diabetes (n = 645) and without diabetes (n = 506). Sarcopenia was defined as a low grip strength and slow gait speed with low skeletal muscle mass index, whereas dynapenia was defined as low strengths of grip and knee extension with a normal skeletal muscle mass index. Participants without sarcopenia and dynapenia were defined as robust. RESULTS Among participants aged ≥65 years, sarcopenia and dynapenia were observed in 12.2% and 0.5% of individuals without diabetes, 42.9% and 11.4% of type 1 diabetes patients, and 20.9% and 13.9% of type 2 diabetes patients. In both type 1 diabetes and type 2 diabetes patients, sarcopenic patients were significantly older and thinner, and showed a significantly higher rate of diabetic neuropathy than robust patients. In patients with type 1 diabetes and type 2 diabetes, dynapenic patients were older, and showed a higher rate of diabetic neuropathy and lower estimated glomerular filtration rate than robust patients. Patients complicated with sarcopenia and dynapenia showed a significantly lower physical quality of life and higher rate of incidental falls than robust patients. CONCLUSIONS Sarcopenia and dynapenia were more frequent in patients with type 1 diabetes and type 2 diabetes than in individuals without diabetes, which might contribute to their impaired quality of life and incidental falls.
Collapse
Affiliation(s)
- Hiroyasu Mori
- Diabetes Therapeutics and Research CenterInstitute of Advanced Medical SciencesTokushima UniversityTokushimaJapan
| | - Akio Kuroda
- Diabetes Therapeutics and Research CenterInstitute of Advanced Medical SciencesTokushima UniversityTokushimaJapan
| | - Sumiko Yoshida
- Department of Hematology, Endocrinology and MetabolismTokushima University Graduate School of Biomedical SciencesTokushimaJapan
| | - Tetsuyuki Yasuda
- Department of Endocrinology and MetabolismOsaka Police HospitalOsakaJapan
| | | | | | | | | | | | - Taka‐aki Matsuoka
- Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaOsakaJapan
| | - Iichiro Shimomura
- Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaOsakaJapan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research CenterInstitute of Advanced Medical SciencesTokushima UniversityTokushimaJapan
| |
Collapse
|
|
40
|
Marincolo JCS, Aprahamian I, Corona LP, Neri AL, Yassuda MS, Borim FSA. Three definitions of probable sarcopenia and associations with falls and functional disability among community-dwelling older adults. Osteoporos Sarcopenia 2021; 7:69-74. [PMID: 34278002 PMCID: PMC8261724 DOI: 10.1016/j.afos.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/18/2021] [Accepted: 05/01/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess the prevalence of probable sarcopenia according to 3 different definitions ("strength, assistance with walking, rise from a chair, climb stairs, falls"- SARC-F score, low grip strength, and the guidelines indicated by the European Working Group on Sarcopenia in Older People 2 - EWGSOP2) and assess the association of probable sarcopenia with functional disability and falls among community-dwelling older adults. METHODS Cross-sectional study with 419 older adults. Probable sarcopenia was assessed by 3 definitions: a SARC-F ≥ 4, low grip strength (< 27 kg for men and < 16 kg for women), and the EWGSOP2 criteria. Associations were investigated using Pearson's chi-square test and prevalence ratios were estimated by Poisson regression (P < 0.05). RESULTS Of the total, probable sarcopenia was identified in 23.0% of participants (SARC-F ≥ 4 score), 33.7% (low grip strength), and 10.4% (EWGSOP2) according to each different definition. In adjusted regression models, having at least 1 instrumental activities of daily living (IADL) disability and having fallen in the last 12 months were significantly associated with a SARC-F ≥ 4 (prevalence ratio, PR = 1.60; and PR = 2.50, respectively) and EWGSOP2 (PR = 1.78; and PR = 2.19, respectively). CONCLUSIONS IADL disability and falls were associated with a SARC-F ≥ 4 and the EWGSOP2 criteria (SARC-F ≥ 4 and low grip strength). Probable sarcopenia may be used in clinical practice in order to facilitate the diagnosis of definite sarcopenia and to implement early interventions that could prevent functional decline and falls in older people.
Collapse
Affiliation(s)
| | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Jundiaí Medical School (FMJ), Jundiaí, Brazil
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Ligiana Pires Corona
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Mônica Sanches Yassuda
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
- School of Arts, Sciences and Humanities (EACH) – University of São Paulo (USP), São Paulo, Brazil
| | - Flávia Silva Arbex Borim
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
- Department of Collective Health, School of Health Sciences, University of Brasilia – Brasília (DF), Brazil
| |
Collapse
|
|
41
|
Smith L, Shin JI, López-Sánchez GF, Veronese N, Soysal P, Oh H, Grabovac I, Barnett Y, Jacob L, Koyanagi A. Association between food insecurity and fall-related injury among adults aged ≥65 years in low- and middle-income countries: The role of mental health conditions. Arch Gerontol Geriatr 2021; 96:104438. [PMID: 34062309 DOI: 10.1016/j.archger.2021.104438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health. METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess associations. RESULTS Data on 14,585 adults aged ≥65 years [mean (SD) age 72.5 (11.5) years; 54.9% females] were analyzed. After adjustment for potential confounders, severe food insecurity (versus no food insecurity) was associated with 1.95 (95%CI = 1.11-3.41) times higher odds for fall-related injury. Moderate food insecurity was not significantly associated with fall-related injury (OR = 1.34; 95%CI = 0.81-2.25). The mediation analysis showed that 37.3%, 21.8%, 17.7%, and 14.0% of the association between severe food insecurity and fall-related injury was explained by anxiety, sleep problems, depression, and cognition, respectively. CONCLUSION Severe food insecurity was associated with higher odds for injurious falls among older adults in LMICs, and a large proportion of this association may be explained by mental health complications. Interventions to improve mental health among those who are food insecure and a strong focus on societal and government efforts to reduce food insecurity may contribute to a decrease in injurious falls.
Collapse
Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hans Oh
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Yvonne Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
| |
Collapse
|
|
42
|
Chung SM, Moon JS, Chang MC. Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population. Front Med (Lausanne) 2021; 8:681232. [PMID: 34095184 PMCID: PMC8174659 DOI: 10.3389/fmed.2021.681232] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: Sarcopenia is a major disease affecting mortality and quality of life in the elderly population. We performed a meta-analysis of studies on the community-dwelling population to investigate the prevalence of sarcopenia and its association with diabetes. Methods: Databases were searched for studies published up to February 3, 2021, reporting the prevalence of sarcopenia in patients with and without diabetes. Data extraction and quality assessment were performed according to the Newcastle-Ottawa scale. Results: Six articles were included in the systematic review. All the patients were Asian, aged ≥60 years (women 53.4%), and the diabetic and non-diabetic population was 1,537 and 5,485, respectively. In all six studies, the Asian Working Group for Sarcopenia criteria were used to diagnose sarcopenia. The prevalence of sarcopenia was 15.9% in diabetics and 10.8% in non-diabetics. Diabetics showed a significantly higher risk of sarcopenia than non-diabetics (pooled OR = 1.518, 95% CI = 1.110 to 2.076, Z-value = 2.611, p = 0.009). Conclusion: Among the Asian community-dwelling geriatric population, the prevalence of sarcopenia was significantly higher in diabetics than in non-diabetics. These results suggest that strategies for the management of sarcopenia are required in Asian elderly patients, especially with diabetes.
Collapse
Affiliation(s)
- Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University, Daegu, South Korea
| | - Jun Sung Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University, Daegu, South Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
| |
Collapse
|
|
43
|
Chew STH, Kayambu G, Lew CCH, Ng TP, Ong F, Tan J, Tan NC, Tham SL. Singapore multidisciplinary consensus recommendations on muscle health in older adults: assessment and multimodal targeted intervention across the continuum of care. BMC Geriatr 2021; 21:314. [PMID: 34001023 PMCID: PMC8127264 DOI: 10.1186/s12877-021-02240-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rapidly aging societies worldwide and in Singapore present a unique challenge, requiring an integrated multidisciplinary approach to address high-value targets such as muscle health. We propose pragmatic evidence-based multidisciplinary consensus recommendations for the assessment and multi-modal management of muscle health in older adults (≥65 years) across the continuum of care. METHODS The recommendations are derived from an in-depth review of published literature by a multidisciplinary working group with clinical experience in the care of the older population in both acute and community settings. RESULTS The panel recommends screening for muscle impairment using the SARC-F questionnaire, followed by assessment for low muscle strength (handgrip strength or 5-times chair stand test ≥10 s as a surrogate for lower limb strength) to diagnose possible/probable sarcopenia. For uncomplicated cases, lifestyle modifications in exercise and diet can be initiated in the community setting without further assessment. Where indicated, individuals diagnosed with possible/probable sarcopenia should undergo further assessment. Diagnosis of sarcopenia should be based on low muscle strength and low muscle mass (bioimpedance analysis, dual-energy X-ray absorptiometry or calf circumference as a surrogate). The severity of sarcopenia should be determined by assessment of physical performance (gait speed or 5-times chair stand test ≥12 s as a surrogate for gait speed). To treat sarcopenia, we recommend a combination of progressive resistance-based exercise training and optimization of nutritional intake (energy, protein and functional ingredients). High quality protein in sufficient quantity, to overcome anabolic resistance in older adults, and distributed throughout the day to enable maximum muscle protein synthesis, is essential. The addition of resistance-based exercise training is synergistic in improving the sensitivity of muscle protein synthesis response to the provision of amino acids and reducing anabolic resistance. An expected dose-response relationship between the intensity of resistance-based training, lean mass and muscle strength is described. CONCLUSIONS Reviewed and endorsed by the Society of Rehabilitation Medicine Singapore and the Singapore Nutrition and Dietetics Association, these multidisciplinary consensus recommendations can provide guidance in the formulation of comprehensive and pragmatic management plans to improve muscle health in older adults in Singapore and Asia.
Collapse
Affiliation(s)
- Samuel T H Chew
- Department of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
- Society for Geriatric Medicine Singapore, Singapore, Singapore.
| | - Geetha Kayambu
- Department of Rehabilitation, National University Hospital, Singapore, Singapore
| | | | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fangyi Ong
- Singapore Nutrition and Dietetics Association, Singapore, Singapore
| | - Jonathan Tan
- Mount Elizabeth Novena Hospital, Singapore, Singapore
| | - Ngiap Chuan Tan
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
| | - Shuen-Loong Tham
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Society of Rehabilitation Medicine, Singapore, Singapore
| |
Collapse
|
|
44
|
Veronese N, Smith L, Barbagallo M, Yang L, Zou L, Haro JM, Koyanagi A. Sarcopenia and fall-related injury among older adults in five low- and middle-income countries. Exp Gerontol 2021; 147:111262. [PMID: 33516908 DOI: 10.1016/j.exger.2021.111262] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained through self-reported information. Multivariable logistic regression analysis and meta-analysis were conducted. The sample consisted of 13,101 individuals aged ≥65 years (mean (SD) age 72.6 (11.3) years; 45% males). The prevalence of fall-related injury was higher among those with sarcopenia than in those without this condition (e.g., Mexico 9.8% vs. 2.7%). Adjusted analyses showed that sarcopenia was associated with a 1.85 (95%CI = 1.24-2.77) times higher odds for fall-related injury, with a low level of between-country heterogeneity. Future studies of longitudinal design may shed light on whether sarcopenia in LMICs may be considered as a risk factor for falls.
Collapse
Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Liye Zou
- Exercise & Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, 518060, China
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| |
Collapse
|
|
45
|
Diagnostic dependence of muscle strength measurements and the risk of falls in the elderly. Int J Rehabil Res 2021; 43:330-336. [PMID: 32784331 DOI: 10.1097/mrr.0000000000000430] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Low muscle strength appears to increase balance disorders and the tendency to fall. Diagnostic terms indicate that sarcopenia and risks of falling are related. The aim of this study is to verify which diagnostic tools used for the assessment of muscle strength in sarcopenia can be used for fall risk assessment in older women. The study included 56 females [71.77 ± 7.43(SD)]. The results of handgrip strength (HGS) and knee extensors torque [knee extension strength (KES)] were compared to the results of stabilographic parameters from Biodex Balance System platform in static and dynamic environment. The one-way ANOVA and Pearson correlation were performed. There were significant differences between groups with low and normal HGS in the chair test, and between groups with low and normal KES in the fall risk index, FRI12-6 and chair test (P < 0.05). Static parameters did not differentiate groups, due to a muscle strength of the upper and lower limbs. There was a statistically significant difference in FRI12-6 values between participants with low and normal KES in age groups (P = 0.047). No differences were found in FRI12-6 values between participants with low and normal HGS in age groups (P = 0.949). Statistical analysis showed differences in FRI12-6 between fallers with low KES and non-fallers with normal KES, non-fallers with low KES and non-fallers with normal KES. Results of the study show that there is diagnostic dependence in muscle strength of lower limbs and risk of falls in older women. KES and chair test can be used in fall risk assessment for older women.
Collapse
|
|
46
|
Clynes MA, Gregson CL, Bruyère O, Cooper C, Dennison EM. Osteosarcopenia: where osteoporosis and sarcopenia collide. Rheumatology (Oxford) 2021; 60:529-537. [PMID: 33276373 DOI: 10.1093/rheumatology/keaa755] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022] Open
Abstract
The coexistence of osteoporosis and sarcopenia has been recently considered in some groups as a syndrome termed 'osteosarcopenia'. Osteoporosis describes low bone mass and deterioration of the micro-architecture of the bone, whereas sarcopenia is the loss of muscle mass, strength and function. With an ageing population the prevalence of both conditions is likely to increase substantially over the coming decades and is associated with significant personal and societal burden. The sequelae for an individual suffering from both conditions together include a greater risk of falls, fractures, institutionalization and mortality. The aetiology of 'osteosarcopenia' is multifactorial with several factors linking muscle and bone function, including genetics, age, inflammation and obesity. Several biochemical pathways have been identified that are facilitating the development of several promising therapeutic agents, which target both muscle and bone. In the current review we outline the epidemiology, pathogenesis and clinical consequences of 'osteosarcopenia' and explore current and potential future management strategies.
Collapse
Affiliation(s)
- Michael A Clynes
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| |
Collapse
|
|
47
|
Notsu M, Naito T, Mori K, Notsu A, Morikawa A, Kawabata T, Okayama T, Yonenaga Y, Sugiyama M, Kenmotsu H, Murakami H, Ito T, Kai M, Takahashi T. Days Spent at Home near the End of Life in Japanese Elderly Patients with Lung Cancer: Post hoc Analysis of A Prospective Study. Asia Pac J Oncol Nurs 2021; 8:228-236. [PMID: 33850956 PMCID: PMC8030590 DOI: 10.4103/2347-5625.311131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Days spent at home (DASH) near the end of life is considered an important patient-centered goal and outcome because many patients want to stay at home toward the end of life. This study aimed to estimate the individual DASH near the end of life and identify its early predictors, including muscle mass and physical function, among elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: We conducted a post hoc analysis of the prospective observational study (UMIN000009768) that recruited patients aged ≥ 70 years who were scheduled to undergo first-line chemotherapy because of advanced NSCLC. We measured the muscle mass by bioelectrical impedance analysis at baseline. DASH was calculated as 30 days minus the number of days spent in hospitals, palliative care facilities, or nursing homes during the last 30 days of life. We performed linear regression analyses to evaluate the predictors of DASH. Results: Altogether, 16 women and 28 men with a median overall survival of 15.5 months (range: 2.9–58.9) were included. The median DASH in the last 30 days of life was 8 days (range: 0–30, interquartile range: 0–23). Men had longer DASH than women by 7.3 days. Patients who had good trunk muscle mass index and hand-grip strength had significantly longer DASH than those who did not (4.7 days per kg/m2 increase [P = 0.017] and 0.4 days per kg increase [P = 0.032], respectively). Conclusions: Most elderly patients with advanced NSCLC had a limited DASH near the end of life. The risk factors for reduced DASH were women, reduced muscle mass, and poor physical function at the time of diagnosis of advanced NSCLC. Our findings would encourage early discussions about end-of-life care for patients with advanced cancers with risk factors for short DASH at the time of diagnosis, and thus, improve the quality of end-of-life care.
Collapse
Affiliation(s)
- Mikako Notsu
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.,Graduate School, Oita University of Nursing and Health Sciences, Oita, Japan
| | - Tateaki Naito
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Keita Mori
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Ayumu Morikawa
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yusuke Yonenaga
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Miwa Sugiyama
- Division of Nursing, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tomoko Ito
- Tachikawa Faculty of Nursing, Tokyo Healthcare University, Tokyo, Japan
| | - Michiaki Kai
- Department of Environmental Health Science, Oita University of Nursing and Health Sciences, Oita, Japan
| | | |
Collapse
|
|
48
|
Kao TW, Peng TC, Chen WL, Han DS, Chen CL, Yang WS. Impact of adiposity on muscle function and clinical events among elders with dynapenia, presarcopenia and sarcopenia: a community-based cross-sectional study. Aging (Albany NY) 2021; 13:7247-7258. [PMID: 33640880 PMCID: PMC7993704 DOI: 10.18632/aging.202581] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/14/2021] [Indexed: 05/01/2023]
Abstract
INTRODUCTION Low muscle function determined unfavorable clinical outcome than low muscle mass; nevertheless, comparison of detrimental parameters among dynapenia, presarcopenia and sarcopenia was sparse. We hypothesized that adiposity is implicated in low muscle function related adverse events. METHODS We recruited community elders to measure handgrip strength and walking speed. Using bioelectronics impedance analyzer to examine body compositions. The faller is indicated of having a fall event in the past one year. Associations of different obesity parameters, metabolic syndrome (MetS) and fall among the groups were analyzed. RESULTS Among 765 participants, the dynapenia group had higher metabolic profiles, body fat percentage (BFP), waist circumference, and fat to muscle ratio (FMR) than the other groups, whereas the presarcopenia subjects had the lowest obesity parameters. The fallers tended to have poorer muscle function than non-fallers (p<0.001). The dynapenia individuals had the highest risk for MetS (odds ratio [OR]= 5.79; 95% confidence interval [CI]= 2.45-13.73), and the highest fall risk (OR= 3.11; 95% CI=1.41-6.87). Among obesity parameters, FMR had better diagnostic performance to estimate low muscle function, followed by BFP. CONCLUSION Dynapenia individual had higher risk of obese-related adverse events. Increased adiposity irrespective of muscle mass is relevant to reduced muscle function among elders.
Collapse
Affiliation(s)
- Tung-Wei Kao
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Der-Sheng Han
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan
| | - Chi-Ling Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Shiung Yang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center for Obesity, Life Style and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
|
49
|
Gadelha AB, Cesari M, Corrêa HL, Neves RVP, Sousa CV, Deus LA, Souza MK, Reis AL, Moraes MR, Prestes J, Simões HG, Andrade RV, Melo GF, Rosa TS. Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial. Int Urol Nephrol 2021; 53:2137-2147. [PMID: 33609277 DOI: 10.1007/s11255-021-02799-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/08/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Sarcopenia and chronic kidney disease (CKD) have been associated with negative outcomes in older people, including inflammatory profile and anemia biomarkers. AIMS To investigate the effects of pre-dialysis resistance training (RT) on sarcopenia, inflammatory profile, and anemia biomarkers in older patients with CKD. METHODS A total of 107 patients with CKD (65.4 ± 3.7 years) were randomly allocated into four groups: sarcopenic RT (n = 37), non-sarcopenic RT (n = 20), sarcopenic control (n = 28), and non-sarcopenic control (n = 22). DXA and handgrip strength were used to classify sarcopenia according to EWGSOP-2. Treatment groups underwent a 24-week intervention with RT before each dialysis session, three times per week. Blood sample analysis for ferritin, hepcidin, iron availability, and inflammatory profile (TNFα, IL-6, and IL-10) was conducted. All-cause mortality was recorded over 5 years. RESULTS Sarcopenic RT group increased iron availability after the intervention, while their counterparts decreased. Ferritin and hepcidin significantly decreased in sarcopenic RT group. RT elicited a reduction in both TNFα and IL-6, while increasing IL-10 in both intervention groups. The rate of sarcopenic subjects substantially decreased after the intervention period (from 37 to 17 in the RT group; p = 0.01). The proportion of deaths was higher (P = 0.033) for sarcopenic subjects (Controls 35.7% vs RT 29.7%) when compared to non-sarcopenic subjects (Controls 18% vs RT 10%). The proportion of deaths decreased according to the randomization group (X2 = 8.704; P < 0.1). CONCLUSIONS The 24-week RT intervention elicited a better sarcopenia status, better inflammatory profile, and improved anemia biomarkers. Sarcopenia was associated with higher mortality rate in older patients with CKD.
Collapse
Affiliation(s)
- André Bonadias Gadelha
- Seção de Educação Física, Colégio Militar de Brasília (CMB), 902/904-Asa Norte, Brasília, DF, 70790-020, Brazil. .,Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil.
| | - Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Milan, Italy
| | - Hugo Luca Corrêa
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | | | - Caio Victor Sousa
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Lysleine Alves Deus
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Michel Kendy Souza
- Department of Nephrology, Federal University of São Paulo, São Paulo, Brazil
| | - Andrea Lucena Reis
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Milton Rocha Moraes
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Jonato Prestes
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Herbert Gustavo Simões
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Rosangela Vieira Andrade
- Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasilia-UCB, Brasília, Brazil
| | - Gislane Ferreira Melo
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| | - Thiago Santos Rosa
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil
| |
Collapse
|
|
50
|
Ishida Y, Maeda K, Ueshima J, Shimizu A, Nonogaki T, Kato R, Matsuyama R, Yamanaka Y, Mori N. The SARC-F Score on Admission Predicts Falls during Hospitalization in Older Adults. J Nutr Health Aging 2021; 25:399-404. [PMID: 33575734 DOI: 10.1007/s12603-021-1597-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Community-dwelling older adults with sarcopenia are likely to fall. However, few studies have investigated whether sarcopenia is associated with falls during hospitalization in older adults. The purpose of this study was to determine whether the SARC-F when used as a simple screening tool for sarcopenia at the time of admission, predicts in-hospital falls. DESIGN A retrospective, observational study. SETTING A 900-bed university hospital. PARTICIPANTS A total of 9,927 patients aged 65 years and older were hospitalized at the hospital between April 2019 and March 2020. MEASUREMENTS The SARC-F contains five items: strength, assistance in walking, rise from a chair, climb stairs, and falls were evaluated at hospital admission. To investigate the relationship between the SARC-F score and falls, a ROC curve analysis was performed. Multivariate analysis adjusted for fall-related confounding factors such as age, gender, ADL, and disease were performed. RESULTS Mean age: 75.9±6.7 years; male: 56.2% were analyzed, and 159 patients (1.6%) fell during hospitalization. SARC-F scores at admission were significantly higher in the fall group than in the control group (3 [1-6] points vs. 0 [¬0-2] point, p<0.001). Statistical association was observed between the SARC-F and in-hospital fall (area under the curve = 0.721 [0.678-0.764], p < 0.001). The cut-off value for the highest sensitivity and specificity of the SARC-F score for in-hospital falls was two (sensitivity = 0.679, specificity = 0.715). Among the subitem of the SARC-F, the hazard ratios for climbing stairs were significantly higher (HR = 1.52 [1.10-2.09], p = 0.011) and for a history of fall was significantly higher (HR = 1.41 [1.02-1.95], p = 0.036). A SARC-F score ≥ 2 had a significantly higher incidence of in-hospital falls compared to a SARC-F score <2 (3.7% vs. 0.7%, p < 0.001). Also, a SARC-F score ≥ 2 had a significantly higher hazard ratio for falls (2.11 [1.37-3.26], p < 0.001). CONCLUSION SARC-F can help predict falls among hospitalized older adults.
Collapse
Affiliation(s)
- Y Ishida
- Keisuke Maeda, M.D., Ph.D., Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan, Phone: +81-562-46-2311; FAX: +81-562-44-8518, E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|