The Turkish Validity and Reliability Study of the Rapid Sarcopenia Screening Questionnaire.

BackgroundSarcopenia is closely associated with activity limitations, falls and fractures, all serving as major causes of physiological deterioration and even mortality in older adults. The purpose of this study was to develop and validate a novel nomogram for predicting the risk of sarcopenia in Chinese older adults from rural areas.MethodsOverall, 611 older adults were enrolled from the Thyroid Diseases in Older Population (TOPS) study and randomly assigned to the training and validation datasets in a ratio of 8:2. Based on the risk factors for sarcopenia identified by stepwise multivariate logistic regression, a nomogram to predict sarcopenia in older adults was created. Its discrimination ability, calibration accuracy and clinical utility were assessed via the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Additionally, a web-based nomogram was developed.ResultsA nomogram to predict sarcopenia in older adults was created by incorporating the following variables: age (years), sex, body mass index (BMI, kg/m2), free triiodothyronine (FT3), total cholesterol (TC), triglyceride (TG), and TG/HDL-C. The area under the curve (AUC) of the nomogram was 0.813 (95% CI 0.775–0.846) in the training dataset and 0.819 (95% CI 0.739–0.883) in the validation dataset. Both calibration curves and DCA verified high calibration accuracy and clinical utility of the nomogram.ConclusionsA nomogram is created based on routine laboratory values of blood testing, showing an outstanding ability to predict sarcopenia in older adults from rural areas in China accurately, specifically and cost-effectively.

The present study aimed to clarify the difference in physical activity (PA) due to sarcopenia in community-dwelling older adults with long-term care insurance (LTCI). This was a cross-sectional study that investigated data of 97 consecutive community-dwelling older Japanese adults with LTCI who underwent rehabilitation at one day care center in Japan from November 2018 to May 2019. Sarcopenia was determined according to criteria of the Asian Working Group for Sarcopenia. Unpaired t-test, Mann-Whitney U test, chi-square test and analysis of covariance were used to compare participant characteristics and clinical parameters between the older adults with and without sarcopenia. A receiver operating characteristic (ROC) curve was constructed to determine the cut-off value of PA for sarcopenia. The sarcopenia group (n = 20) had significantly lower body mass index (BMI), skeletal muscle mass index, gait speed, and PA than those in the no sarcopenia group (n = 28) (p < 0.05). After adjustment for BMI and sex, the sarcopenia group showed significantly lower PA than the no sarcopenia group. Findings showed that the cut-off value of PA indicating sarcopenia by ROC curve analysis was 1494.4 steps/day (p < 0.05); this value may aid in identifying sarcopenia in older adults with LTCI.

BackgroundThis study aimed to examine the association between oral health-related quality of life and probable sarcopenia in community-dwelling older adults, and to evaluate the potential role of oral health assessment in routine geriatric care.MethodsThis cross-sectional study included 315 individuals aged ≥65 years who were registered with the Home Health Unit and the Geriatric Outpatient Clinic of a tertiary hospital in Türkiye. Oral health-related quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI). Muscle strength was assessed with a handgrip dynamometer, and probable sarcopenia was defined according to the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria as low muscle strength. Additional assessments included the Mini Nutritional Assessment–Short Form (MNA-SF), Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire, Clinical Frailty Scale (CFS), Katz Index of Independence in Activities of Daily Living, and Mini-Cog test. Correlation, logistic regression, and receiver operating characteristic (ROC) analyses were performed.ResultsParticipants had a mean age of 80.8 years (SD 7.5); 43.5% were male. Handgrip strength was positively correlated with GOHAI (r = 0.376, p <0.001), MNA-SF (r = 0.446, p <0.001), and Mini-Cog (r = 0.126, p <0.05), and negatively correlated with age, SARC-F, and frailty. GOHAI correlated positively with MNA-SF (r = 0.206, p <0.01) and negatively with SARC-F (r = –0.134, p <0.05). In univariate logistic regression, lower GOHAI, lower MNA-SF, older age, polypharmacy, and higher SARC-F scores were significantly associated with probable sarcopenia. In multivariate analysis, GOHAI, MNA-SF and polypharmacy remained independent predictors.ConclusionPoor oral health–related quality of life was independently associated with probable sarcopenia in older adults. Incorporating an oral health measure such as the GOHAI into routine geriatric assessment may facilitate early detection of at-risk individuals and support timely, targeted interventions.

To explore the associations between nutrition literacy (NL) and possible sarcopenia in older Chinese adults. A cross-sectional study was conducted. NL was assessed using a twelve-item short-form NL scale. Possible sarcopenia was identified using SARC-CALF. Logistic regression was used to calculate OR and 95 % CI for NL and the incidence of possible sarcopenia. A total of 1338 older individuals, aged 71·41 (sd 6·84) years, were enrolled in this study. After confounders were adjusted for, older adults in the upper quartile of NL were found to be 52 % less likely to have possible sarcopenia than those in the lower quartile of NL (OR = 0·48, 95 % CI: 0·29, 0·77). The associations between NL and possible sarcopenia were present only in those who lived in rural areas (OR: 0·38, 95 % CI: 0·19, 0·77), had a primary school education or less (OR: 0·21, 95 % CI: 0·09, 0·48), had a monthly income < 3000 RMB (OR: 0·39, 95 % CI: 0·22, 0·70) and had chronic diseases (OR: 0·37, 95 % CI: 0·22, 0·63). Moreover, an interaction effect was observed between having a chronic disease and junior high school education and being in the upper quartile of NL. The prevalence of possible sarcopenia in older Chinese adults is substantial, with prevalence decreasing with increasing NL. Moreover, the association between NL and possible sarcopenia varies by residence type, education level, monthly income and chronic disease experience. Targeted NL interventions are required to prevent and manage sarcopenia in older adults, particularly those with low socio-economic status and chronic diseases.

This systematic review aims to reevaluate the role of minerals on muscle mass, muscle strength, physical performance, and the prevalence of sarcopenia in community-dwelling and institutionalized older adults. Systematic review. In March 2022, a systematic search was performed in PubMed, Scopus, and Web of Sciences using predefined search terms. Original studies on dietary mineral intake or mineral serum blood concentrations on muscle mass, muscle strength, and physical performance or the prevalence of sarcopenia in older adults (average age ≥65years) were included. Eligibility screening and data extraction was performed by 2 independent reviewers. Quality assessment was performed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Risk of bias was evaluated using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool. From the 15,622 identified articles, a total of 45 studies were included in the review, mainly being cross-sectional and observational studies. Moderate quality of evidence showed that selenium (n= 8) and magnesium (n= 7) were significantly associated with muscle mass, strength, and physical performance as well as the prevalence of sarcopenia. For calcium and zinc, no association could be found. For potassium, iron, sodium, and phosphorus, the association with sarcopenic outcomes remains unclear as not enough studies could be included or were nonconclusive (low quality of evidence). This systematic review shows a potential role for selenium and magnesium on the prevention and treatment of sarcopenia in older adults. More randomized controlled trials are warranted to determine the impact of minerals on sarcopenia in older adults.

Clinical validation of SARC-F by proxy as a practical tool to evaluate sarcopenia in dependent older adults

IntroductionThe study aim was to estimate the prevalence of sarcopenia in community-dwelling Nigerian older adults using the Asian Working Group for Sarcopenia (AWGS) and the revised European Working Group on Sarcopenia in Older People (EWGSOP2) references.MethodsA total of 767 community-dwelling older adults aged 60 years were recruited for the study. Sarcopenia was defined in accordance with the AWGS and EWGSOP2 references.ResultsAs for the AWGS reference, 24.4% (95% CI: 21.4–27.6) of older adults had sarcopenia and the prevalence was significantly similar between men and women (&lt;i&gt;p&lt;/i&gt; = 0.18); whereas with the EWGSOP2 reference, 36.2% were classified as having sarcopenia and the prevalence was significantly higher in men (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). The agreement between the AWGS and EWGSOP2 criteria in estimating the prevalence of sarcopenia was moderate (&lt;i&gt;κ&lt;/i&gt; = 0.591), with EWGSOP2 showing higher sensitivity (0.882). In accordance with the 2 references, the multivariable logistic regression showed that age was consistently associated with increased odds of sarcopenia, whereas female gender, muscle strength, and physical performance were significantly associated with decreased odds of sarcopenia in older adults (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).ConclusionsThe EWGSOP2 reference, compared with the AWGS reference, is more likely to identify older individuals with sarcopenia. Both references showed that muscle strength and physical performance were associated with a decreased risk of sarcopenia. Clinicians may use the EWGSOP2 reference criteria for early diagnosis and management of sarcopenia in older adults.

High-density lipoprotein cholesterol level and risk of muscle strength decline and sarcopenia in older adults

BackgroundSarcopenia, an age-related disease, has been implicated as both a cause and consequence of type 2 diabetes mellitus (T2DM) and a symbol of poor prognosis in older adults with T2DM. Therefore, early detection and effective treatment of sarcopenia are particularly important in older adults with T2DM. We aimed to investigate the prevalence of sarcopenia in Chinese older T2DM patients and explore whether homocysteine and inflammatory indexes could serve as biomarkers and participate in the development process of sarcopenia.MethodsT2DM patients aged over 60 years were consecutively recruited from the ward of department of Endocrinology, Xuanwu Hospital between April 2017 and April 2019. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia, including muscle mass, grip strength and gait speed. Logistic regression was used to explore the association between biochemical indicators and sarcopenia. Receiver operating characteristic (ROC) curves were applied to determine the diagnostic effect of these clinical indicators.ResultsTotally 582 older adults with T2DM were characterized and analyzed in the study. Approximately 8.9% of the older T2DM patients had sarcopenia. After adjusting for age, sex, body mass index (BMI) and hemoglobin A1c (HbA1c), increased concentrations of homocysteine [odds ratio (OR): 2.829; 95% confidence interval (CI), 1.064–7.525] and high-sensitive C-reactive protein (hs-CRP) (OR: 1.021; 95% CI, 1.001–1.042) were independent predictors of sarcopenia; but not interleukin-6. The combination of age, sex, BMI and HbA1c provided a discriminatory effect of sarcopenia with an area under the curve (AUC) of 0.856, when homocysteine was added to the model, the value of the ROC curve was further improved, with an AUC of 0.861.ConclusionIn the current study, we demonstrated a positive correlation of homocysteine, hs-CRP with sarcopenia in older adults with T2DM and the relationship remained significant even after adjustment for HbA1c. These biomarkers (homocysteine and hs-CRP) may play important roles in the pathological process of sarcopenia.

Absolute muscle strength or adjusted by body mass index (BMI) are useful to identify sarcopenia. However, these values are not accurate for older adults with extreme body sizes because the nonlinear relationship between strength and body size. The purpose was to determine cut-off points for identify sarcopenia in older adults using allometric coefficients to normalise handgrip strength (HGS) and 30-sec chair stand test (30-s CST) by body size. Allometric exponents were proposed with log-linear models for body-size variables (body mass, height and BMI). The remotion of body-size effect on muscle strength with allometric normalisation was tested by partial correlation. Cut-off points for low muscle strength were established by ROC curve and Youden index considering functional limitation (six-minute walk test&lt;400m). Allometric exponents provided for body-size variables range from -0.01 to 2.28 (HGS) and -0.27 to 0.21 (30-s CST). The effect of body size on muscle strength was removed with allometric normalisation (r&lt;0.30). Cut-off points accuracy was always adequate (AUC≥0.78; p&lt;0.001). In conclusion, cut-off points of HGS and 30-s CST allometrically normalised were proposed to identify sarcopenia in Portuguese older adults and allometry maintained adequate the accuracy (AUC&gt;70%). Allometry removed influence of body size on the expression of HGS and 30-s CST and permits evaluate muscle strength regardless of body-size.

Sarcopenia significantly contributes to physical disability and reduced quality of life in older adults, leading to disability. Therapeutics used to manage sarcopenia can improve not only muscle health but also the overall functional capacity of individuals at risk of developing disabilities. This review focuses on the therapeutic interventions evaluated in phase 4 clinical trials to address sarcopenia and its associated disabilities in older adults. To review and summarize the therapeutic agents tested in phase 4 clinical trials for the management of sarcopenia and their potential impact on reducing functional disabilities in older adults. A review of phase 4 clinical trials was conducted on 6th November 2024, focusing on interventions for sarcopenia in older adults. Data on therapeutic agents, trial outcomes, and their effects on muscle mass, strength, and disability prevention were collected from clinicaltrials.gov database. Several therapeutic agents, including whey protein powder, eldecalcitol, testosterone enanthate, and Denosumab, have been tested in Phase 4 trials for their ability to enhance muscle mass and function in older adults with sarcopenia. Allopurinol and Pioglitazone were also studied for their potential to improve muscle metabolism, while Medrol (Methylprednisolone) and Levothyroxine offered supportive effects in inflammatory and metabolic disorders that exacerbate muscle loss. Moreover, combination therapies, such as nutritional supplementation with HMB and vitamin D, showed promise in improving muscle function. These interventions demonstrated varying degrees of efficacy in improving muscle strength, reducing physical disability, and enhancing overall functional capacity in older adults. Therapeutic strategies targeting sarcopenia in older adults have the potential to reduce functional disabilities and improve quality of life. Phase 4 clinical trials provide valuable insights into the long-term safety and effectiveness of these treatments. Continued research and refinement of these therapies are essential to fully address the disabling effects of sarcopenia and promote healthy aging.

BackgroundSarcopenia and type 2 diabetes mellitus (T2DM) are prevalent health conditions that significantly impact mortality risk, particularly among older adults. While both conditions have been individually associated with increased mortality, limited evidence exists regarding their combined effect, and no prior systematic review has synthesized this association specifically among older adults with T2DM. This study aims to examine the association between sarcopenia and all-cause mortality in older adults with T2DM. It seeks to evaluate whether this relationship varies by population characteristics, sarcopenia definitions, and follow-up duration.MethodsWe will conduct a comprehensive literature search using databases such as PubMed, Scopus, CINAHL, and Embase to identify studies exploring the relationship between sarcopenia and all-cause mortality in older adults with T2DM from January 1, 2014, to September 1, 2024. Two authors will independently screen all eligible clinical studies. Statistical analyses will be conducted using JBI SUMARI software.ResultsPreliminary findings will indicate the overall prevalence and mortality rate among older adults with sarcopenia and T2DM. By consolidating findings from diverse studies, this meta-analysis will provide clearer insights into how sarcopenia and T2DM interact to affect mortality risk.ConclusionUnderstanding the relationship between sarcopenia and T2DM is crucial leading to developing effective interventions to reduce mortality risk and improve the quality of life in older adults. Addressing this important research gap will contribute to better healthcare practices and outcomes.

BackgroundSarcopenia is a progressive age-related disease that can cause a range of adverse health outcomes in older adults, and older adults with severe sarcopenia are also at increased short-term mortality risk. The aim of this study was to construct and validate a risk prediction model for sarcopenia in Chinese older adults.MethodsThis study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), a high-quality micro-level data representative of households and individuals aged 45 years and older adults in China. The study analyzed 65 indicators, including sociodemographic indicators, health-related indicators, and biochemical indicators.Results3454 older adults enrolled in the CHARLS database in 2015 were included in the final analysis. A total of 997 (28.8%) had phenotypes of sarcopenia. Multivariate logistic regression analysis showed that sex, Body Mass Index (BMI), Mean Systolic Blood Pressure (MSBP), Mean Diastolic Blood Pressure (MDBP) and pain were predictive factors for sarcopenia in older adults. These factors were used to construct a nomogram model, which showed good consistency and accuracy. The AUC value of the prediction model in the training set was 0.77 (95% CI = 0.75–0.79); the AUC value in the validation set was 0.76 (95% CI = 0.73–0.79). Hosmer–Lemeshow test values were P = 0.5041 and P = 0.2668 (both P > 0.05). Calibration curves showed significant agreement between the nomogram model and actual observations. ROC and DCA showed that the nomograms had good predictive properties.ConclusionsThe constructed sarcopenia risk prediction model, incorporating factors such as sex, BMI, MSBP, MDBP, and pain, demonstrates promising predictive capabilities. This model offers valuable insights for clinical practitioners, aiding in early screening and targeted interventions for sarcopenia in Chinese older adults.

BackgroundSarcopenia is associated with age-related loss of muscle mass and function and is becoming prevalent in the older Chinese population. This systematic review aims to obtain a reliable estimation of the prevalence of sarcopenia among community-dwelling Chinese populations aged 65 years and older and to characterize its epidemiology.MethodsA literature search was performed in the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and CQVIP databases up to September 31, 2021. All studies that reported the prevalence of sarcopenia in Chinese community-dwelling older adults were included, and Hoy et al.’s tool was used to assess the risk of bias. The overall prevalence of sarcopenia will be calculated as the primary outcome, and subgroup analyses will be performed by study year, age, sex, muscle mass assessment method, diagnostic criteria and area.ResultsA total of 26 studies were included in this study, which involved 25,921 subjects, and 3597 had sarcopenia. Although significant heterogeneity between studies was reported, no statistically significant publication bias was detected. The overall prevalence of sarcopenia in community-dwelling older adults aged over 65 years in the Chinese population was 17.4% (95% CI: 14.6%-20.2%). Subgroup analysis based on study year, age and sex, muscle mass assessment method, diagnostic criteria, region and area showed that the prevalence of sarcopenia was different in each subgroup.ImplicationsThe prevalence of sarcopenia in Chinese community-dwelling older adults was higher than that in previous studies. As a multidimensional survey of the prevalence of sarcopenia in older adults, this meta-analysis provides data support for the targeted management of sarcopenia among Chinese older adults.

Development of multiple biomarker panels for prediction of sarcopenia in community-dwelling older adults