Unseen burden: Prevalence and determinants of possible sarcopenia in Indonesian older adults - a secondary data analysis.

A Prospective Observational Study Evaluating Sarcopenia By Using the Bioelectrical Impedance Analysis in Elderly Patients with Hematologic Malignancies

Sarcopenia in Korean Community-Dwelling Adults Aged 70 Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update

New criteria of the Asian working group for sarcopenia (AWGS) were updated in 2019. However, the impact of this change on hospitalized patients has not been fully evaluated. We aimed to investigate the prevalence of sarcopenia and its distribution by age and gender in hospitalized patients. Furthermore, we explored the effects of the new criteria on sarcopenia prevalence compared to the previous criteria. From July 2020 to August 2021, a total of 380 patients underwent skeletal muscle mass assessment using dual-energy X-ray absorptiometry. Handgrip strength and usual gait speed were used to evaluate muscle strength and physical performance. Based on both AWGS 2014 and AWGS 2019 criteria, the prevalence of sarcopenia was significantly higher in males compared to females in the age groups of ≥65 years and ≥75 years. According to the AWGS criteria from 2014 to 2019, the prevalence of sarcopenia showed a significant increase from 35.3% to 37.6%. Specifically, the prevalence rate in males increased from 38.1% to 41.6%, while in females, it increased from 31.2% to 31.8%. The prevalence of severe sarcopenia, a new diagnostic category in the AWGS 2019 criteria, was 25.8%. Surprisingly, the majority of sarcopenic patients in the age group of ≥65 years fell into this category. By applying the new criteria, more patients were classified as sarcopenia in males. In addition, a new category called severe sarcopenia is expected to contribute to subdividing sarcopenic patients in detail and facilitating more proactive management strategies.

1564-P: Prevalence of Sarcopenia in Community Dwelling Korean Older Adults with Diabetes

The aim of the study was to investigate a prevalence of sarcopenia in patients with gynecological cancer in accordance with current diagnostic criteria of sarcopenia. A series of 513 patients with gynecological cancer who were intended to newly receive initial or salvage treatment were recruited in a prospective study. Eligible patients were examined with dual energy X-ray absorptiometry and underwent handgrip strength test and the Short Physical Performance Battery before treatment. Sarcopenia was defined as both low skeletal muscle mass (skeletal muscle mass index) and low muscle strength (handgrip strength of <18.0 kg) or both low skeletal muscle mass index and low physical performance (Short Physical Performance Battery score of ≤9). A total of 475 patients (92.6%) were completely assessed in this study. Eligible patients' median age was 60 years (range: 29-89 years). Frequencies of patients with low skeletal muscle mass index, low hand grip strength and low Short Physical Performance Battery were 118 (24.8%), 70 (14.7%) and 80 (16.8%), respectively. Sarcopenia was finally identified in 45 patients (9.5%), which accounted for 38.1% of patients with low skeletal muscle mass index, 64.3% of the patients with low hand grip strength and 56.3% of the patients with low physical performance, respectively. The prevalence of sarcopenia of 9.5% in patients with gynecological malignancy who were scheduled to newly receive an initial or a salvage treatment. A large-scale, nation-wide study might be planned to elucidate an accurate prevalence of sarcopenia among gynecologic cancer patients.

Determining the prevalence of sarcopenia and identifying associated factors can aid in early detection and treatment among community-dwelling elderly. This study aims to estimate the prevalence of sarcopenia and identify associated factors. This cross-sectional study was conducted in the elderly community within the two areas of Public Health Center, Semarang, Indonesia, through random sampling. Sarcopenia was defined based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Data on socio-demographics, clinical, and functional status were collected and associated factors analyzed using multivariable logistic regression. Of the 153 participants, the prevalence of severe sarcopenia was 50.33%, and overall sarcopenia prevalence was 44.44%. Elderly individuals with severe sarcopenia had a mean age of 69.45, with a higher occurrence in women (79.2%) compared to men. Age (p=0.003; APR: 1.105; 95% CI: 1.035-1.180), toilet type (p=0.002; APR: 4.194; 95% CI: 1.677-10.493), and being female (p=0.049; APR: 2.341; 95% CI: 1.003-5.460) were identified as risk factors for severe sarcopenia. The prevalence of severe sarcopenia is elevated among community-dwelling elderly. Sarcopenia was defined as low muscle mass with low handgrip strength and/or low gait speed. Routine check-ups are needed to detect sarcopenia and its risk factors in primary health care to enable early intervention for sarcopenia in the elderly.

BackgroundObesity is a chronic disease that causes various medical health problems, increases morbidity, and reduces the quality of life. Obesity (especially central obesity) in older adults is expected to act with the development of sarcopenia. However, the relationship between obesity, central obesity, and sarcopenia remains controversial. This study aimed to investigate the impact of obesity on sarcopenia.MethodsIn this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 1,827 community-dwelling older adults (883 men and 944 women) aged 70–84 years were recruited. The Asian Working Group for Sarcopenia (AWGS) criteria were used to evaluate sarcopenia. Subjects with a low appendicular skeletal muscle mass index (ASMI; men: < 7.0 kg/m2, women: < 5.4 kg/m2) and either low handgrip strength (HGS; men: < 28 kg, women: < 18 kg) or low Short Physical Performance Battery (SPPB; ≤ 9) were diagnosed with sarcopenia. Obesity was defined as a body mass index (BMI) of ≥ 25 kg/m2, while central obesity was defined as WC measurements of ≥ 90 cm in men and ≥ 85 cm in women. Logistic regression analyses were performed to evaluate the impact of obesity and central obesity on sarcopenia and the parameters of sacropenia.ResultsIn both sexes, the obese group, defined based on the BMI, had a significantly low prevalence of low ASMI (odds ratio [OR] = 0.14, 95% confidence interval CI = 0.10–0.20 in men, OR = 0.17, 95% CI = 0.12–0.25 in women) and sarcopenia (OR = 0.28, 95% CI = 0.16–0.50 in men, OR = 0.17, 95% CI = 0.08–0.35 in women) in the multivariable logistic regression analysis. In women, the central obese group had a low prevalence of sarcopenia (OR = 0.46, 95% CI = 0.27–0.77) in the multivariable logistic regression analysis. Meanwhile, the obese group had a significantly higher prevalence of low SPPB in women (OR = 1.75, 95% CI = 1.18–2.59).ConclusionsObesity may have a protective effect on low ASMI and sarcopenia, as defined by the AWGS criteria. Central obesity was associated with a low prevalence of sarcopenia in women only. However, obesity did not have a positive impact on functional parameters of sarcopenia including muscle strength and physical performance.

Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta‐analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random‐effect models. A total of 140 studies (42 041 patients) across 25 countries were included in this systematic review and meta‐analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9–28.3) and did not differ among stages (P = 0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P = 0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7–32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6–37.1) compared to non‐dialysis (3.0%, 95% CI: 0–11.1; P < 0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5–21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0–51.9), low muscle mass in 29.1% (95% CI: 23.9–34.5), and low physical performance in 38.6 (95% CI: 30.9–46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7–57.4) compared to non‐dialysis (19.6%, 95% CI: 12.8–27.3; P < 0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.

To date, no study has systematically investigated the prevalence of sarcopenia in cardiovascular disease (CVD) according to the international consensus definition. The aim of this study was to investigate the prevalence and prognostic value of sarcopenia in older patients with CVD. The study population consisted of 1929 admitted patients aged 60 years and older (72.3 ± 7.3 years, 633 females) with CVD. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS). Handgrip strength was measured with a handheld dynamometer, and gait speed was measured by a 10-m walking test. Using the cut-off points from the AWGS consensus, low hand grip strength was defined as <26 kg for men and <18 kg for women, and slow gait speed was defined as <0.8 m/sec. The muscle mass was estimated according to a previously validated anthropometric equation in Asian population. The endpoint was all-cause mortality. The prevalence of sarcopenia was 26.8% (male:17.6%, female:45.7%) and increased with age (<75 years: 16.5%, 75–84 years: 40.3%, ≥85 years: 62.6%, P for trend <0.001). During follow-up (2.3 ± 2.2years), 203 deaths occurred. Patients with sarcopenia had a higher risk of all-cause death compared with non-sarcopenic patients (age-sex adjusted hazard ratio: 2.00, 95% confidence interval: 1.46 - 2.73, P < 0.001). The present study suggests that sarcopenia is highly prevalent among older patients with CVD and it is associated with increased mortality.

Chronic low back pain is prevalent among older adults, who are at a higher risk for sarcopenia. The waist-to-calf circumference ratio has emerged as a health indicator, reflecting the balance between central adiposity and muscle mass. This study examined the association between waist-to-calf circumference ratio and sarcopenia, as well as factors like muscle mass, strength, and physical performance in older patients with chronic low back pain. Ambulatory patients aged 65 years and older with chronic low back pain were included. Sarcopenia was assessed using the 2019 diagnostic criteria from the Asian Working Group for Sarcopenia. We compared demographic data, pain-related factors, comorbidities, and measurements related to sarcopenia and obesity across quartiles of the waist-to-calf circumference ratio. The prevalence of sarcopenia and severe sarcopenia was investigated, and multivariable analysis was conducted to identify independent factors associated with sarcopenia. Among 592 patients, 85had sarcopenia (14.3%), and 71had severe sarcopenia (11.9%). Patients with a high waist-calf circumference ratio had more comorbidities and longer pain duration. The prevalence of severe sarcopenia increased with higher quartile of waist-calf circumference ratio (Q1=7.9%, Q2=8.6%, Q3=14.8%, Q4=16.9%, P=0.006). When recommended cut-off values for the parameters used to diagnose sarcopenia were applied, the numbers of patients with low grip strength and low physical performance but not low muscle mass were greater among patients with a high waist-calf circumference ratio. Also, a high waist-calf circumference ratio was significantly associated with severe sarcopenia. In older patients with chronic low back pain, a high waist-calf circumference ratio was associated with severe sarcopenia, characterized by reduced muscle strength and impaired physical performance. The waist-calf circumference ratio might serve as a useful tool for assessing sarcopenia in this population.

The prevalence of sarcopenia and the health status of affected individuals, particularly among the young elderly, are unclear in Japan. We determined the prevalence of possible sarcopenia, a concept proposed by the Asian Working Group for Sarcopenia (AWGS) in 2019, and then investigated its clinical features in community-dwelling young elderly individuals in Kobe, a representative large city in Japan. This retrospective cross-sectional study examined 1768 residents of Kobe aged 65 years who underwent health and frailty checkups implemented by Kobe City between April 2017 and March 2019. Possible sarcopenia was diagnosed by the AWGS 2019 algorithm. Frailty status was assessed with the use of the Kihon Checklist, which was developed to identify senior citizens requiring nursing care in Japan. Fifty-one of the 1768 subjects were diagnosed with possible sarcopenia (overall prevalence of 2.9% [confidence interval: 2.1-3.7%]), with the prevalence being higher in women than in men. Individuals with possible sarcopenia had a lower body mass index, abdominal circumference, diastolic blood pressure and percentage of taking lipid-lowering drugs as well as a higher high-density lipoprotein cholesterol level and estimated glomerular filtration rate. They also showed a higher degree of frailty. A low body mass index and physical inactivity were significantly associated with possible sarcopenia. The prevalence of possible sarcopenia based on the AWGS 2019 criteria was 2.9% among 65-year-olds in Japan, with affected individuals more likely to be frail compared with those without this condition. Geriatr Gerontol Int 2021; 21: 689-696.

The objective of this study was to evaluate the correlation between sarcopenia and transthyretin levels among community-dwelling older adults in Padang. This study employed a cross-sectional design and included 45 community-dwelling individuals aged 60 years and above who visited Andalas Primary Health Care in Padang, West Sumatra, Indonesia. Characteristics of sociodemographic and lifestyle habits were collected using a general questionnaire. Sarcopenia was defined in accordance with the criteria set forth by the Asian Working Group for Sarcopenia (AWGS) criteria encompass three components: low muscle mass, as determined by an index of appendicular skeletal mass/height2 less than 7,0 kg/m2 for males and less than 5,7 kg/m2 for females; low physical performance, as indicated by a gait speed less than 1,0 m/s; low muscle strength, defined as handgrip strength less than 26 kg for males and less than 18 kg for females. Accordingly, sarcopenia was defined as the presence of low muscle mass in conjunction with low physical performance and/or low muscle strength. Transthyretin levels were considered as independent variables in order to evaluate the potential correlation between transthyretin and sarcopenia status using bivariate analysis. The overall prevalence of sarcopenia was 51.1%, with four cases (40%) observed in males and 19 cases (54.3%) in females classified as having sarcopenia. The prevalence of sarcopenia was significantly lower among participants with normal nutritional status. A comparison of the participants with and without sarcopenia revealed that the former exhibited higher levels of transthyretin (p = 0,000).

BackgroundThe aim of the present study was to validate the usefulness of the new octapolar multifrequency bioelectrical impedance analysis (BIA) for assessment of appendicular skeletal muscle mass (ASM) by comparing it with that of dual-energy X-ray absorptiometry (DXA) and to investigate the prevalence of sarcopenia in Chinese community-dwelling elderly according to Asian Working Group for Sarcopenia (AWGS) definition.MethodsA cross-sectional study was conducted in communities of Chengdu, China. A total of 944 community-dwelling elderly adults aged ≥60 years were included. ASM was measured by using DXA as a criterion method to validate a standing eight-electrode multifrequency BIA (InBody 720), followed by a further estimation of the prevalence of sarcopenia according the AWGS definition.ResultsIn the Bland-Altman analysis, no significant difference was found between DXA and BIA based on the ASM measurements. The prevalence of AWGS-defined sarcopenia was 12.5% in the elderly women and 8.2% in the elderly men.ConclusionsBIA is suitable for body composition monitoring (ASM) in elderly Chinese as a fast, noninvasive, and convenient method; therefore, it may be a better choice in large epidemiological studies in the Chinese population. The prevalence of AWGS-defined sarcopenia was approximately 10.4% and increased with age in the Chinese community-dwelling elderly in this study.

Background and Aim: To determine the protein intake associated with the prevalence of sarcopenia, we conducted a cross-sectional study of 1251 community-dwelling older Japanese aged 60 years and older. Methods: The mean age of the participants was 68.8 years, and the percentage of women was 56.7%. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 by low muscle mass (skeletal muscle mass), muscle strength (grip strength), and physical performance (gait speed). Protein and energy intake were assessed using a food frequency questionnaire (FFQ). Logistic regression models were used to estimate the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs) of the prevalence of sarcopenia according to gender-specific tertiles of protein intake as a percentage of total energy. Corresponding analyses were done also for protein intake per day and for protein intake per kg of body weight, separately, instead of protein intake as a percentage of total energy. Results: The prevalence of sarcopenia was 8.0% (100/1251). The median protein intake as a percentage of total energy, protein intake per day, and protein intake per body weight by gender were, in order, 11.8%E, 59.2 g/day, and 0.9 g/kg/day for males and 14.1%E, 54.7 g/day, and 1.0 g/kg/day for females. Since there was no gender interaction in the association between each protein intake and the prevalence of sarcopenia, we performed the analysis for males and females combined. The multivariable adjusted ORs (95%CI) of the prevalence of sarcopenia was lower in the high protein intake as a percentage of total energy (&gt;12.6%E in males and &gt;15.2%E in females, respectively) group (0.47 (0.27-0.83)) than in the low intake (&lt;11.1%E in males and &lt;13.4%E in females, respectively) group; the linear trend was significant (p =0.009). Similarly, we found a significantly inverse association for sarcopenia prevalence at protein intakes higher than 54.4 g/day for males and 50.6 g/day for females, compared to those with lower intakes. However, there was no association between protein intake per body weight and the prevalence of sarcopenia. We obtained similar results when the participants were restricted to those 65 years and older as a sensitivity analysis. Conclusion: Significant inverse associations were found between the prevalence of sarcopenia and protein intake in community-dwelling older Japanese. However, we should consider that protein intake assessed by the FFQ is often underestimated when discussing absolute protein intake for sarcopenia prevention.

Prognostic implication of sarcopenia diagnosed by updated Asian Working Group for Sarcopenia criteria in older patients with heart failure: utility and limitation