Age-related Loss Of Muscle Mass Research Articles

Exercise-induced gene expression changes in skeletal muscle of old mice

Exercise is believed to be beneficial for skeletal muscle functions across all ages. Regimented exercise is often prescribed as an effective treatment/prophylaxis for age-related loss of muscle mass and function, known as sarcopenia, and plays an important role in the maintenance of mobility and functional independence in the elderly. However, response to exercise declines with aging, resulting in limited gain of muscle strength and endurance. These changes likely reflect age-dependent alterations in transcriptional response underlying the muscular adaptation to exercise. The exact changes in gene expression accompanying exercise, however, are largely unknown, and elucidating them is of a great clinical interest for understanding and optimizing the exercise-based therapies for sarcopenia.In order to characterize the exercise-induced transcriptomic changes in aged muscle, a paired-end RNA sequencing was performed on rRNA-depleted total RNA extracted from the gastrocnemius muscles of 24 months-old mice after 8 weeks of regimented exercise (exercise group) or no formal exercise program (sedentary group).Differential gene expression analysis of aged skeletal muscle revealed upregulations in the group of genes involved in neurotransmission and neuroexcitation, as well as equally notable absence of anabolic gene upregulations in the exercise group. In particular, genes encoding the transporters and receptor components of glutaminergic transmission were significantly upregulated in exercised muscles, as exemplified by Gria 1, Gria 2 and Grin2c encoding glutamate receptor 1, 2 and 2C respectively, Grin1 and Grin2b encoding N-methyl-d-aspartate receptors (NMDARs), Nptx1 responsible for glutaminergic receptor clustering, and Slc1a2 and Slc17a7 regulating synaptic uptake of glutamate. These changes were accompanied by an increase in the post-synaptic density of NMDARs and acetylcholine receptors (AChRs), as well as their innervation at neuromuscular junctions (NMJs).These results suggest that neural responses predominate the adaptive response of aged skeletal muscle to exercise, and indicate a possibility that glutaminergic transmission at NMJs may be present and responsible for synaptic protection and neural remodeling accompanying the exercise-induced functional enhancement in aged skeletal muscle. In addition, the absence of upregulations in the anabolic pathways highlights them as the area of potential pharmacological targeting for optimizing exercise-led sarcopenia therapy.

Late-onset neuromuscular disorders in the differential diagnosis of sarcopenia

BackgroundSarcopenia is the age-related loss of muscle mass and strength. Undiagnosed late-onset neuromuscular disorders need to be considered in the differential diagnosis of sarcopenia.AimBased on emblematic case reports and current neuromuscular diagnostic guidelines for three common late-onset neuromuscular disorders, a differential diagnostic approach for geriatric patients presenting with a sarcopenic phenotype is given.MethodsPatients over 65 years of age with sarcopenia, amyotrophic lateral sclerosis, inclusion body myositis and myotonic dystrophy type 2 were recruited. All patients were assessed for sarcopenia based on the revised European consensus definition. Patients with neuromuscular diseases were diagnosed according to the revised El Escorial criteria and the European neuromuscular centre criteria. Phenotypes and diagnostic criteria for all patients were summarized including their specific histopathological findings.ResultsAll patients with neuromuscular diseases were positively screened for sarcopenia and classified as severe sarcopenic by means of assessment. The clinical phenotype, the evolution pattern of weakness and muscle atrophy combined with laboratory finding including electromyography could unquestionably distinguish the diseases.DiscussionNeuromuscular disorders can manifest beyond the age of 65 years and misdiagnosed as sarcopenia. The most common diseases are inclusion body myositis, amyotrophic lateral sclerosis and myotonic dystrophy type 2. A diagnostic work-up for neuromuscular diseases ensures their correct diagnosis by clinical-, electrophysiological, histopathological, and genetic work-up.ConclusionsIn geriatric patients with a focal or asymmetrical muscular weakness and atrophy, sarcopenia assessment should be extended with patient’s history of disease course. Furthermore, concomitant diseases, analysis of serum creatine kinase, electrophysiological examination, and in selected patients muscle biopsy and gene analysis is needed to rule out a late-onset neuromuscular disorder.

Quadriceps muscle power and optimal shortening velocity are inversely related to angiotensin converting enzyme activity in older men.

Background: Methods which potentially could prevent age-related loss of muscle mass and function are still being sought. There are various attempts to use pharmacological agents to prevent loss of muscle mass, but the effectiveness of many of them still needs to be confirmed. One of the promising therapeutics are Angiotensin Converting Enzyme Inhibitors (ACEIs) and lowering of serum ACE activity. The goal of this study was to assess if taking Angiotensin Converting Enzyme Inhibitors (ACEI) and other angiotensin system blocking medications (ASBMs) can modify muscle performance in older men as well as to assess the association of serum ACE activity with muscle strength, power, muscle contraction velocity and functional performance. Methods: Seventy-nine older men took part in the study. Muscle function was assessed with hand grip strength, maximum power relative to body mass (Pmax) and optimal shortening velocity (Ʋopt) of the knee extensor muscles. Anthropometric data, ACE activity and functional performance were also measured. Results: Negative correlations between ACE activity and Pmax (rho=-0.29, p=0.04) as well as Ʋopt (rho=-0.31, p=0.03) in a group of patients not taking ACEI and between ACE activity and Ʋopt (rho=-0.22, p=0.05) in the whole group of men were found. Positive relationship between age and ACE activity was demonstrated (rho=0.26, p=0.02). Age was the only selected variable in the multiple regression analyses to determine both Pmax and Ʋopt. Conclusions: Serum ACE activity negatively associates to muscle power and muscle contraction velocity. The issues related to the impact of taking ACEI on the maintenance of muscle function and functional performance in older man require further studies.

Human muscle stem cells are refractory to aging.

Age‐related loss of muscle mass and strength is widely attributed to limitation in the capacity of muscle resident satellite cells to perform their myogenic function. This idea contains two notions that have not been comprehensively evaluated by experiment. First, it entails the idea that we damage and lose substantial amounts of muscle in the course of our normal daily activities. Second, it suggests that mechanisms of muscle repair are in some way exhausted, thus limiting muscle regeneration. A third potential option is that the aged environment becomes inimical to the conduct of muscle regeneration. In the present study, we used our established model of human muscle xenografting to test whether muscle samples taken from cadavers, of a range of ages, maintained their myogenic potential after being transplanted into immunodeficient mice. We find no measurable difference in regeneration across the range of ages investigated up to 78 years of age. Moreover, we report that satellite cells maintained their myogenic capacity even when muscles were grafted 11 days postmortem in our model. We conclude that the loss of muscle mass with increasing age is not attributable to any intrinsic loss of myogenicity and is most likely a reflection of progressive and detrimental changes in the muscle microenvironment such as to disfavor the myogenic function of these cells.

Higher Protein Intake Does Not Augment Muscle Protein Synthetic Responses During the Early Stages of Resistance Training in Middle-Aged Adults

Abstract Objectives Dietary protein intake augments muscle protein synthesis rates during acute recovery from resistance exercise training (RET) and can help offset age-related loss in muscle mass. Skeletal muscle tissue contains a variety of different protein pools such as myofibrillar (contractile), mitochondrial (substrate oxidation), and collagen (structural support) proteins that have been reported to have different contraction and nutrient sensitivities in controlled laboratory studies. However, no study has investigated the impact of dietary protein intake on the synthesis of these specific muscle proteins fractions during RET in a free-living setting. Therefore, we investigated the effect of dietary protein intake on daily muscle protein synthesis rates (PS) within the myofibrillar (MyoPS), mitochondrial (MitoPS), and collagen (CPS) protein fractions throughout the early phase (0 – 3 wks) of RET in middle-aged adults. Methods Twenty middle-aged adults (47 ± 1 y, BMI 28 ± 1 kg/m2, M = 12, F = 8) were stratified and randomized to consume either moderate (MOD; 1.06 ± 0.22 g/kg/d) or high (HI; 1.55 ± 0.25 g/kg/d) amounts of protein during a dietary counseling-controlled resistance training program. On day 0, participants ingested intermittent boluses of deuterated (2H) water followed by daily maintenance doses throughout the study period. Muscle biopsies were collected prior to and at weeks 1, 2, and 3 of the intervention to assess MyoPS, MitoPS, and CPS by LC/MS. Results MitoPS decreased at 0–3 wks when compared to 0–1 wks (P = 0.010, CI: −0.77 – −0.10%/d) regardless of group (HI: 0.64 ± 0.32%/d and MOD 0.86 ± 0.55%/d; P = 0.827). A similar decline was also observed for CPS (group P = 0.323; time P = 0.007). The MyoPS in the HI condition remained constant (0–1 wk: 0.81 ± 0.42%/d and 0–3 wks: 0.81 ± 0.72%/d, P = 1.0), but MOD decreased over time (0–1 wk: 1.35 ± 0.9%/d and 0–3 wks: 0.77 ± 0.43%/d, P = 0.023). Conclusions Our results demonstrated that additional protein intake above moderate amounts does not meaningfully potentiate the stimulation of longer-term muscle protein synthetic responses within the myofibrillar, mitochondrial, or collagen protein fractions during the early stages of a RET in middle-aged adults. Funding Sources Funded in part by the Beef Checkoff. AFS funded by CAPES Scholarship.

The Impact of Whey Protein and/or Omega-3 Fatty Acid Supplementation on Body Composition, Energy Expenditure and Metabolic Health in Postmenopausal Women (SHAPE Study)

Abstract Objectives Age-related deleterious shifts in body composition can lead to sarcopenia, which is the age-related loss of muscle mass, strength, and function. Furthermore, declines in endogenous estrogen production during the menopausal transition are associated with muscle mass loss and increased central adiposity, putting postmenopausal women at increased risk for negative health outcomes such as cardiovascular disease and type-2 diabetes mellitus. The objective of this study was to determine the effect of protein and/or omega-3 fatty acid (O3FA) supplementation on metabolic health in postmenopausal women. Methods Thirty-nine postmenopausal women (age: 61.3 ± 8.7 years; BMI: 27.6 ± 6.6 kg/m2) were randomly allocated to one of 5 groups: 1) control (CON; no intervention free-living; n = 6), 2) whey protein isolate (PRO; 25 g/d; n = 7), 3) O3FA (DHA/EPA; 4.3 g/d; n = 10), 4) PRO + placebo soybean oil (PRO + PLA; 4.1 g/d; n = 7), or 5) PRO + O3FA (n = 9). Energy expenditure via indirect calorimetry, dietary intake via 3-day weighed dietary records, hand grip strength (HGS), and metabolic health were assessed at 0, 4, 8, 12, and 16 weeks. Body composition was measured via dual x-ray absorptiometry at 0 and 16 weeks. Metabolic health was assessed using waist-to-hip ratio and biomarkers such as plasma glucose, insulin, free fatty acids, and cholesterol. Results There was not an effect of treatment effect on anthropometrics, body composition, HGS, or resting energy expenditure. However, a decrease in android fat % was observed in PRO compared to baseline (P < 0.05) in the absence of anthropometric change (BMI, weight, waist, hip). A significant group by time effect was observed on resting fat oxidation (P < 0.05); O3FAs (+34.6%; P < 0.05) and PRO + O3FAs (+55.6%; P < 0.05) significantly increased and PRO decreased (−37.8%; P < 0.05) from baseline to 16 weeks. There was a significant (P < 0.05) decrease in cholesterol in all groups compared to CON. Conclusions Although not significant, the data suggests individual and combined supplementation of protein and O3FA have the potential to improve body composition and substrate oxidation in postmenopausal women. NCT0303041 Funding Sources Arkansas Biosciences Institute

Quadriceps muscle power and optimal shortening velocity are inversely related to angiotensin converting enzyme activity in older men

Background: Methods which potentially could prevent age-related loss of muscle mass and function are still being sought. There are various attempts to use pharmacological agents to prevent loss of muscle mass, but the effectiveness of many of them still needs to be confirmed. One of the promising therapeutics are Angiotensin Converting Enzyme Inhibitors (ACEIs) and lowering of serum ACE activity. The goal of this study was to assess if taking Angiotensin Converting Enzyme Inhibitors (ACEI) and other angiotensin system blocking medications (ASBMs) can modify muscle performance in older men as well as to assess the association of serum ACE activity with muscle strength, power, muscle contraction velocity and functional performance. Methods: Seventy-nine older men took part in the study. Muscle function was assessed with hand grip strength, maximum power relative to body mass (Pmax) and optimal shortening velocity (Ʋopt) of the knee extensor muscles. Anthropometric data, ACE activity and functional performance were also measured. Results: Negative correlations between ACE activity and Pmax (rho=-0.29, p=0.04) as well as Ʋopt (rho=-0.31, p=0.03) in a group of patients not taking ACEI and between ACE activity and Ʋopt (rho=-0.22, p=0.05) in the whole group of men were found. Positive relationship between age and ACE activity was demonstrated (rho=0.26, p=0.02). Age was the only selected variable in the multiple regression analyses to determine both Pmax and Ʋopt. Conclusions: Serum ACE activity negatively associates to muscle power and muscle contraction velocity. The issues related to the impact of taking ACEI on the maintenance of muscle function and functional performance in older man require further studies.

Sarcopenic Obesity and its Prognostic Impact on Urological Cancers: A Systematic Review.

Sarcopenia, an age-related loss of muscle mass and function, may predict adverse outcomes for patients with urological cancers. However, the clinical implications and significance of sarcopenic obesity are not well understood. We systematically reviewed data on the prevalence and prognostic impact of sarcopenic obesity for patients with renal cell carcinoma, urothelial carcinoma and prostate cancer undergoing treatment. We searched EMBASE®, PubMed®/MEDLINE® and Scopus® for relevant original articles and abstracts published between January 2010 and February 2021. Primary outcomes were overall survival (OS), cancer-specific survival (CSS) and progression-free survival. The secondary outcome was the prevalence of sarcopenic obesity. A total of 15 studies comprising 3,866 patients were included. Of the 10 studies that evaluated survival outcomes, the association between sarcopenic obesity and survival was mixed. One of 10 studies showed a significant association of sarcopenic obesity with OS (HR 0.7, 95% CI 0.51-0.98; p=0.04). One additional study showed reported a trend for shorter OS (p=0.05) associated with sarcopenic obesity. Others reported that it is an adverse prognostic factor for CSS (HR 5.0, 95% CI 1.4-16.7; p=0.01). All other studies did not demonstrate that sarcopenic obesity was of prognostic relevance with regard to OS, CSS and progression-free survival. Overall, its mean prevalence was 27% (range 11-63). There is considerable heterogeneity in methods used to define sarcopenic obesity in the literature, and current data are limited. Future studies are needed to further understand the relationship of obesity and sarcopenia on the clinical trajectory of patients with urological cancer.

The impact of quadriceps disuse atrophy on motor unit properties

Disuse atrophy describes the reduction in skeletal muscle mass and strength accompanying periods of inactivity (1). This impairment is of interest in the lower limbs due to their high functional importance in activities of daily living. Similar to the age-related loss of muscle mass associated with sarcopenia, disuse atrophy has widespread impact throughout the muscle tissue, and whilst mechanisms of muscle atrophy are reasonably well described (2), data on adaptations of the peripheral neuromuscular system are scant. The aim of the current study was to explore neuromuscular changes in individual motor units (MUs) of the vastus lateralis (VL) following 15 days of whole-leg immobilisation. Intramuscular electromyography (iEMG) was performed in 8 healthy males (18-25 years) before and after 15 days of unilateral leg immobilisation. Individual MU potentials (MUPs) were sampled from near the VL motor point during isometric contractions held at 25% of maximum voluntary contraction (MVC). MUP complexity was quantified by the number of significant slope changes within the MUP template (turns), and MUP duration as the time in ms between MUP onset and offset. The non-immobilised limb served as a control. Multi-level mixed effects linear regression models were used to examine effects of the intervention, with leg and time as factors. Significance was accepted as p<0.05. MVC decreased by 30% in the immobilised leg (p<0.05) with no difference in the control leg (p=0.23). Analysis of the number of MUP turns revealed significant interaction effects between leg and time (p<0.05); the number of MUP turns increased in the immobilised leg (β = 0.442, 95% CI: 0.160 – 0.724, p<0.01), and did not differ in the control leg (p=0.861). Similarly, there was a significant interaction between leg and time point for MUP duration (p<0.05), which was greater post intervention in the immobilised leg (β = 1.349, 95% CI: 0.72 – 1.97, p<0.001), and did not differ in the control leg (p=0.183). The increased MUP complexity and duration in the immobilised leg can be caused by increased electrophysiological temporal dispersion across MU fibres, which in turn can be related to increased differences in conduction times along axonal branches and/or MU fibres. These findings therefore indicate that short-term immobilisation of large limb muscles can exert notable effects on MU morphology and electrophysiology. Clinical pre-/rehabilitation regimes targeting disuse atrophy should also aim to specifically target peripheral motor nerves to mitigate the MU changes shown to occur following periods of disuse, potentially facilitating enhanced improvements in functional outcomes. 1. Rudrappa SS et al, J. Front Physiol. 2016;7(AUG):1–10. 2. Brook MS et al, J. Curr Opin Clin Nutr Metab Care. 2017;20(6):433–9.

Hip fracture and sarcopenia: the need for a new paradigm in drug trials for older adults?

Long-term outcomes after hip fracture remain poor. Many patients never recover their pre-fracture mobility and many patients require additional care. Sarcopenia, the age-related loss of muscle mass and strength,1 is common in people who sustain hip fracture and is a major contributor to poor outcomes. Treating sarcopenia in patients with hip fracture is therefore a logical therapeutic strategy to improve physical function and quality of life in this vulnerable group of patients. Although resistance exercise training is an effective intervention for sarcopenia,2 not all patients are able or willing to do this type of training.

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review.

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health.

Background: Sarcopenia is defined as a progressive age-related loss in muscle mass and strength affecting physical performance. It is associated with many negative outcomes including falls, disability, cognitive decline, and mortality. Protein enriched diet and resistance training have shown to improve muscle strength and function but there is limited evidence on impact of dual-task exercise in possible sarcopenia.Objective: To evaluate impact of community-based dual-task exercise on muscle strength and physical function in possible sarcopenia defined by either slow gait (SG) or poor handgrip strength (HGS). The secondary aims include effect on cognition, frailty, falls, social isolation, and perceived health.Methods: Community-dwelling older adults ≥60 years old were recruited from screening program intended to identify seniors at risk, and invited to participate in dual-task exercise program called HAPPY (Healthy Aging Promotion Program for You). One hundred and eleven participants with possible sarcopenia completed 3 months follow-up. Questionnaire was administered on demographics, frailty, sarcopenia, falls, perceived health, social network, functional, and cognitive status. Physical performance included assessment of HGS, gait speed, and Short Physical Performance Battery test (SPPB).Results: The mean age of the Exercise group was 75.9 years old and 73.0% were women. The Exercise group had more female (73.0 vs. 47.5%), were older (75.9 vs. 72.5 years old), had higher prevalence of falls (32.4 vs. 15.0%), lower BMI (23.7 vs. 25.8), and education (4.0 vs. 7.2 years). The gait speed of the Exercise group increased significantly with significant reduction in the prevalence of SG and poor HGS. All components of SPPB as well as the total score increased significantly while the prevalence of pre-frailty and falls dropped by half. The risk of social isolation reduced by 25% with significant improvement in perceived health and cognition in the Exercise group. Significant impact on improvement gait speed and SPPB persisted after adjustment for baseline factors.Conclusion: Dual-task exercise program is effective in improving gait speed, SPPB score, and reducing the prevalence of poor HGS with significant improvement in perceived health, cognition, and reduction in falls and frailty. Future prospective randomized control trials are needed to evaluate the effectiveness of dual-task interventions in reversing sarcopenia.

Consumption of chilies and sweet peppers is associated with lower risk of sarcopenia in older adults.

Background: Sarcopenia is an aging-related loss of muscle mass and function, which induces numerous adverse outcomes. Capsaicin and capsiate, separately extracted from chilies and sweet peppers, have the potential to induce muscle hypertrophy via activation of transient receptor potential vanilloid 1. The present study aimed to investigate whether chili and sweet pepper consumption are related to sarcopenia in the elderly general population.Methods: A cross-sectional study with 2,451 participants was performed. Dietary chili and sweet pepper consumption were assessed using a validated self-administered food frequency questionnaire. Sarcopenia was defined according to the consensus of the Asian Working Group for Sarcopenia. Logistic regressions were performed to measure the effect of chili and sweet pepper consumption on sarcopenia.Results: The prevalence of sarcopenia was 16.1%. After adjustment for potential confounding variables, the odds ratios (95% confidence intervals) for sarcopenia across chili and sweet pepper consumption categories were 1.00 (reference) for almost never, 0.73 (0.55, 0.97) and 0.73 (0.56, 0.96) for ≤1 time/week, 0.60 (0.39, 0.90) and 0.66 (0.45, 0.95) for ≥2-3 times/week (both P for trend <0.01), respectively.Conclusion: The present study showed that higher consumption of chilies and sweet peppers was related to a lower risk of sarcopenia in older adults.

Follistatin-induced muscle hypertrophy in aged mice improves neuromuscular junction innervation and function

Sarcopenia, or age-related loss of muscle mass and strength, is an important contributor to loss of physical function in older adults. The pathogenesis of sarcopenia is likely multifactorial, but recently the role of neurological degeneration, such as motor unit loss, has received increased attention. Here, we investigated the longitudinal effects of muscle hypertrophy (via overexpression of human follistatin, a myostatin antagonist) on neuromuscular integrity in C57BL/6J mice between the ages of 24 and 27 months. Following follistatin overexpression (delivered via self-complementary adeno-associated virus subtype 9 injection), muscle weight and torque production were significantly improved. Follistatin treatment resulted in improvements of neuromuscular junction innervation and transmission but had no impact on age-related losses of motor units. These studies demonstrate that follistatin overexpression-induced muscle hypertrophy not only increased muscle weight and torque production but also countered age-related degeneration at the neuromuscular junction in mice.

Quadriceps muscle power and optimal shortening velocity are inversely related to angiotensin converting enzyme activity in older men

Background: Methods which potentially could prevent age-related loss of muscle mass and function are still being sought. There are various attempts to use pharmacological agents to prevent loss of muscle mass, but the effectiveness of many of them still needs to be confirmed. One of the promising therapeutics are Angiotensin Converting Enzyme Inhibitors (ACEIs) and lowering of serum ACE activity. The goal of this study was to assess if taking Angiotensin Converting Enzyme Inhibitors (ACEI) and other angiotensin system blocking medications (ASBMs) can modify muscle performance in older men as well as to assess the association of serum ACE activity with muscle strength, power, muscle contraction velocity and functional performance. Methods: Seventy-nine older men took part in the study. Muscle function was assessed with hand grip strength, maximum power relative to body mass (Pmax) and optimal shortening velocity (Ʋopt) of the knee extensor muscles. Anthropometric data, ACE activity and functional performance were also measured. Results: Negative correlations between ACE activity and Pmax (rho=-0.29, p=0.04) as well as Ʋopt (rho=-0.31, p=0.03) in a group of patients not taking ACEI and between ACE activity and Ʋopt (rho=-0.22, p=0.05) in the whole group of men were found. Positive relationship between age and ACE activity was demonstrated (rho=0.26, p=0.02). Age was the only selected variable in the multiple regression analyses to determine both Pmax and Ʋopt. Conclusions: Taking ACEI is not associated with a functional performance in older men of the same age and with the same anthropometric parameters. Serum ACE activity negatively associates to muscle power and muscle contraction velocity.

Development of age-related loss of muscle mass and function – role of oxidative DNA damage repair systems

Development of age-related loss of muscle mass and function – role of oxidative DNA damage repair systems

Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People

Introduction: The respiratory muscle strength regulates the effectiveness of coughing, which clears the airways and protects people from pneumonia. Sarcopenia is an aging-related loss of muscle mass and function, the worsening of which is associated with malnutrition. The loss of respiratory and swallowing muscle strength occurs with aging, but its effect on pneumonia is unclear. This study aimed to determine the risks of respiratory muscle weakness on the onset and relapse of pneumonia in older people in conjunction with other muscle-related factors such as malnutrition. Methods: We conducted a longitudinal study with 47 pneumonia inpatients and 35 non-pneumonia controls aged 70 years and older. We evaluated the strength of respiratory and swallowing muscles, muscle mass, and malnutrition (assessed by serum albumin levels and somatic fat) during admission and confirmed pneumonia relapse within 6 months. The maximal inspiratory and expiratory pressures determined the respiratory muscle strength. Swallowing muscle strength was evaluated by tongue pressure. Bioelectrical impedance analysis was used to evaluate the muscle and fat mass. Results: The respiratory muscle strength, body trunk muscle mass, serum albumin level, somatic fat mass, and tongue pressure were significantly lower in pneumonia patients than in controls. Risk factors for the onset of pneumonia were low inspiratory respiratory muscle strength (odds ratio [OR], 6.85; 95% confidence interval [CI], 1.56–30.11), low body trunk muscle mass divided by height2 (OR, 6.86; 95% CI, 1.49–31.65), and low serum albumin level (OR, 5.46; 95% CI, 1.51–19.79). For the relapse of pneumonia, low somatic fat mass divided by height2 was a risk factor (OR, 20.10; 95% CI, 2.10–192.42). Discussion/Conclusions: Respiratory muscle weakness, lower body trunk muscle mass, and malnutrition were risk factors for the onset of pneumonia in older people. For the relapse of pneumonia, malnutrition was a risk factor.

Influence of Age and Individual Differences on Mouthfeel Perception of Whey Protein-Fortified Products: A Review.

Protein needs are considered to increase with age, with protein consumption being associated with many positive outcomes. Protein-fortified products are often used to improve nutritional status and prevent age-related muscle mass loss in older adults. Accordingly, older adults are commonly provided with products fortified with whey protein; however, such products can cause mouthdrying, limiting consumption and product enjoyment. Currently, the extent to which age and individual differences (e.g., saliva, oral health, food oral processing) influence the perception of whey protein-derived mouthdrying is relatively unclear. Previous research in this area has mainly focused on investigating mouthdrying, without taking into account individual differences that could influence this perception within the target population. Therefore, the main focus of this review is to provide an overview of the relevant individual differences likely to influence mouthfeel perception (specifically mouthdrying) from whey protein-fortified products, thereby enabling the future design of such products to incorporate better the needs of older adults and improve their nutritional status. This review concludes that age and individual differences are likely to influence mouthdrying sensations from whey protein-fortified products. Future research should focus more on the target population and individual differences to maximise the benefits from whey protein fortification.

Alterations of macrophage and neutrophil content in skeletal muscle of aged versus young mice.

BackgroundSkeletal muscle inflammation and oxidative stress are associated with aging‐related loss of muscle mass and may be attributable to alterations in the number and types of leukocytes in skeletal muscle. Here, we tested the hypothesis that aging changes the number and composition of leukocyte subsets in skeletal muscle tissue.MethodsSkeletal muscle was sampled from 4‐mo‐old (young) and 27‐mo‐old (old) C57BL/6J mice. Mononuclear cells of the gastrocnemius muscle were isolated, and flow cytometry was used to characterize the number and types of immune cells.ResultsThe number of neutrophils and Ly‐6C+ inflammatory macrophages in the skeletal muscle was significantly higher in old mice than in young mice. Inflammation and oxidative stress (measured using the markers phosphorylated JNK and nitrotyrosine) were also higher in the skeletal muscle of old mice than in that of young mice.ConclusionsIncreasing age promotes skeletal muscle inflammation and oxidative stress, as well as infiltration of inflammatory macrophages and neutrophils.

Diagnosing sarcopenia: Functional perspectives and a new algorithm from the ISarcoPRM.

Sarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. It is a precursor of physical frailty, mobility limitation, and premature death. Muscle loss is mainly due to the loss of type II muscle fibres, and progressive loss of motor neurones is thought to be the primary underlying factor. Anterior thigh muscles undergo atrophy earlier, and the loss of anterior thigh muscle function may therefore be an antecedent finding. The aim of this review is to provide an in-depth (and holistic) neuromusculoskeletal approach to sarcopenia. In addition, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), a novel diagnostic algorithm is proposed, developed with the consensus of experts in the special interest group on sarcopenia (ISarcoPRM). The advantages of this algorithm over the others are: special caution concerning disorders related to the renin-angiotensin system at the case finding stage; emphasis on anterior thigh muscle mass and function loss; incorporation of ultrasound for the first time to measure the anterior thigh muscle; and addition of a chair stand test as a power/performance test to assess anterior thigh muscle function. Refining and testing the algorithm remains a priority for future research. LAY ABSTRACTSarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. The diagnostic recommendations published to date have addressed total or appendicular muscle mass. However, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), experts in the special interest group on sarcopenia (ISarcoPRM) developed a new algorithm, based on regional measurements and functional evaluations of the anterior thigh muscle, which is the most commonly and initially affected condition in sarcopenia. Unlike other suggestions, diseases associated with the renin-angiotensin system are emphasized in this algorithm, and ultrasound has been used for measurement of anterior thigh muscle mass.