European Working Group On Sarcopenia In Older People Research Articles

Sarcopenia in older people with multiple sclerosis: A cross-sectional study

BackgroundOlder people with multiple sclerosis (pwMS) make up over one-third of the MS population. Ageing increases the risk of sarcopenia, characterised by reduced muscle mass, strength, and function. MS symptoms likely exacerbate sarcopenia, but its impact on older pwMS remains largely unexplored ObjectivesThe primary aim of this study was to investigate how the diagnosis of sarcopenia using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) diagnostic tool in older pwMS is influenced by using upper extremity-based or lower extremity-based tests. MethodsThe present cross-sectional study analysed baseline data from the PoTOMS trial. A total of n = 41 older pwMS and n = 27 healthy controls (HC) were included. Participants were assessed for sarcopenia using the EWGSOP2 diagnostic tools and a lower extremity muscle strength test. ResultsOlder pwMS had a preferentially lower muscle mass and strength in the lower extremities compared to HC. According to EWGSOP2 criteria, 5 % of older pwMS had reduced upper extremity strength, 7 % had reduced lower extremity strength, and 15 % had sarcopenic muscle mass. However, only 5 % were diagnosed with sarcopenia despite these reductions. ConclusionThe present study shows that the sarcopenia diagnosis in older pwMS is more sensitive when using a lower extremity test, underlined by the preferentially lower muscle mass and strength in older pwMS compared to HC. Hence, when evaluating sarcopenia in older pwMS the diagnostics test should rely on the lower extremity test.

Functional status of the cardiovascular system in elderly patients with sarcopenia

Sarcopenia is a pathological condition found in elderly patients that impairs their quality of life and increases the risks of disability. Objective. To assess the functional state of the cardiovascular system in elderly patients with sarcopenia. Materials and methods. The main group included patients with sarcopenia diagnosed according to the criteria of EWGSOP-2 (European Working Group on Sarcopenia in Older People 2) supplemented by the screening questionnaire SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls). The state of the cardiovascular system was assessed based on the results of ECG, echocardiography and duplex examination of vessels at rest. Results. The features of the functional state of the cardiovascular system in sarcopenia were determined, which manifested themselves in the form of impaired repolarization processes and arrhythmic dysfunction, lower parameters of cerebral perfusion, and the presence of an early sign of latent heart failure. Conclusions. The treatment of cardiovascular diseases in the elderly population requires special attention due to the polymorbidity of patients and sarcopenia should be taken into account, among other things, as a factor affecting the state of the cardiovascular system.

Genetic Influence of the Brain on Muscle Structure: A Mendelian Randomization Study of Sarcopenia.

The association between brain and sarcopenia has not been clarified. We aim to investigate the causal association between brain structure, function, gene expression and sarcopenia-related traits. All participants were Europeans. GWAS data of Brain Imaging Data Structure (BIDs) was from the UK Biobank. Gene expression in 13 brain regions was acquired from the GTEx Consortium. The sarcopenia-related traits, including appendicular lean mass (ALM), whole body lean mass (WBLM), grip strength and sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People (EWGSOP) or Foundation for the National Institutes of Health (FNIH), were from the IEU website. The inverse variance weighted (IVW), MR Egger, weighted median, weighted mode and Wald ratio methods were used for a two-sample Mendelian randomization (MR) analysis between brain structures and sarcopenia-related traits. The summary-data-based MR (SMR) was used to investigate brain genes causally influencing sarcopenia. We calculated the F-value, odds ratio with 95% CI and p-value. For the sensitivity analysis, the heterogeneity I2 statistic, Cochrane's Q test, Egger's intercept test, MR-PRESSO and the leave-one-out sensitivity test were used. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, protein-protein interaction (PPI), transcription factor interaction prediction and miRNA interaction prediction analysis were used to reveal potential signalling pathways and mechanisms. We included 3144 imaging phenotypes from 8428 participants in BIDs data. One hundred forty-one BIDs were identified to causally influence ALM, 160 BIDs showed significant causal effect on the WBLM, and 86 BIDs showed significant causal effect on grip strength. There were 48 or 32 BIDs causally associated with sarcopenia diagnosed by the EWGSOP or FNIH criteria respectively. After FDR correction, there were 35 BIDs showing causal effect on the ALM, 28 BIDs showing causal effect on the WBLM and 7 BIDs showing causal effect on grip strength (p < 0.05). Twelve to forty-eight genes in different brain regions showed causal effect on all the five sarcopenia-related traits. MMP24-AS1, HLA-DRB6, HLA-DQA2, DDX42, BAG6, NUSAP1, LINC00940, NME1-NME2 and AS3MT in the amygdala region showed detrimental effect on all the five sarcopenia-related traits, whereas HLA-DRB1, HLA-DQB1-AS1 and C6ORF3 showed protective effect (p < 0.05). The gene enrichment analysis indicated these screened genes was mainly enriched in immune-related signalling. We discovered the causal effect of BIDs and brain gene expression on sarcopenia. The positive genes were mainly enriched in immune-related signalling, suggesting an immune-based cross-organ regulation mechanism of brain-muscle axis.

Assessment of muscle strength in elderly as a screening method for sarcopenia in primary care: a scoping review

ObjectivesTo identify and map the available evidence for whether a test of handgrip strength (HGS) and/or the chair stand test (CST) have been used as screening tools for the detection...

Anthropometric equation has sufficient diagnostic capacity to identify sarcopenia in women with breast cancer

BackgroundSarcopenia is a common condition in women with breast cancer, however still presents limitations for an effective diagnosis. This study aimed to evaluate the agreement and diagnostic accuracy of an anthropometric equation in diagnosing sarcopenia in women with breast cancer based on different constructs.MethodsCross-sectional study carried out with women with breast cancer aged ≥ 20 years. Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was obtained by the handgrip strength test (HGS) and muscle mass (MM) by dual-energy x-ray absorptiometry (DXA) and by the anthropometric predictive equation. For the diagnosis of sarcopenia, eight constructs were proposed based on the MM assessment method (equation or DXA) and different cutoff points. Agreement analyses using Cohen’s Kappa test and diagnostic performance measures were performed. The significance level for all tests was 5%.ResultsA total of 122 women, with a mean age of 55.3 ± 11.4 years, were evaluated. There was a predominance of brown participants (50.8%), insufficiently active (57.4%), with diagnosis time ≤ 3 months (54.1%), and with invasive breast carcinoma (69.7%). The prevalence of sarcopenia ranged from 3.3 to 8.2%, depending on the construct used. The constructs determined from the cutoff points < 16.0 kg/< 7.58 m² and < 23.0 kg/< 7.58 m² were the ones that showed the best ability to detect sarcopenia.ConclusionThe anthropometric equation showed sufficient diagnostic capacity to be used as an alternative in identifying sarcopenia in women with breast cancer.

Impact of sarcopenia and muscle strength on postoperative complication risk following pancreatic resection

Background and aimsThe association between sarcopenia and postoperative complications has been widely reported in patients with cancer. Yet, the lack of standardized population-specific diagnostic cut-off points and assessments of muscle strength is hampering prospective clinical utilization. Therefore, we aimed to examine the impact of sarcopenia, defined by both regional and international cut-off points, along with various methods of measuring skeletal muscle and muscle strength, on the risk of postoperative complications following pancreatic resection. MethodsThe present prospective observational study enrolled patients scheduled for pancreatic resection. Body composition was assessed by DXA and CT prior to surgery. We applied the algorithm and cut-off points suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as well as cut-off points from a Danish normative reference population to classify patients as sarcopenic. Physical performance was assessed by usual gait speed while muscle strength was assessed by handgrip strength, leg extensor power, and 30-second sit-to-stand. Postoperative complications within 30 days following surgery were classified according to the Clavien-Dindo classification and the American College of Surgeons National Surgical Quality Improvement Program. Complications graded ≥3 according to Clavien-Dindo were considered major complications. ResultsA total of 134 patients with a mean age of 67 years (SD: 9) were enrolled of whom most underwent pancreaticoduodenectomy (64%). Using international cut-off points, eight patients (7%) were classified as sarcopenic using CT scans and sarcopenia was associated with an increased risk of major postoperative complications (RR 2.14 [1.33-3.43]). Using DXA, four patients (3%) were classified as sarcopenic, all of whom experienced a major complication. With regional cut-off points, 16 patients (13%) were classified as sarcopenic using CT scans, but sarcopenia was not associated with major complications (RR 1.39 [0.80-2.42]). Nine patients (7%) were classified as sarcopenic using DXA, but sarcopenia was not associated with major complications (RR 1.15 [0.54-2.48]). Across the different muscle strength assessment methods, handgrip strength consistently demonstrated a stronger association with postoperative complications. ConclusionSarcopenia defined according to the EWGSOP criteria and with international cut-off points is associated with an increased risk of postoperative complications following pancreatic resection. Using regionally based cut-off points, the prevalence of sarcopenia is higher, but it does not confer a higher postoperative complication risk. The use of different muscle strength assessment methods results in vastly different estimates of prevalence of low strength and associations with postoperative outcomes.

Comparison of diagnostic accuracy of the SARC-F, SARC-CalF, and Ishii tests for diagnosis of sarcopenia in hospitalized older patients: A cross-sectional study.

Several screening tools have been developed to identify sarcopenia. However, data on the use of these screening tools in hospital settings are limited. This study assessed the diagnostic accuracy of three screening methods-strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F); SARC-F combined with calf circumference (SARC-CalF); and the Ishii tests-for detecting sarcopenia in older individuals who are hospitalized. This study included 204 older people who were hospitalized. Sarcopenia was assessed relative to the diagnostic criteria established by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Muscle mass, muscle strength, and physical performance were evaluated using bioimpedance analysis, handgrip strength, and usual gait speed, respectively. Sensitivity and specificity analyses were conducted for the SARC-F, SARC-CalF, and Ishii tests to determine their effectiveness. Receiver operating characteristics curves were generated, and the area under curve was calculated to compare the overall diagnostic accuracy of the SARC-F, SARC-CalF, and Ishii tests. The SARC-F, SARC-CalF, and Ishii tests demonstrated sensitivities of 72%, 88.6%, and 93.5%, respectively, and specificities of 41%, 78.5%, and 30.3%, respectively. SARC-CalF demonstrates the highest performance in terms of sensitivity and specificity compared with the other two tests, making it a valuable tool for detecting sarcopenia in hospital settings. In contrast, the Ishii test exhibits high sensitivity but low specificity within this population. Based on our results, we found that SARC-CalF can be used as a simple, effective test for identifying sarcopenia in older patients in the hospital setting.

Muscle Makers: Evaluating a 10-Week Strength and Nutrition Programme's Impact on Sarcopenia

Abstract Background Sarcopenia is a progressive skeletal muscle disorder characterized by loss of muscle mass and strength, leading to adverse outcomes like physical disability, poor quality of life, and death. The European Working Group on Sarcopenia in Older People (EWGSOP) identifies sarcopenia using criteria including low muscle strength, quantity, quality, and performance. This highlights the importance of early detection and intervention strategies, such as the physiotherapy-led Muscle Makers programme —a 10-week outpatient Progressive Resistance Training (PRT) program with fortnightly Clinical Nutrition input. This data collection aimed to evaluate the programme's effectiveness over a 6-month period. Methods Data was collected on all participants who attended Muscle Makers (one 1-hour session/week) between September 2023 and February 2024. Analysis included participants with both pre- and post-10-week programme outcome measures completed. Data was collected and analysed using MS Excel. Outcome Measures (OCMsused: Timed Up and Go (TUG) and 5-time sit to stand (5TST).Inclusion: Participants with both pre- and post-OCMscompletedExclusion: Participants without pre/post OCMsNon-normally distributed data was log-transformed prior to statistical testing.Results: Number of participants fitting inclusion criteria: 44 (Male: 20, Female: 24)Average age: 80.6 yearsAverage sarcopenia score (SARC F): 4.04 (probable sarcopenia)Average number of falls in the past 12 months: 1.56Average number of classes attended: 8.12 Data Results Conclusion The participants in the Muscle Makers programme achieved significant improvements in both the 5TST and TUG tests, demonstrating enhanced lower body strength, balance, and overall functional mobility. These improvements suggest that the 10-week strength and nutrition intervention effectively mitigates the effects of sarcopenia, highlighting the potential of targeted exercise and nutritional strategies in managing and potentially reversing the progression of this condition.

The clinical utility of handgrip strength as a malnutrition screening tool in hospitalized older adults: a cross-sectional study in Saudi Arabia.

Malnutrition is prevalent among hospitalized older patients. Early identification is therefore essential to implementing appropriate therapeutic interventions. This study aimed to explore the correlation between handgrip strength (HGS) and nutritional status in hospitalized older adults. This observational cross-sectional study was conducted at King Abdulaziz University Hospital, where a consecutive cohort of older adult inpatients was enrolled for participation. Shortly after admission, HGS and nutritional status were assessed using a dynamometer and the most recent version of the Mini-Nutritional Assessment Short Form (MNA-SF) test, respectively. Key anthropometric and biochemical indicators were also collected. A total of 135 consecutive patients were evaluated. Among participants with low HGS, 18 (16.22%) were malnourished, 43 (38.74%) were at risk of malnutrition, and 50 (45.05%) had normal nutrition status. The participants with low HGS had low hemoglobin, low lymphocyte levels, high creatinine levels, high BUN levels, high CRP levels, high HbA1c levels, and high vitamin B12 levels. Multiple logistic regression analysis showed that age, hemoglobin, and HbA1C were independently associated with low HGS. Based on the cut-off values for the HGS by the European Working Group on Sarcopenia in Older People-2 (EWGSOP2), low HGS showed high sensitivity to detect "malnourished and at risk of malnutrition" as well as "malnourished alone;" however, the specificity was low to exclude "malnourished and at risk of malnutrition" as well as "malnutrition alone." Age over 75 years, low hemoglobin, and elevated HbA1C levels were independent risk factors for low HGS. While HGS was sensitive in detecting malnutrition or risk, its specificity was low. Therefore, HGS may not be adequate as a standalone tool to assess nutritional status in hospitalized older adults. Replication of this study using locally reliable and validated HGS cut-off values is warranted to confirm these findings.

Circulating miR-28-5p is overexpressed in patients with sarcopenia despite long-term remission of Cushing's syndrome: a pilot study.

Patients with Cushing's syndrome (CS) in remission show sustained fatigue, myopathy, and an increased prevalence of sarcopenia. The mechanisms that determine these persistent muscle problems are not well known. We aimed to identify circulating microRNAs (miRNAs) with differential expression that could be potential biomarkers for the diagnosis and/or prognosis in CS. Thirty-six women in sustained remission for 13 ± 7 years (mean ± SD) from CS, with a median age (IQ range) of 51 (45.2-60) years and mean ± SD BMI of 27 ± 4 Kg/m2, and 36 matched healthy controls were investigated. In 7 patients sarcopenia was present according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Small RNA libraries were generated and indexed using a modified Illumina TruSeq small RNA-sequencing protocol. MiRNAs were identified in plasma using bioinformatic analysis, and validation was carried out using RT-qPCR. For the validation, Taqman probes were performed on QuantStudio 5 equipment (Applied Biosystems). In a first discovery group using RNA-sequencing, plasma samples of 18 CS patients and 18 healthy subjects were investigated; circulating miR-28-5p, miR-495-3p and miR-654-5p were upregulated in CS patients as compared with controls (p<0.05). In a validation study of the 3 upregulated miRNAs in 36 patients and 26 controls, no differences were observed by RT-qPCR; however, the expression of circulating miR-28-5p was upregulated in CS patients with sarcopenia as compared with those without (AUC for fold-change in the ROC analysis, 0.798; p=0.0156). The optimized cut-off value for miR-28-5p to identify CS patients with sarcopenia was 3.80, which yielded a sensitivity of 86% and a specificity of 69%. MiR-28-5p, a muscle-specific microRNA involved in myotube proliferation and differentiation in vivo, may serve as an independent non-invasive biomarker for identifying CS patients at high-risk of sarcopenia despite biochemical remission.

Evaluating sarcopenia prevalence and SARC-F effectiveness in elderly Spanish women with RA: a comparative study of EWGSOP criteria.

The European Working Group on Sarcopenia in Older People (EWGSOP) has put forward two key proposals for diagnosing sarcopenia: the EWGSOP1 in 2010 and the EWGSOP2 in 2019. These proposals are currently the most widely used guidelines for diagnosing sarcopenia. However, data on the prevalence of sarcopenia in patients with rheumatoid arthritis (RA) based on EWGSOP criteria are limited. This study aimed to: (a) establish the prevalence of sarcopenia in an elderly Spanish cohort of women with RA using both EWGSOP1 and EWGSOP2 criteria; and (b) evaluate the effectiveness of the SARC-F questionnaire in detecting sarcopenia. In this observational, cross-sectional study, 67 women aged over 65 years who met the ACR 2010 criteria for RA were consecutively recruited from a tertiary university hospital. Assessments included: (a) demographic and anthropometric data; (b) RA-related variables (disease history, analytical evaluation, activity, disability, quality of life); and (c) sarcopenia-related variables (muscle strength, gait speed, skeletal muscle mass, and SARC-F questionnaire). The prevalence of sarcopenia was determined using both EWGSOP1 and EWGSOP2 criteria. Furthermore, the effectiveness of the SARC-F questionnaire for detecting sarcopenia were calculated. The prevalence of sarcopenia was 43% according to the EWGSOP1 criteria and 16% according to the EWGSOP2 criteria. Patients diagnosed with sarcopenia based on the latter criteria also met the EWGSOP1's criteria for sarcopenia. Agreement between the two sets of EWGSOP criteria was poor. The SARC-F questionnaire demonstrated an inherently high sensitivity (100%) as well as good specificity (75%) and diagnostic accuracy (79%) in detecting sarcopenia according to EWGSOP2 criteria. The prevalence rate of sarcopenia among elderly Spanish women with RA varies significantly depending on whether EWGSOP1 or EWGSOP2 criteria are applied. The SARC-F questionnaire is effective for predicting sarcopenia when used in conjunction with the EWGSOP2 criteria, which is currently the most accepted standard in clinical practice.

Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults.

Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.

Association Between Sarcopenia and Functional Independence After Acute Fragility Hip Fracture at 6 Months

Purpose: The primary goal of hip fracture treatment is to allow ambulatory life as early as possible to avoid any subsequent complication after fracture. The European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia as the presence of both low muscle strength and low muscle quantity. Our purpose in this study was to identify the association between sarcopenia and functional independence after acute fragility hip fracture. Methods: Patients 50 years old or more without neurologic diseases who encountered fragility hip fracture for the first time were included. Sarcopenia was assessed using EWGSOP revised 2018 criteria. Functional independence was assessed using the Barthel Index (BI) at 6 months after injury. Data were analyzed using multiple linear regression. Results: A total of 240 patients were included; overall, 84 patients with and 156 without sarcopenia. Multiple linear regression analysis showed significant difference in BI at 6 months among those with and without sarcopenia (p&lt;0.001). Specifically, the lower limb related components of BI were decreased four points in patients with sarcopenia, which is a more statistically significant result when compared to the overall BI score. Conclusions: In this study, patients with sarcopenia were associated with functional independence impairment. Lower limb-related components of the BI must be specifically assessed in patients with hip fracture. Moreover, rehabilitation programs should be tailored to the specific needs of the patient.

Mapping the causal associations of cytokines with sarcopenia and aging traits: Evidence from bidirectional Mendelian randomization.

Cytokines and growth factors may serve as a bridge in studying the causal relationships between inflammaging and sarcopenia due to their roles in inflammaging. In this study, we aim to explore the causal association of cytokines with sarcopenia and aging traits and further identify the significant inflammation factors. Bidirectional Mendelian randomization (MR) analysis was used to identify the causality. Forty-one kinds of circulation cytokines and growth factors were set as exposures, and the data were from a summary genome-wide association study (GWAS) containing three cohorts with 8293 healthy participants of European ancestry from 1983 to 2011. Hand grip strength, adjusted appendicular lean mass (AALM), usual walking pace, moderate-to-vigorous physical activity (MVPA) levels, able to walk or cycle unaided for 10min (AWCU10) and telomere length were selected as outcomes. Data for outcomes were obtained from meta-GWAS and the UK Biobank, and sample sizes ranged from 69537 to 472174. Low hand grip strength was defined by the European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) cut-off points, respectively. Other outcome traits were defined and measured according to the UK Biobank and raw cohorts' criteria. We set two significance thresholds for single nucleotide polymorphisms (SNPs) associated with exposures to obtain adequate SNPs (5×10-6 and 5×10-8). Inverse-variance weighted, MR-Egger and weighted median were employed to estimate the causality. Twenty-seven factors were identified to relate to sarcopenia and aging traits causally, and most were associated with only one outcome trait. IL16 (interleukin-16), CTACK (cutaneous T-cell attracting chemokine), MIP1b (macrophage inflammatory protein 1b) and PDGFbb (platelet-derived growth factor BB) were proven to relate causally to at least one sarcopenia and aging trait in both analyses with two significance thresholds. IL16 was causally associated with hand grip strength (0.977 [0.956-0.998] for EWGSOP and 0.933 [0.874-0.996] for FNIH), AALM (0.991 [0.984, 0.998]), MVPA (0.997 [0.995-1.000]) and AWCU10 (1.008 [1.003-1.013]). CTACK was proven to relate causally to hand grip strength (1.013 [1.007-1.019] for EWGSOP and 1.090 [1.041-1.142] for FNIH), AWCU10 (0.990 [0.986-0.994]) and telomere length (0.998 [0.983-0.994]). The results indicated that MIP1b has a causal effect on hand grip strength (1.032 [1.001-1.063] for EWGSOP), AWCU10 (0.994 [0.988-1.000] and 0.993 [0.988-0.998]) and telomere length (1.006 [1.000-1.012]). PDGFbb may causally relate to AALM (1.016 [1.001-1.030]) and telomere length (1.011 [1.007-1.015]). Reserve MR analyses also proved their unidirectional causal effects. Twenty-seven factors were causally related to sarcopenia and aging traits, and the causal effects of IL16, CTACK, MIP1b and PDGFbb were proven in both analyses with two significance thresholds.

Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women.

To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM). This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%. A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m2 for the predictive equation and 7.66 kg/m2 for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively. The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.

Physical activity for muscle rehabilitation in sarcopenia

Background: sarcopenia is a progressive and generalized clinical condition associated with loss of mass, strength, and/or muscle function, impairing physical performance. The definition of sarco-penia is a dilemma, as several studies have been published in the last ten years by different socie-ties. One of the most used definitions is the Guideline created by the European Working Group on Sarcopenia in Older People (EWGSOP) and updated in 2019 (EWGSOP2) to facilitate the under-standing of sarcopenia and improve treatment proposals. This is the only definition supported by several international scientific societies for clinical practice and research in patients with sarcope-nia. Treatment can be divided into non-pharmacological and pharmacological. There are no spe-cific drugs approved for the treatment of sarcopenia. As for non-pharmacological interventions, physical exercise is the most effective intervention, especially resistance exercises. Nutritional in-tervention has a low level of evidence. Objectives: The objective of this article is to review data on the effect of physical exercise in the treatment of sarcopenia. Method: Reviews and systematic re-views were searched in different data sources, including PubMed, between the years 2010 and 2024, with the keywords (sarcopenia and non-pharmacological treatment; sarcopenia and exercise and sarcopenia). Conclusions: Physical exercise is the first-line treatment for sarcopenia. There is no drug released for the specific treatment of sarcopenia, and nutritional interventions have little clinical evidence in improving the quantitative and functional aspects of the muscular system in sarcopenic patients. Among the exercise modalities, resistive exercises alone showed the most sig-nificant benefit in the muscular rehabilitation of sarcopenic patients. Despite this, when evaluated with resistive exercise, aerobic and balance exercises brought additional benefits in some muscular functions. Nutritional intervention also appears to improve muscle strength when associated with resistive exercises. More studies are needed to elucidate the best physical activity program and whether other nutritional interventions could benefit the patient more.

Body composition assessment for sarcopenic obesity and 3-year mortality in older adults: A comparison study.

There is no universally accepted definition of sarcopenic obesity (SO), and its prevalence is ambiguous. This study aimed to investigate the prevalence of SO in older adults based on different definitions and determine which predicts all-cause mortality. This prospective longitudinal follow-up study included outpatients aged ≥60 years. SO was defined by sarcopenia definition based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria plus obesity. Three different methods were used to define obesity. Body mass index (BMI) ≥ 30 kg/m2, waist circumference (WC) ≥ 102 cm for men and ≥88.0 cm for women, and body fat percentage (BF%) ≥ 37.3% for men and ≥51.1% for women. Different definitions of SO and their mortality predictions were compared. The median age of the 584 patients in the study was 70.0 (interquartile range, 66.0-76.0) years. The prevalence of sarcopenia was 38.5% (47.5% in men and 35.7% in women). The prevalence of SO based on BMI, WC, and BF% was 15.3%, 16.4%, and 10.5%, respectively. The mortality rate was 6.7%. SO based on BMI (odds ratio [OR], 2.73; 95% CI, 1.12-17.9; P = 0.024) and BF% (OR, 1.43; 95% CI, 1.19-3.02; P = 0.007) were significantly associated with 3-year mortality after adjusting for the confounding variables of age, sex, and number of comorbidities. SO based on WC was not associated with mortality (OR, 0.78; 95% CI, 0.07-1.27; P = 0.104). The use of BF% and BMI for defining SO is appropriate in outpatient older adults.

Association between the sarcopenia-related traits and Parkinson's disease: A bidirectional two-sample Mendelian randomization study

ObjectiveTo explore the causal association between sarcopenia-related traits and Parkinson's disease by Mendelian randomization (MR) approach. MethodsA genome-wide association study (GWAS) of sarcopenia-related traits was done at the UK Biobank (UKB). The traits were appendicular lean mass, low hand grip strength (including the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health (FNIH) criteria and usual walking pace. The International Parkinson's Disease Genomics Consortium (IPDGC) gave us GWAS data for Parkinson's disease (PD). We used three different types of MR analyses: including Inverse-variance weighted (IVW), Mendelian randomized Egger regression (MR-Egger), and weighted median methods (both weighted and simple modes). ResultsThe MR analysis showed that low hand grip strength was negatively associated with the risk of developing Parkinson's disease, including EWGSOP criterion (odds ratio (OR) = 0.734; 95% confidence interval (CI) = 0.575–0.937, P = 0.013) and FNIH criterion (OR = 0.619; 95% CI = 0.419–0.914, P = 0.016), and usual walking pace was also a risk factor for Parkinson's disease (OR = 3.307, 95% CI = 1.277–8.565, P = 0.014). ConclusionsIn European population, low hand grip strength is negatively associated with the risk of developing Parkinson's disease, and usual walking pace is also a risk factor for Parkinson's disease. Further exploration of the potential genetic mechanisms underlying hand grip strength and Parkinson's disease and the potential relationship between walking pace, balance, and falls in Parkinson's patients may help to reduce the burden of sarcopenia and Parkinson's disease.

Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients.

Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults.

Concordance between muscle mass assessed by bioelectrical impedance analysis and by muscle ultrasound: a cross-sectional study in a cohort of patients on chronic hemodialysis

BackgroundSarcopenia is a common problem in hemodialysis (HD) patients, and it is diagnosed by low muscle mass, strength and/or low physical performance. Muscle ultrasound (US) is a non-invasive portable tool that might be used for assessment of muscle mass. The aim of the current study was to investigate the concordance between muscle US and bioelectrical impedance analysis (BIA) in diagnosis of sarcopenia in HD patients.MethodsThis cross-sectional study included 41 HD patients. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP). The skeletal mass index was measured by BIA and the muscle strength was measured by handgrip strength. Muscle US was used to measure cross-sectional area (CSA) and thickness of quadriceps and biceps muscles.ResultsThe current study included 41 patients on HD (25 males), with a mean (SD) age of 44.18 (13.11) years and a median HD duration of 48 months. Sarcopenia was diagnosed in 58.5% of the patients. Patients with sarcopenia had significantly lower quadriceps muscle CSA than those without sarcopenia. The optimal cut-offs of quadriceps muscle CSA for both males and females for the diagnosis of sarcopenia were 2.96 and 2.92 cm2, respectively.ConclusionSarcopenia is prevalent among Egyptian HD patients. US on quadriceps muscle CSA could be used for diagnosis of sarcopenia in these patients.