European Working Group On Sarcopenia In Older People Definition Research Articles

Acute Sarcopenia Secondary to Hospitalisation - An Emerging Condition Affecting Older Adults.

There has been increasing interest and research into sarcopenia in community-dwelling older adults since the European Working Group on Sarcopenia in Older People (EWGSOP) agreed a consensus definition in 2010. Sarcopenia has been defined as loss of muscle mass with loss of muscle function (strength or physical performance), with measurements two Standard Deviations (SDs) below the mean of a young reference population. This definition does not necessitate longitudinal measurements, or the absence of acute illness and diagnosis can be made from single measurements. We hypothesise that hospitalisation, due to a combination of acute inflammatory burden and muscle disuse, leads to an acute decline in muscle mass and function and may lead to some individuals meeting criteria for sarcopenia, acutely, based on the EWGSOP definition. This may be partially recoverable or may lead to increased risk of developing sarcopenia long-term. We have denoted the term “acute sarcopenia” to refer to acute loss of muscle mass and function associated with hospitalisation. This review discusses some of the current available research in this context and also identifies some of the knowledge gaps and potential areas for future research.

Associations of Sarcopenia Definitions, and Their Components, With the Incidence of Recurrent Falling and Fractures: The Longitudinal Aging Study Amsterdam.

The aim was to investigate the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, and their underlying components, with the incidence of recurrent falling and fractures. In 498 older men and women (mean age = 75.2 [SD = 6.4]) from the Longitudinal Aging Study Amsterdam (LASA), the sarcopenia components lean mass (DXA), handgrip strength (handheld dynamometer), and gait speed were measured. Data on falls (3-year follow-up) and fractures (10-year follow-up) were collected. Cox regression analyses were performed, adjusting for age, sex, and total body fat. Recurrent falling occurred in 130 persons and 60 persons experienced a fracture during follow-up. Participants who were identified as sarcopenic based on the FNIH definitions had a more than 2-fold increased risk to become a recurrent faller. There was no association between sarcopenia based on the EWGSOP definition and incidence of recurrent falling. When the sarcopenia components were examined individually, only a low grip strength was associated with incidence of recurrent falling, independent of a low lean mass or a slow gait speed. Sarcopenia according to both definitions was not associated with incident fractures, which may be caused by low statistical power. Sarcopenia according to the FNIH definitions, but not according to the EWGSOP definition was associated with recurrent falling. When examining the individual components, only a low grip strength was independently associated with recurrent falling. No associations between sarcopenia with incidence of fractures were found.

Prevalence and Clinical Correlates of Sarcopenia, Identified According to the EWGSOP Definition and Diagnostic Algorithm, in Hospitalized Older People: The GLISTEN Study.

Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia. Cross-sectional analysis of 655 participants enrolled in a multicenter observational study of older adults admitted to 12 acute hospital wards in Italy. Sarcopenia was assessed as low skeletal mass index (kg/m2) plus either low handgrip strength or low walking speed (EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Of the 655 patients (age 81.0 ± 6.8 years; women 51.9%) enrolled in the study, 275 (40.2%) were not able to perform the 4-m walking test because of medical problems. The overall prevalence of sarcopenia on hospital admission was 34.7% (95% confidence interval 28-37) and it steeply increased with aging (p < .001). In multivariable analysis, patients with sarcopenia on hospital admission were older and were more likely to be male and to have congestive heart failure, cerebrovascular disease, and severe basic activities of daily living disability. The prevalence of sarcopenia was inversely correlated with body mass index. Based on EWGSOP criteria, prevalence of sarcopenia is extremely high among older adults on admission to acute hospital wards. Older age, male gender, congestive heart failure, cerebrovascular disease, severe activities of daily living disability, and body mass index were the clinical variables significantly associated with the presence of sarcopenia.

Prevalence of Sarcopenia in Community-Dwelling Chilean Elders According to an Adapted Version of the European Working Group on Sarcopenia in Older People (EWGSOP) Criteria.

Sarcopenia is the progressive loss of mass and skeletal muscle strength and has serious consequences on older people's health. The Chilean older population has a high life-expectancy, but the prevalence of functional dependence is also high. To determine the prevalence of sarcopenia in Chilean older adults and its relationship with age, gender, and body mass index (BMI). Cross-sectional study. Community. 1,006 non-disabled, community-dwelling subjects aged 60 years or older living in Santiago. Anthropometric measurements, handgrip strength, physical performance tests, and dual-energy-x-ray-absorptiometry (DXA) scan were performed. Sarcopenia was defined using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP). Muscle mass was measured with DXA scan; skeletal muscle mass index (SMI) and hand dynamometry were defined with cut-off points obtained for the Chilean population. For a 3m walking speed we used the cut-off point of the EWGSOP definition. Nutritional status and obesity were defined according to World Health Organization standards. Association between sarcopenia and age, gender, BMI and lean/fat mass ratio was estimated by logistic regression models. The prevalence of sarcopenia was 19.1% (95%CI: 16.8%-21.8%), similar in men and women. There was an increasing trend of sarcopenia by age group and a decreasing trend with nutritional status. After logistic regression, sarcopenia was positively associated with age (OR=1.10; 95%CI:1.06-1.15) and falls (OR=1.83; 95%CI:1.07-3.15) and negatively associated with overweight (OR=0.31; 95%CI:0.16-0.59), obesity (OR=0.02; 95%CI:0.004-0.11), lean mass/fat mass ratio (OR=0.69; 95%CI:0.48-0.9997), knee height (OR=0.78; 95%CI:0.68-0.89) and calf circumference (OR=0.87; 95%CI:0.77-0.97). The total prevalence of sarcopenia was 19.1% increasing with age reaching 39.6% in people of 80 or more years of age. A negative association of sarcopenia with overweight, obesity and lean/fat mass ratio was observed. Although the high prevalence of obesity (35.9%), only 2% of obese people were sarcopenic.

Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study.

IntroductionRecognition that an older person has sarcopenia is important because this condition is linked to a range of adverse outcomes. Sarcopenia becomes increasingly common with age, and yet there are few data concerning its descriptive epidemiology in the very old (aged 85 years and above). Our aims were to describe risk factors for sarcopenia and estimate its prevalence and incidence in a British sample of the very old.MethodsWe used data from two waves (2006/07 and 2009/10) of the Newcastle 85+ Study, a cohort born in 1921 and registered with a Newcastle/North Tyneside general practice. We assessed sarcopenia status using the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Grip strength was measured using a Takei digital dynamometer (Takei Scientific Instruments Ltd., Niigata, Japan), gait speed was calculated from the Timed Up and Go test, and lean mass was estimated using a Tanita‐305 body fat analyzer. We used logistic regression to examine associations between risk factors for prevalent sarcopenia at baseline and incident sarcopenia at follow‐up.ResultsEuropean Working Group on Sarcopenia in Older People sarcopenia was present in 21% of participants at baseline [149/719 participants, mean age 85.5 (0.4) years]. Many participants had either slow gait speed or weak grip strength (74.3%), and hence measurement of muscle mass was frequently indicated by the EWGSOP definition. Incidence data were available for 302 participants, and the incident rate was 3.7 cases per 100 person years at risk. Low Standardized Mini‐Mental State Examination, lower occupational social class, and shorter duration of education were associated with sarcopenia at baseline, while low muscle mass was associated with incident sarcopenia. Low body mass index (BMI) was a risk factor for both in a graded fashion, with each unit decrease associated with increased odds of prevalent [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.21, 1.37] and incident (OR 1.20, 95% CI: 1.08, 1.33) sarcopenia.ConclusionsTo our knowledge, this is the first study to describe prevalence and incidence of EWGSOP sarcopenia in the very old. Low BMI was a risk factor for both current and future sarcopenia; indeed, there was some evidence that low BMI may be a reasonable proxy for low lean mass. Overall, the high prevalence of sarcopenia among the very old suggests that this group should be a focus for future research.

Sarcopenia in community-dwelling persons over 60 years of age from a northern spanish city: relationship between diagnostic criteria and association with the functional performance.

Sarcopenia is a recognized problem in older people. Currently, its diagnosis goes beyond a simple loss of muscle mass. The aim of this study was to determine the frequency of sarcopenia, defined by the European Working Group on Sarcopenia in Older People (EWGSOP), in independent persons over 60 years of age from a northern Spanish city. In addition, this study compared the diagnostic criteria for sarcopenia and assessed the differences in functional performance according to them. A cross-sectional study was carried out on 258 members of community centers of both genders. Body composition was assessed with dual-energy X-ray absorptiometry. Appendicular lean mass index (App LMI), hand grip strength (HGS), and 8 foot up-and-go test (8f-UG) were used to diagnose sarcopenia. The frequency of sarcopenia was 2.4% (n=6). In women, the App LMI was correlated with HGS (r= 0.164, p<0.05) and 8f–UG (r= -0.167, p<0.05), while in men, the App LMI was correlated with HGS (r=0.241, p<0.05) but not with 8f–UG (r= -0.173, p=0.117). The subjects with low HGS and low performance in the 8f–UG presented lower values in other functional outcomes than people with low App LMI (p<0.05). Using the EWGSOP definition, the frequency of sarcopenia was low in a group of individuals over 60 years of age from a northern Spanish city. In clinical practice, greater emphasis should be placed on the decrease in muscle strength and functional performance rather than on low muscle mass alone.

Sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP) versus dynapenia as a risk factor for mortality in the elderly.

Sarcopenia and dynapenia have been associated with poorer physical performance, disability and death. The aim of this study was to compare the association between sarcopenia and dynapenia with mortality. We studied 1,149 Brazilians aged 60 years or older residing in São Paulo. Sarcopenia was defined according to the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which includes three components: low muscle mass (LMM) assessed by skeletal muscle mass index ≤ 8.90kg/m2 (men) and ≤ 6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength <30kg (men) and < 20kg (women); and low physical performance (LPP) assessed by walking speed ≤ 0.8m/s. Diagnosis of sarcopenia required presence of LMM plus LMS or LPP. Dynapenia was defined as handgrip strength < 30kg (men) and < 20kg (women). Covariates included socio-demographic and behavioral variables, medical conditions, hospitalization, depressive symptoms, cognition, and disability in activities of daily living or instrumental activities of daily living. The outcome was all-cause mortality over five-year follow-up. During the five-year follow-up, 187 subjects died. The mortality rate for those with or without sarcopenia were 65.9/1,000 person/years and 20.1/1,000 person/years and for dynapenia were 44.3/1,000 person/years and 14.9/1,000 person/years. The adjusted model showed that sarcopenia (HR=1.52, 95%CI: 1.06 - 2.19) and dynapenia (HR=2.04, 95%CI: 1.24 - 3.37) are independent risk factors for death. The EWGSOP definition of sarcopenia and dynapenia can help to determine risk for mortality and can be used as a screening instrument in public health.

Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS).

Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP).Methods: PubMed and Dialog databases were searched (January 2000–October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected.Results: prevalence of sarcopenia was, with regional and age-related variations, 1–29% in community-dwelling populations, 14–33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function.Conclusion: prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes.

Sarcopenia according to the european working group on sarcopenia in older people (EWGSOP) versus Dynapenia as a risk factor for disability in the elderly.

Sarcopenia, defined as low muscle mass (LMM), and dynapenia have been associated with adverse outcomes in elderly. Contrast the association of sarcopenia versus dynapenia with incidence of disability. A four-year prospective study (2006-2010). São Paulo, Brazil. 478 individuals aged 60 and older from the Saúde, Bem-Estar e Envelhecimento (SABE) study who were non-disabled at baseline. Sarcopenia, measured according to the European Working Group on Sarcopenia in Older People (EWGSOP), includes: LMM assessed by skeletal muscle mass index ≤8.90kg/m2 (men) and ≤6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength <30kg (men) and <20kg (women); and low physical performance (LPP) assessed by gait speed ≤0.8m/s. Diagnosis of sarcopenia required LMM plus LMS or LPP. Dynapenia was defined as handgrip strength <30kg (men) and <20kg (women). Covariates included socio-demographic and behavioral variables, medical conditions, hospitalization, depressive symptoms, cognition, perception of vision, hearing and body mass index. Disability in mobility or instrumental activities of daily living (IADL) or disability in activities of daily living (ADL) and IADL. The incidence density of mobility or IADL disability was 43.4/1000 person/year and 22.6/1000 person/year for IADL and ADL disability. There was no significant difference in incidence density according sarcopenia or dynapenia status. After controlling for all covariates, sarcopenia was associated with mobility or IADL disability (relative risk ratio = 2.23, 95%Confidence Interval: 1.03-4.85). Dynapenia was not associated with disability. Sarcopenia according to the EWGSOP definition can be used in clinical practice as a screening tool for early functional decline (mobility or IADL disability).

Comparisons of Sarcopenia Defined by IWGS and EWGSOP Criteria Among Older People: Results From the I-Lan Longitudinal Aging Study

To compare clinical characteristics of sarcopenia defined by the International Working Group on Sarcopenia (IWGS) and European Working Group on Sarcopenia in Older People (EWGSOP) criteria among older people in Taiwan. A prospective population-based community study. I-Lan County of Taiwan. A total of 100 young healthy volunteers and 408 elderly people. None. Anthropometry, skeletal muscle mass measured by dual x-ray absorptiometry, relative appendicular skeletal muscle index (RASM), percentage skeletal muscle index (SMI), 6-meter walking speed, and handgrip strength. The prevalence of sarcopenia was 5.8% to 14.9% in men and 4.1% to 16.6% in women according to IWGS and EWGSOP criteria by using RASM or SMI as the muscle mass indices. The agreement of sarcopenia diagnosed by IWGS and EWGSOP criteria was only fair by using either RASM or SMI (kappa = 0.448 by RASM, kappa = 0.471 by SMI). The prevalence of sarcopenia was lower by the IWGS definition than the EWGSOP definition, but it was remarkably lower by using RASM than SMI in both criteria. Overall, sarcopenic individuals defined by SMI were older, had a higher BMI but similar total skeletal muscle mass, and had poorer muscle strength and physical performance than nonsarcopenic individuals. However, by using RASM, sarcopenic individuals had less total skeletal muscle mass but similar BMI than nonsarcopenic individuals. Multivariable logistic regression showed that age was the strongest associative factor for sarcopenia in both IWGS and EWGSOP criteria. Obesity played a neutral role in sarcopenia when it is defined by using RASM, but significantly increased the risk of sarcopenia in both criteria by using SMI. The agreement of sarcopenia defined by IWGS and EWGSOP was only fair, and the prevalence varied largely by using different skeletal muscle mass indices. Proper selections for cutoff values of handgrip strength, walking speed, and skeletal muscle indices with full considerations of gender and ethnic differences were of critical importance to reach the universal diagnostic criteria for sarcopenia internationally.

Prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) definition: findings from the Hertfordshire Cohort Study (HCS)

Introduction: sarcopenia is associated with adverse health outcomes. The aim of this study was to describe the prevalence of sarcopenia in community-dwelling older people in the UK using the European Working Group on Sarcopenia in Older People (EWGSOP) consensus definition.Methods: we applied the EWGSOP definition to 103 community-dwelling men participating in the Hertfordshire Sarcopenia Study (HSS) using both the lowest third of dual-energy X-ray absorptiometry (DXA) lean mass (LM) and the lowest third of skin-fold-based fat-free mass (FFM) as markers of low muscle mass. We also used the FFM approach among 765 male and 1,022 female participants in the Hertfordshire Cohort Study (HCS). Body size, physical performance and self-reported health were compared in participants with and without sarcopenia.Results: the prevalence of sarcopenia in HSS men (mean age 73 years) was 6.8% and 7.8% when using the lowest third of DXA LM and FFM, respectively. DXA LM and FFM were highly correlated (0.91, P < 0.001). The prevalence of sarcopenia among the HCS men and women (mean age 67 years) was 4.6% and 7.9%, respectively. HSS and HCS participants with sarcopenia were shorter, weighed less and had worse physical performance. HCS men and women with sarcopenia had poorer self-reported general health and physical functioning scores.Conclusions: this is one of the first studies to describe the prevalence of sarcopenia in UK community-dwelling older people. The EWGSOP consensus definition was of practical use for sarcopenia case finding. The next step is to use this consensus definition in other ageing cohorts and among older people in a range of health-care settings.