Low Handgrip Strength Research Articles

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.

Effects of sarcopenia on changes in prevalence of patients with depressive mood during hospitalization in geriatric rehabilitation.

The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting. This observational cohort study enrolled 204 patients aged ≥65 years (mean: 78.8±7.6 years, 45.1% women) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment (AWGS2019) criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge. We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio, 5.460; 95% confidence interval, 2.344-13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037). Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.

Predictors of hip fracture in 15 European countries: a longitudinal study of 48,533 geriatric adults using SHARE dataset.

Hip fracture is a major cause of functional disability, mortality, and health costs. However, the identification and characterization of its causative factors remain poor. We investigated demography, handgrip strength (HGS), depression, and multiple age-associated comorbidities for predicting future hip fracture in individuals aged 50 or above from 15 European countries (n = 48,533). All participants were evaluated from 2013 to 2020 using four successive waves of the Survey of Health, Aging, and Retirement in Europe (SHARE). Altogether, 1130 participants developed hip fractures during the study period. We identified female gender, an advancing age from quinquagenarians onward, and a poor socioeconomic status as critical risk factors for future hip fracture. Having mobility difficulty, a low HGS (< 27kg in men, < 16kg in women) and higher scores on Euro-D depression scales were also significant risk factors for hip fracture. Summated scales of hypertension, diabetes mellitus, cancer, Alzheimer's disease, and stroke did not appear as risk factors. Collectively, we report advancing age, female gender, low HGS, and depression as independent risk factors for hip fracture. Our findings are useful in identifying high-risk populations for hip fractures in pre-clinical settings before rigorous evaluation and treatment in clinics.

Association of Visceral Adiposity Index and Handgrip Strength with Cardiometabolic Multimorbidity among Middle-Aged and Older Adults: Findings from Charls 2011-2020.

The visceral adiposity index (VAI) and handgrip strength (HGS) are identified as important objectives for the prevention of illness. Nevertheless, there is limited understanding regarding the impact of the VAI and HGS on cardiometabolic multimorbidity (CMM). We aimed to ascertain the impact of the VAI and HGS on CMM among middle-aged and older people. Data spanning from 2011 to 2020 were derived from the China Health and Retirement Longitudinal Study (CHARLS). In total, 7909 individuals aged 45 years and older were included. Cox proportional hazard regression was utilized to examine the correlation among the VAI, HGS, and CMM. Throughout the 10-year follow-up, we determined that both the VAI (HR = 1.330; 95%CI = 1.179-1.500) and HGS (HR = 0.745, 95%CI = 0.645-0.861) exhibited significant associations with CMM risk. Individuals exposed to both a high VAI and low HGS were found to have higher hazards of CMM (HR = 1.377, 95%CI = 1.120-1.694) in contrast to participants exposed to one or none of these conditions. The older (HR = 1.414; 95%CI = 1.053-1.899) and male (HR = 1.586; 95%CI = 1.114-2.256) groups are more likely to experience CMM risk. Our findings suggest that both the VAI and HGS have significant effects on CMM risk. Appropriate interventions focused on vulnerable groups are recommended to prevent the incidence of CMM.

The water imbalance of skeletal muscle and muscle weakness in patients with heart failure.

A high extracellular water (ECW) to intracellular water (ICW) ratio of skeletal muscle as assessed by bioelectrical impedance analysis is reportedly associated with loss of muscle strength. However, the validity of this index for heart failure (HF), which is likely associated with changes in the water distribution, is unclear. This study involved 190 patients with HF. The total ECW and ICW of both upper and lower extremities were measured, and a high ECW/ICW ratio was defined as an ECW/ICW ratio higher than the median (≥0.636 for men, ≥0.652 for women). Low muscle strength was defined as reduced handgrip strength according to the criteria established by the Asian Working Group for Sarcopenia. Patients with a high ECW/ICW ratio had a lower handgrip strength (21.1±8.1kg vs. 27.6±9.3kg, P≤0.05) and 6min walk distance (329±116m vs. 440±114m) than those with a low ECW/ICW ratio. An increasing ECW and/or decreasing ICW was associated with a higher ECW/ICW ratio and a lower handgrip strength (P<0.05). In the multivariate logistic regression analysis, a high ECW/ICW ratio and low skeletal muscle mass were independently associated with low muscle strength (P<0.05). A high ECW/ICW ratio in limb muscles, that is, the water imbalance of increasing ECW and/or decreasing ICW, is useful in assessing muscle quality in patients with HF.

Association between immune cells, inflammatory cytokines, and sarcopenia: Insights from a Mendelian randomization analysis

BackgroundRecent studies have suggested a possible link between sarcopenia, immune dysregulation, and chronic inflammation, although the specific immune components implicated remain unclear. This investigation employs Mendelian Randomization (MR) to explore the reciprocal relationship between immune cells, inflammatory markers, and sarcopenia. MethodWe performed two-sample and multivariate MR analyses using publicly accessible genome-wide association studies (GWAS) summary statistics. Our analyses included 731 immune cells, 41 inflammatory cytokines, and sarcopenia related traits (appendicular lean mass [ALM], low hand-grip strength [LHS], and walking pace [WP]), with additional sensitivity analyses conducted to confirm the findings. ResultsAfter false discovery rate (FDR) correction, significant associations were found between ten immune traits and ALM, with the CD127 marker in the Treg panel showing consistent positive correlation across four sites. In contrast, NKT%lymphocyte negatively correlated with WP (OR = 0.99, P = 0.023). In terms of inflammatory cytokines, macrophage colony-stimulating factor (MCSF) (OR = 1.03, P = 0.024) and hepatocyte growth factor (HGF) (OR = 1.03, P = 0.002) demonstrated positive associations with ALM, while interleukin-16 (IL-16) (OR = 0.99, P = 0.006) was inversely related. The reverse Mendelian randomization analysis found no direct causal links between sarcopenia traits and immune or inflammatory markers. Sensitivity analyses underscored the findings' resilience to pleiotropy, and adjusting for inter-trait dynamics weakened these relationships in the multivariable MR analysis. ConclusionOur study reveals causal associations between specific immune phenotypes, inflammatory cytokines, and sarcopenia, providing insight into the development of sarcopenia and potential treatment strategies.

Lymphocyte-to-C-reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis.

In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional-inflammatory markers and lymphocyte-to-C-reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF. This study was a secondary analysis of the FRAGILE-HF study, a prospective observational study conducted across 15 hospitals in Japan. We included 1212 patients (mean age, 80.2±7.8years; 513 women) hospitalized with HF, who were classified into three groups according to their LCS score: 0 (n=498), 1 (n=533), and 2 (n=181). Baseline data on physical examination, echocardiography, blood test results (including lymphocyte counts and CRP levels), and oral medication usage were collected in a clinically compensated state before discharge. Nutritional status and physical function were evaluated using several indices and tests. The primary outcome of this study was all-cause death within 2years. Univariate and multivariate linear regression analyses were performed to evaluate the associations among the nutritional status, physical function, and LCR/LCS. Patients with an LCS score of 2 were older and had a lower body mass index than those in the other two groups. Multivariate linear regression analysis revealed that lower LCR and higher LCS were independently associated with worse nutritional status, lower handgrip strength, shorter physical performance battery score, and shorter 6-min walk distance. At 2years, all-cause death occurred in 254 patients: 86 (17.6%), 113 (21.5%), and 55 (30.9%) with LCS scores of 0, 1, and 2, respectively (P=0.001). Cox proportional hazards analysis revealed that LCR and LCS were significantly associated with 2-year mortality even after adjusting for the conventional risk model (LCS score, 0 vs. 2: hazard ratio, 1.64; 95% confidence interval [CI]; 1.14-2.35; P=0.007; log-transformed LCR: hazard ratio, 0.88; 95% CI, 0.81-0.95; P=0.002). LCR yielded additional prognostic predictability compared with the conventional risk model (continuous net reclassification improvement, 0.153; 95% CI, 0.007-0.299; P=0.041). LCR and LCS emerge as potential predictors of nutritional status, physical function, and prognosis in older patients with HF.

Dietary Intake, Menopausal Symptoms, and Body Composition Associated with Possible Sarcopenia Among Vietnamese Middle-Aged Women: A Cross-Sectional Study.

Background: This study aims to investigate the prevalence of possible sarcopenia and its associated factors among middle-aged Vietnamese women. Methods: A cross-sectional study was conducted on 205 women aged 40-55 years who were admitted to the Can Tho Obstetrics and Gynecology Hospital between February and December 2023. The presence of possible sarcopenia was determined according to the AWGS 2019 criteria. Associated factors were dietary intake (total energy, protein, lipid, and carbohydrate intake), the severity of menopausal symptoms by using the Kupperman index, and body composition by using the bioelectrical impedance analysis device, Inbody S10. Logistic regressions were built to analyze the association between possible sarcopenia and its associated factors. Results: The prevalence of possible sarcopenia was 29.8%, with a mean age of 47.2. Possible sarcopenia was detected in 23% of the participants based on the criterion of low handgrip strength, whereas 83.6% of the participants when considered low performance in the chair stand test. Adjusted logistic regression analysis showed that living in a rural area (adjusted odds ratio [AOR]: 2.16, 95% confidence interval [95% CI]: 1.22-4.72), energy intake <25 kcal/body weight, (AOR: 1.94, 95% CI: 1.75-5.06), protein intake <0.91 g/body weight (AOR: 2.42, 95% CI: 1.51-5.76), skipping breakfast (AOR: 2.03, 95% CI: 0.91-4.54), mild menopausal symptoms (AOR: 2.68, 95% CI: 1.61-5.36), and obesity (AOR: 1.59, 95%CI: 1.29-3.67) were significantly associated with higher risk of possible sarcopenia. Conversely, higher muscle mass and higher upper limb mass were associated with a decreased risk of possible sarcopenia (total muscle mass AOR: 0.20, 95% CI: 0.07-0.59). Conclusions: These findings would provide a basis for enhancing management and prevention strategies to reduce the risk of sarcopenia in Vietnam. In particular, attention to nutrient intake and the management of menopausal symptoms may reduce the risk of sarcopenia.

Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 – a pragmatic randomised controlled trial

Physical strength can be an important parameter to monitor for patients with diabetes mellitus type 2 (T2DM) to promote healthy lifestyle choices. Functional measurements can contribute to healthcare advice and possibly motivate more active lifestyles. The aim of the study was to investigate whether adding measurement and feedback concerning handgrip strength (HGS) to the parameters measured for patients with T2DM at annual check-ups leads to change in physical activity (PA) level, HGS, HbA1c or waist circumference. Methods Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires. Results Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels. Conclusions Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function. ClinicalTrials registration: NCT03693521

Association of lipid-lowering drugs with risk of sarcopenia: a drug target mendelian randomization study and meta-analysis

BackgroundLipid-lowering drugs are widely used among the elderly, with some studies suggesting links to muscle-related symptoms. However, the causality remains uncertain.MethodsUsing the Mendelian randomization (MR) approach, we assessed the causal effects of genetically proxied reduced low-density lipoprotein cholesterol (LDL-C) through inhibitions of hydroxy-methyl-glutaryl-CoA reductase (HMGCR), proprotein convertase subtilisin/kexin type 9 (PCSK9), and Niemann-Pick C1-like 1 (NPC1L1) on sarcopenia-related traits, including low hand grip strength, appendicular lean mass, and usual walking pace. A meta-analysis was conducted to combine the causal estimates from different consortiums.ResultsUsing LDL-C pooled data predominantly from UK Biobank, genetically proxied inhibition of HMGCR was associated with higher appendicular lean mass (beta = 0.087, P = 7.56 × 10− 5) and slower walking pace (OR = 0.918, P = 6.06 × 10− 9). In contrast, inhibition of PCSK9 may reduce appendicular lean mass (beta = -0.050, P = 1.40 × 10− 3), while inhibition of NPC1L1 showed no causal impact on sarcopenia-related traits. These results were validated using LDL-C data from Global Lipids Genetics Consortium, indicating that HMGCR inhibition may increase appendicular lean mass (beta = 0.066, P = 2.17 × 10− 3) and decelerate walking pace (OR = 0.932, P = 1.43 × 10− 6), whereas PCSK9 inhibition could decrease appendicular lean mass (beta = -0.048, P = 1.69 × 10− 6). Meta-analysis further supported the robustness of these causal associations.ConclusionsGenetically proxied HMGCR inhibition may increase muscle mass but compromise muscle function, PCSK9 inhibition could result in reduced muscle mass, while NPC1L1 inhibition is not associated with sarcopenia-related traits and this class of drugs may serve as viable alternatives to sarcopenia individuals or those at an elevated risk.

Combination of handgrip strength and high-sensitivity modified Glasgow prognostic score predicts survival outcomes in patients with colon cancer.

Handgrip strength (HGS) and the high-sensitivity modified Glasgow prognostic score (HS-mGPS) are associated with the survival of patients with cancer. However, no studies have investigated the combined effect of HGS and HS-mGPS on the overall survival (OS) of patients with colon cancer. Prospective follow-up data of colon cancer patients undergoing radical resection from April, 2016 to September, 2019 were retrospectively collected. We combined the HGS and HS-mGPS to create a new composite index, HGS-HS-mGPS. The hazard ratio (HR) and 95% confidence interval (CI) were calculated using Cox regression models to assess the association between variables and OS. Risk factors on OS rates were investigated by Cox analyses and the nomogram was constructed using significant predictors and HGS-HS-mGPS. The predictive performance of the nomogram was evaluated by receiver operating characteristic curve and calibration curve. This study included a total of 811 patients, of which 446 (55.0%) were male. The HGS optimal cut-off values of male and female patients were 28.8 and 19.72 kg, respectively. Multivariate analysis revealed that low HGS and high HS-mGPS were independent risk factors of colon cancer after adjusting confounders (adjusted HR = 3.20; 95% CI: 2.27-4.50; p < 0.001 and adjusted HR = 1.55; 95% CI: 1.12-2.14; p = 0.008 respectively). Patients with low HGS and high HS-mGPS had a 10.76-fold higher mortality risk than those with neither (adjusted HR = 10.76; 95% CI: 5.38-21.54; p < 0.001). A nomogram predicting 1-, 3-, and 5 year OS was constructed based on three clinicopathologic prognostic factors. Importantly, incorporating HGS-HS-mGPS into the nomogram model meaningfully improved the predictive performance. The decision curve analyses demonstrated the application value of the HGS-HS-mGPS nomogram for predicting OS of patients with colon cancer. HGS-HS-mGPS is associated with the survival of patients with colon cancer. These findings indicate the usefulness of HGS and HS-mGPS measurements in clinical practice for improving patient assessment, cancer prognosis, and precise intervention.

Associations between DEET, Organophosphorus Insecticides, and Handgrip Strength in Diabetes: An NHANES Analysis.

Sarcopenia and diabetes mellitus (DM) have been shown to be related. It has been demonstrated that pesticides/insecticides are linked to various health issues, including DM. This study investigated the relationships between exposure to pesticides/insecticides and muscle strength among community-dwelling DM patients in a national sample of the United States (US). Data from the 2011-2012 and 2013-2014 U.S. National Health and Nutrition Examination Survey (NHANES) on people aged 20 years with diabetes were retrieved. A digital dynamometer was used to quantify handgrip strength, and urine pesticide concentrations were determined through laboratory testing. Regression models were used to investigate the relationship between pesticide/insecticide exposure and handgrip strength. After weighting, the data from 412 NHANES participants represented 6,696,865 U.S. inhabitants. The mean age of the participants was 58.8 years. High para-nitrophenol levels (tertile 3 vs. tertile 1) were shown to be associated with lower handgrip strength in both males (aBeta = -7.25, 95% CI: -11.25, -3.25) and females (aBeta = -3.73, 95% CI: -6.89, -0.56). Further, females with elevated 2-isopropyl-4-methyl-pyrimidinol had decreased handgrip strength. Desethyl hydroxy N, N-diethyl-m-toluamide (DEET) was inversely related to handgrip strength in men aged ≥60 years. DEET acid and para-nitrophenol were inversely correlated to handgrip strength in women over 60 years. This study has linked certain pesticides/insecticides to decreased muscle strength in people with diabetes. Para-nitrophenol, in particular, is negatively related to muscular strength in both males and females, and 2-isopropyl-4-methyl-pyrimidinol is inversely related to muscle strength in females.

Handgrip Strength and Clinical Evolution of People Living with HIV: A Mini Narrative Review.

HIV infection is a worldwide epidemic. Antiretroviral therapy allows people living with HIV (PLHIV) increased longevity and a better quality of life. Among the various ways of monitoring the clinical evolution of PLHIV, handgrip strength (HGS) is a promising strategy, as this test can be used to assess the health condition quickly and at a low cost. In this sense, the present study aims to describe, through a literature review, the relationship between HGS and the clinical evolution of PLHIV, especially with morbimortality. Initially, it is highlighted that aging, HIV infection, and excess body fat are related to the loss of HGS in PLHIV. Furthermore, PLHIV is more likely to present cardiometabolic diseases that can be aggravated by reduced HGS. Thus, in people without positive HIV serology, low HGS indirectly, through the presence of risk factors or cardiometabolic diseases, or directly increases the chance of mortality. In conclusion, the lack of studies on this topic for PLHIV is highlighted, and more longitudinal studies, including control groups, are needed.

Beyond sarcopenia: frailty in chronic haemodialysis patients.

Frailty, characterized by vulnerability, reduced reserves and increased susceptibility to severe events, is a significant concern in chronic haemodialysis (HD) patients. Sarcopenia, corresponding to the progressive loss of muscle mass and strength, may contribute to frailty by reducing functional capacity, mobility and autonomy. However, consensus lacks on the optimal bedside frailty index for chronic HD patients. This study investigated the influence of frailty on chronic HD patient survival and explored the associated factors. A total of 135 patients were enrolled from January to April 2019 and then followed up prospectively until April 2022. At inclusion, frailty was assessed by the Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) tests including gait speed, standing balance and lower limb muscle strength. From a total of 114 prevalent chronic HD patients (66% men, age 67.6±15.1years), 30 died during the follow-up period of 23.7months (range 16.8-34.3). Deceased patients were older, had more comorbidities and a higher sarcopenia prevalence (P<.05). The TUG and SPPB test scores were significantly reduced in patients who had died [SPPB total score: 7.2±3.3 versus 9.4±2.5; TUG time 8.7±5.8 versus 13.8±10.5 (P<.05)]. Multivariate analysis showed that a higher SPPB score (total value >9) was associated with a lower mortality risk [hazard ratio 0.83 (95% confidence interval 0.74-0.92); P<.03). Each component of the SPPB test was also associated with mortality in univariate analysis, but only the SPPB balance test remained protective against mortality in multivariate analysis. Older age, lower handgrip strength and lower protein catabolic rate were associated with SPPB total scores <9, SPPB balance score and TUG time >10s. Screening for frailty is crucial in chronic HD patients, and incorporating SPPB, especially the balance test, provides valuable insights. Diminished muscle strength and inadequate protein intake negatively influence the SPPB score and balance in chronic HD patients. Effective identification and management of frailty can therefore improve outcomes. NCT03845452.

Association between oxidative balance score and skeletal muscle mass and strength: NHANES from 2011 to 2018.

Oxidative stress is a risk factor for sarcopenia. The Oxidative Balance Score (OBS) is a widely employed tool for evaluating the oxidative stress-related exposures from dietary and lifestyle factors. In this study, we aimed to conducted to explore the relationship between OBS and skeletal muscle mass and strength. 6,438 subjects from 2011 to 2018 and 5,414 from 2011 to 2014 from the National Health and Nutrition Examination Survey (NHANES) were selected for analysis. The correlations between OBS and skeletal muscle mass and handgrip strength were investigated using multivariate logistic regression and linear regression analysis. Compared with lowest OBS, participants with OBS in the highest quartile had lower risk of low skeletal muscle mass (OR = 0.173 (0.120 ~ 0.248), p < 0.0001) and low handgrip strength (β = 0.173 (0.120 ~ 0.248), p = 0.011). The negative association also were found between dietary/lifestyle OBS and skeletal muscle mass (OR = 0.268 (0.178 ~ 0.404), p < 0.0001; OR = 0.231 (0.130 ~ 0.410), p < 0.0001) and handgrip strength (β = 1.812 (0.555 ~ 3.071), p = 0.008; β = -2.255 (-3.430 ~ -1.079), p < 0.001) independently. The positive association remains significant, especially among men and those with higher education levels by subgroup analysis. All of these results indicated a negative association between OBS and low skeletal muscle mass and handgrip strength. An antioxidant-rich diet and healthy lifestyle are crucial for enhancing skeletal muscle mass and strength.

Resistance Exercise Reduces Sarcopenia by Repairing Leaky Gut in Patients with Alzheimer's Disease

PurposeSarcopenia or age-associated muscle loss is common in patients with Alzheimer's disease (AD). We have previously demonstrated the contribution of a leaky gut to sarcopenia in AD. Here, we asked whether resistant exercise (RE) reduces the sarcopenia phenotype by repairing intestinal leakage in patients with AD. MethodA prospective, single-center study of older adults, including healthy controls and patients with AD (n = 44–51/group), was conducted to measure plasma zonulin and claudin-3 (markers of intestinal leakage), handgrip strength (HGS), and short physical performance battery (SPPB) as a measure of functional capacity. Measurements in patients with AD were performed at baseline and after 12 weeks of RE. ResultsAt baseline, patients with AD had higher plasma zonulin and claudin-3 and lower HGS, gait speed, and SPPB scores than controls. RE reduced plasma zonulin and claudin-3 levels and improved HGS, SPPB scores, and gait speed. Regression analysis revealed robust relationships between changes in plasma zonulin and claudin-3 with HGS. Plasma zonulin was also positively associated with SPPB scores. In addition, RE downregulated plasma markers of inflammation and oxidative stress. However, the prevalence of sarcopenia based on low HGS and muscle atrophy or low SPPB was not affected by RE. ConclusionTaken together, disruption of the intestinal mucosal barrier may contribute to functional decline and sarcopenia in AD, which is incompletely recovered by RE. Circulating levels of zonulin and claudin-3 may be valuable in predicting sarcopenia and functional capacity in older adults with AD.

Evaluation of Sarcopenia in Patients with Monoclonal Gammopathy of Undetermined Significance.

Background: We aimed to determine the prevalence of sarcopenia in patients with monoclonal gammopathy of undetermined significance (MGUS) and to evaluate the links between MGUS and sarcopenia. Methods: Eighty-two patients with a diagnosis of MGUS were enrolled in the study. Muscle strength was measured using the handgrip dynamometer. Physical performance was assessed by assessing gait speed over a 6-minute walking test. Muscle mass was determined using a bioelectrical impedance analyzer. Results: Sarcopenia was confirmed in 34.15% of patients. Male predominance was demonstrated in MGUS subjects with sarcopenia, particularly patients with low hand grip strength, low appendicular skeletal muscle mass (ASMM), or low ASMM index (p < 0.001, 0.013, and 0.001, respectively). Higher age and lower serum free light-chain Lambda levels were shown in MGUS patients with low muscle function scores compared to normal scores (p < 0.001, and 0.014, respectively). In addition, having a low ASMM score was related to low body mass index and high-risk group (p = 0.020, 0.033, respectively). Conclusions: We demonstrated that the frequency of sarcopenia is high in patients with MGUS. Whether sarcopenia has a possible role as a factor contributing to the pathogenesis of MGUS should be supported by further studies containing longitudinal data.

Mild cognitive impairment predicts the onset of Sarcopenia: a longitudinal analysis from the English Longitudinal Study on Ageing

BackgroundMild cognitive impairment (MCI) and sarcopenia are two common conditions in older people. It is not widely known if MCI could predict the onset of sarcopenia. Therefore, we aimed to investigate whether MCI could predict the occurrence of sarcopenia in a population of older adults.MethodsIn the ELSA (English Longitudinal Study on Ageing), MCI was defined as the absence of dementia, preserved functional capacity and low performance in three objective cognitive tests. Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index during follow-up. The longitudinal association between MCI at the baseline and incident sarcopenia was assessed using a multivariable logistic regression model, reporting the data as adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results3,106 participants (mean age of 63.1 years; 55.3% males) were included. People with MCI reported significantly lower mean handgrip strength values and Skeletal Mass Index (SMI), as well as a higher prevalence of obesity at baseline. At baseline, 729 people had MCI and during the ten years follow-up period, 12.1% of the initial population included had sarcopenia. On multivariate analysis, adjusted for 18 potential confounders, the presence of MCI (OR = 1.236; 95%CI: 1.090–1.596, p = 0.01) significantly predicted the onset of sarcopenia during follow-up.ConclusionThe presence of MCI at baseline was associated with a higher incidence of sarcopenia at ten-years follow-up, demonstrating a likely role of MCI as a predictor of the onset of sarcopenia in older people.

FRI-296 Metabolic dysfunction-associated steatotic liver disease and low handgrip strength are independently associated with a higher risk for cardiovascular disease

FRI-296 Metabolic dysfunction-associated steatotic liver disease and low handgrip strength are independently associated with a higher risk for cardiovascular disease

Growth differentiation factor 15 (GDF15) levels are associated with malnutrition in acutely admitted older adults

Background and aimsThe aging process is often accompanied by high risk of malnutrition and elevated levels of growth differentiation factor 15 (GDF15). GDF15 is an increasingly recognized biomarker for regulation of metabolism, but few studies have investigated the connection between GDF15 and malnutrition in older age and how it relates to other features of aging such as decreased appetite and physical function. Therefore, we investigated the associations between GDF15 levels and nutritional status, appetite, and physical function in acutely admitted older adults. MethodsPlasma GDF15 levels were measured using immunoassays in 302 older adults (≥65 years) admitted to the emergency department (ED). Nutritional status was evaluated with the Mini Nutritional Assessment Short-Form (MNA®-SF), appetite was evaluated with the Simplified Nutritional Appetite Questionnaire (SNAQ), and physical function was evaluated with handgrip strength (HGS), 30-second chair stand test (30s-RSS), and gait speed (GS). Associations between GDF15 and each outcome was determined by logistic regression adjusted for age, sex, and C-reactive protein (CRP). ResultsEach doubling in plasma GDF15 level was associated with an adjusted odds ratio (OR) (95% confidence interval) of 1.59 (1.10–2.29, P=0.01) for risk of malnutrition compared to normal nutrition and 1.19 (0.85–1.69, P=0.3)) for malnutrition compared to risk of malnutrition. Each doubling in GDF15 was associated with an adjusted OR of 1.63 (1.21–2.23)) for having poor appetite, 1.46 (1.07–1.99) for having low HGS, 1.74 (1.23–2.51) for having low 30s-RSS, and 1.99 (1.39–2.94) for having low GS. ConclusionAmong older adults admitted to the ED, higher GDF15 levels were significantly associated with malnutrition, poor appetite, and low physical function independent of age, sex, and CRP.