The Association of Pain With Physical Performance Among Community-Dwelling Older Adults in the PRO-EVA Study.

Whether the components of sarcopenia provide sex-specific prognostic information in heart failure (HF) remains uncertain. We enrolled 604 patients with HF (259 women; median age, 73 years) undergoing dual-energy X-ray absorptiometry. During 2.18-year follow-up, 124 deaths occurred. All sarcopenia components as continuous variables were associated with death in the overall cohort. Asian Working Group for Sarcopenia (AWGS2019) cutoffs for weak handgrip strength, prolonged fivetimes sittostand time (FTSS), or low Short Physical Performance Battery (SPPB) score showed the strongest association, whereas low appendicular skeletal muscle mass index (ASMI) did not predict death. No significant sex interactions were observed for ASMI, gait speed, FTSS, or SPPB, and only handgrip strength showed a borderline interaction trend (P=0.058), with a stronger association for death in women. Despite a nonsignificant interaction (P=0.284), the AWGS2019 criteria predicted death in men (adjusted HR, 2.23; 95% confidence interval (CI), 1.21-4.09, P=0.013) but not in women (aHR, 1.28; 95% CI, 0.70-2.34, P=0.423). Exploratory analyses showed that optimized, HF-specific ASMI thresholds improved prognostic performance. Performancebased sarcopenia components can provide valuable mortality risk stratification in HF irrespective of sex. Although sex interactions were limited, population-derived muscle mass thresholds showed reduced prognostic performance in women, indicating that refining disease-specific or sex-adapted thresholds may enhance risk stratification in HF.

Introduction: Sarcopenia, characterized by progressive muscle decline, threatens functional independence and global health sustainability. Early identification of low muscle strength is critical in community settings that lack advanced diagnostic tools. This cross-sectional study aimed to measure the prevalence of low muscle strength and identify key physical factors in a combined pre-elderly (45-59 years) and elderly (≥ 60 years) cohort, aligning with the concept of community-based physical fitness measurement. Methods: We conducted a cross-sectional study among 62 participants (67.7% female; 61.3% elderly) in Cirebon, Indonesia. Probable sarcopenia was screened using the Asian Working Group for Sarcopenia (AWGS 2019) criteria: Low Muscle Strength (handgrip < 28 kg for men, < 18 kg for women) and Low Physical Performance (≥ 12.0 sec chair stand). Analysis included non-parametric tests and a multivariate logistic regression adjusting for age and calf circumference. Results: Low muscle strength prevalence was high at 66.1% (n = 41). Strength was significantly higher in males (20.30 kg) than females (15.66 kg, p-value = 0.004). Physical performance was poor, with 80.6% of the population meeting the criteria for slowness (median = 13.98 sec). Multivariate analysis identified calf circumference as a significant independent protective factor for both low strength (AOR: 0.77; 95% CI: 0.62–0.92; p-value = 0.008) and poor performance (AOR: 0.77; 95% CI: 0.57–0.96; p-value = 0.043). Advanced age was a significant predictor specifically for low muscle strength (AOR: 4.41; 95% CI: 1.23–17.6; p-value = 0.026). No significant associations were found with body mass index (BMI), blood sugar, cholesterol, smoking, or job status (p-value > 0.05). Conclusion: The high prevalence of low muscle strength in this pre-elderly and elderly cohort, independently predicted by smaller calf circumference, signals a critical public health threat. This functional decline is primarily driven by physical and age-related factors, not socioeconomic status. Our findings demand urgent, community-based strength training programs to empower healthy aging and preserve functional independence.

The longitudinal relationship between fatigue and physical deterioration is least explored. The aim of the study was to investigate the physical performance transitions and the relationship with adverse outcomes over 3-years in older people with or without fatigue. This 3-year longitudinal study included 456 community-dwelling older adults (mean age: 73.5 ± 7.5 years; female 43.0%). Physical performance was assessed using the Short Physical Performance Battery (SPPB). Fatigue was assessed by a single-item question "Have you felt tired or fatigued on at least 3 or 4 days each week?" At follow-up, both groups showed a trend towards lower physical performance levels, with the fatigue group exhibiting a significantly more pronounced decline. After adjusting for covariates, new-onset sarcopenia(OR = 3.08, 95%CI = 2.18-5.45) and malnutrition(OR = 2.70, 95%CI = 1.38-5.57) were the significant adverse events associated with physical performance deterioration in individuals with fatigue at 3-year follow-up. While for non-fatigue older adults, cognitive impairment (OR = 1.81,95%CI = 1.52-3.84) and sarcopenia(OR = 1.83, 95%CI = 1.50-5.33) were the significant adverse events associated with physical performance deterioration. The characteristics of older individuals with and without fatigue are distinct while considering longitudinal physical performance transitions. Fatigue is a significant risk factor associated with geriatric syndromes such as sarcopenia and malnutrition in individuals who have poor physical performance.Clinical trial number: ChiCTR2100051397.

Serum branched-chain amino acids, dietary factors, and sarcopenia risk in older adults with and without diabetes mellitus.

C-reactive protein-to-albumin ratio as a marker of frailty, impaired physical function, and mortality in older adults with heart failure.

Parkinson's disease (PD) presents motor and non-motor symptoms that impair function and quality of life. Identifying clinical factors linked to physical performance is key for patient care and management.To examine associations between sarcopenia-related measures and physical performance in mild-to-moderate PD (Hoehn & Yahr [HY] I-III).This was a cross-sectional study including patients with idiopathic Parkinson's disease at mild to moderate stages (Hoehn & Yahr I-III), evaluated in the ON medication state. Physical performance was assessed using the Short Physical Performance Battery (SPPB). Sarcopenia was evaluated according to the revised European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, including screening with the SARC-F questionnaire and the Ishii score, assessment of muscle strength by handgrip dynamometry, and evaluation of body composition and appendicular lean mass by whole-body dual-energy X-ray absorptiometry (DXA). Analyses included bivariate comparisons, correlation analyses, and logistic regression models (Enter and Best Subsets).A total of 127 patients were evaluated (mean age 66 years; 41.7% females). Low physical performance was observed in 39% (n = 50) of patients and was strongly associated with positive screening of sarcopenia (SARC-F score ≥ 4; odds ratio [OR]: 1.67; 95%CI: 1.30-2.15; p < 0.001). Ishii score (p = 0.009), reduced mean handgrip strength (26 ± 10 kgf versus 30 ± 10 kgf; p = 0.02), and postural instability and gait difficulty (PIGD) (p < 0.001) were also significantly associated with low SPPB performance in bivariate analyses. In the multivariable models, SARC-F and PIGD emerged as independent predictors of poor physical performance. The best subset model, combining SARC-F and PIGD, showed good discriminative accuracy (area under the curve [AUC] = 0.82).Higher PIGD scores and SARC-F ≥ 4 correlated with poor physical performance in PD. Low performance was linked to both SARC-F and Ishii scores, which help identify risk of functional decline. Longitudinal studies are needed to clarify causality and treatment implications.

Air pollution and muscle-fat imbalance: How PM2.5 components and ozone drive sarcopenic obesity through inflammation

Inflammation-related indices and low physical performance in older adults with unintentional weight loss: a cross-sectional study.

BackgroundDespite established health benefits of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet in older populations, its relationship with muscle health remains largely unexplored. This study investigated associations between adherence to a Chinese-modified MIND diet and both low muscle mass (LMM) and physical performance among community-dwelling older Chinese adults.MethodsData were drawn from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 13,422 older adults. Muscle mass was assessed using a validated appendicular skeletal muscle mass (ASM) prediction formula. Physical performance was evaluated using a four-item functional assessment scale in reference to SARC-F. The associations between Chinese version of the MIND (cMIND) diet adherence and outcomes were examined using multivariable logistic regression for LMM and linear regression for physical performance. Comprehensive subgroup and sensitivity analyses were conducted to assess effect modification and result robustness.ResultsThe prevalence of LMM was 45.2% among participants. Higher cMIND diet scores demonstrated significant inverse associations with LMM probability across all analytical models. After full adjustment for sociodemographic, lifestyle, and health-related confounders, participants in the highest tertile of cMIND adherence showed substantially lower odds of LMM compared to those in the lowest tertile (odds ratio [OR]: 0.79; 95% confidence intervals [CI]: 0.69–0.90). Similarly, better cMIND diet adherence was positively associated with higher physical performance score in multivariable models. These findings remained consistent across sensitivity analyses.ConclusionGreater adherence to the cMIND dietary pattern is independently associated with lower probability of LMM and better physical performance among older Chinese adults. These findings suggest potential benefits of promoting MIND diet principles for maintaining musculoskeletal health in aging populations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40520-026-03325-3.

Frailty is a condition resulting from age-related decline in physical, cognitive, physiological, and immune reserves. It is increasingly recognized as an important clinical syndrome in patients with chronic kidney disease, with special relevance among those on the kidney transplant waitlist or who have undergone kidney transplantation. Therefore, a comprehensive understanding of its prevalence, risk factors, and impact on transplant outcomes in both kidney transplant candidates and kidney transplant recipients is essential. The aim of this systematic review is to provide a comprehensive understanding of frailty across the kidney transplant continuum, including its prevalence, predictive factors, clinical outcomes, assessment tools, and implications for clinical practice and future research, through an up-to-date synthesis of recent evidence. A comprehensive literature search was performed in PubMed, Web of Science, Ovid MEDLINE, Cochrane Library, and Scopus to identify relevant studies published up to May 1, 2025. The eligibility of studies was screened by 2 independent reviewers. Due to substantial heterogeneity in populations, frailty definitions, and outcomes, a narrative synthesis was performed instead of a meta-analysis. This systematic review was conducted in accordance with PRISMA guidelines and was registered in the PROSPERO database. A total of 127 studies were included in this review. The reported prevalence of frailty among kidney transplant candidates ranged from 8.7 to 75%, while among transplant recipients it ranged from 5.1 to 40.5%. Several risk factors were consistently associated with frailty, including advanced age, diabetes, cardiovascular disease, and low physical performance. Frailty was linked to increased waitlist mortality, delayed graft function, prolonged hospital stay, higher risk of postoperative complications, and reduced graft and patient survival. Some studies reported partial or complete improvement in frailty status following kidney transplantation. Although the Physical Frailty Phenotype is the most used tool to assess frailty in studies, there is still no consensus on a standardized assessment method. Frailty is a critical condition that requires comprehensive assessment during the kidney transplantation process. Recent clinical research has focused on elucidating the mechanisms underlying the association between frailty and transplantation, and the insights gained may contribute to the development of more effective management strategies throughout the transplantation process.

BackgroundDiabetes represents a growing global public health burden. Traditional risk assessments based on static metabolic markers may not adequately reflect underlying mechanisms such as insulin resistance. As the primary site of glucose disposal, skeletal muscle may offer additional insight through functional assessments. However, the predictive value of muscle function indicators, including grip strength and the five-times chair stand test (5-CST), remains uncertain.MethodsThis prospective cohort study comprised 6,604 participants drawn from the China Health and Retirement Longitudinal Study (CHARLS), with follow-up data collected from 2011 to 2020. Muscle strength and physical performance were assessed at baseline using grip strength and 5-CST, respectively. New-onset diabetes was identified through self-report of physician diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between muscle function indicators and new-onset diabetes, adjusting for potential confounders. Subgroup and interaction analyses were performed by age, gender, and body mass index (BMI). Nomograms and Sankey diagrams were used for data visualization.ResultsAmong the 6,604 participants, 3,020 were male (45.7%) and 3,584 were female (54.3%), with a median age of 58 years (IQR: 51–65). Low muscle strength was identified in 605 participants (9.2%), and low physical performance in 2,025 (30.7%). Low physical performance was associated with an elevated risk of new-onset diabetes (HR 1.354, 95% CI 1.174–1.561; p < 0.001), which persisted after multivariable adjustment (HR 1.219, 95% CI 1.052–1.414; p = 0.008). This association was stronger in participants aged 40–49 years (HR 1.835, 95% CI 1.249–2.696; p = 0.002), and those with BMI < 25 kg/m² (HR 1.528, 95% CI 1.266–1.845; p < 0.001). Although each 1-second longer 5-CST time was linked to a 2.6% higher risk before adjustment (HR 1.026, p < 0.001), this continuous association was not significant after full adjustment. Neither absolute nor relative grip strength showed independent associations with diabetes risk.ConclusionsPhysical performance surpasses grip strength as a predictor of new-onset diabetes, particularly in middle-aged and non-obese individuals. As a brief, low-resource assessment of lower-limb performance, it provides a practical and scalable tool for identifying high-risk individuals, especially young lean adults who are often missed by traditional risk models.

BackgroundThe A body shape index (ABSI) has been associated with various diseases, and existing research suggests a link with sarcopenia. However, systematic evaluations focusing on Asian populations—particularly middle-aged and older adults in China—remain insufficient, and the specific association mechanisms and predictive value have yet to be fully elucidated. This study aimed to examine this relationship utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) database.MethodsA total of 1873 participants aged ≥ 45 years with complete data from the 2015 CHARLS were included. Eligibility criteria required the availability of: (1) parameters necessary for ABSI calculation, namely, waist circumference (WC), height, and weight; (2) sarcopenia assessment components (muscle mass, grip strength (GS), and physical performance); and (3) all relevant covariates. Sarcopenia was diagnosed according to AWGS2019 guidelines, defined as low muscle mass (appendicular skeletal muscle mass (ASM)/height2 < 7.0 kg/m2 for male, < 5.7 kg/m2 for female) in combination with either low GS (< 28 kg for male, < 18 kg for female) or impaired physical performance (gait speed < 1 m/s or chair stand time > 12 s). Three progressively adjusted weighted logistic regression models were constructed: Model 1 (unadjusted), Model 2 (adjusted for demographic variables, including age, sex, and marital status), and Model 3 (fully adjusted for demographic, lifestyle, and clinical variables, such as physical activity, chronic diseases, and depression). Predictive performance was assessed using receiver operating characteristic (ROC) curve analysis, and a K-nearest neighbors (KNN) algorithm was applied to determine variable importance.ResultsThe cross-sectional analysis demonstrated significant differences in ABSI between individuals with sarcopenia (n = 329) and those without (n = 1544), with mean ABSI values of 4.59 and 3.71, respectively. The prevalence of sarcopenia was approximately 17.57% in the study population. All three models consistently indicated a significant association between ABSI and sarcopenia: Model 1 (odds ratio = 5.85, 95% confidence interval: 4.73–7.33), Model 2 (odds ratio = 5.34, 95% confidence interval: 4.23–6.83), and Model 3 (odds ratio = 5.22, 95% confidence interval: 4.10–6.74). The ROC analysis revealed that the fully adjusted model yielded an area under the curve of 0.871, compared to 0.760 for the ABSI-only model. In the KNN model, ABSI ranked highest in feature importance.ConclusionsABSI is strongly associated with sarcopenia prevalence and functions as an independent indicator, suggesting its potential applicability in sarcopenia screening strategies.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-025-03513-3.

Sarcopenia is an age-related progressive disease characterized by loss of muscle mass accompanied with low muscle strength and/or physical performance. The aim of the present study was to investigate the relationship between green tea intake and sarcopenia in a Chinese population of community-dwelling older adults. A cross-sectional retrospective study with 2553 participants aged ≥65years was performed. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were measured to assess sarcopenia. A quantitative questionnaire was used to obtain information of green tea consumption. Sarcopenia group had lower proportion of green tea consumers when compared to the non-sarcopenia group (21.6% vs. 28.1%, P = .001). Multivariate logistic regression analysis showed that green tea intake was associated with decreased risk of sarcopenia (OR = 0.695, 95% CI = 0.547-0.882, P = .003). Subgroup analysis demonstrated that the association of green tea intake with sarcopenia was significant in individuals who drank a small amount (<125g/month) and weak tea. Moreover, green tea consumers had higher ASMI and faster gait speed than non-green tea consumers. Our results suggest that green tea intake is associated with decreased risk of sarcopenia in a Chinese population of older adults, especially for those who prefer weak tea. Key messages What is already known on this topic: Although in vitro and in vivo studies have shown the protective effects of polyphenols on aging-related muscle loss and muscle dysfunction; however, the relationship between green tea consumption and the risk of sarcopenia remains unclear. What this study adds: Our findings demonstrate that green tea consumers had higher appendicular skeletal muscle mass index and faster gait speed than non-green tea consumers. Moreover, green tea consumption is associated with lower risk of sarcopenia in the older adults, especially for those who prefer weak tea. How this study might affect research, practice or policy: Our results suggest that drinking proper amount of green tea might be a health-promoting lifestyle for the prevention of sarcopenia in the older adults.

ObjectiveObserve how instruction to avoid rounding the low back while lifting a relatively light mass impacts isometric lifting strength.BackgroundAs opposed to manual materials handling training directives recommending whole-body techniques such as a squat lift, targeting specific body regions such as low back curvature, theoretically affords workers greater flexibility to organize the rest of the body to reduce musculoskeletal loading without reducing physical performance. However, providing these directives during sub-maximal tasks may not prompt prioritization of physical performance as individuals self-organize, eventually making the intervention ineffective.MethodsForty participants (50% female) lifted a crate with and without the instruction to avoid rounding the low back. Postures at the initiation of crate lifting were replicated to test isometric strength.ResultsAt the group-level, instruction decreased low back flexion (p < 0.0001) but did not change strength (p = 0.862). However, high heterogeneity motivated examining individual responses. Thirty-seven participants (92.5% of the sample) exhibited greater than 40% of their flexion range-of-motion during baseline lifting, a threshold below which passive tissue strain is typically minimized. Yet, 22 participants (55%) were unsuccessful in reducing low back flexion below this threshold with instruction. Independent from these postural response groups, 23 maintained (57.5%), 8 increased (20%) and 9 decreased (22.5%) isometric strength.ConclusionOn average, physical performance potential was maintained in response to a low back postural directive. However, personalized movement coaching is needed to ensure the desired response for all.ApplicationManual materials handling training should include personalized movement coaching that considers both musculoskeletal loading and performance.

The aim of this study was to identify relationships between body composition and physical performance measures with cognitive responses assessed through the D2 attention test. Ten semiprofessional women players from South of Spain participated in the study. Data was collected prior to training sessions, starting with body composition assessments, followed by the D2 test, and finally, the physical performance tests. The results showed that defenders presented a higher percentage of body fat compared to midfielders, and even more so compared to forwards. They also obtained poorer results in the 3-m sprint and in the concentration index (p &lt; 0.05). Significant correlations were found between body fat percentage and the variation index (r = 0.737), as well as between RSA decrement and both the total number of processed characters and the concentration index from the D2 test (r = -0.704 / -0.694). In conclusion, female soccer players are exposed to repeated efforts at varying intensities; therefore, a higher body fat percentage negatively influences sports performance, which explains why defenders and goalkeepers tend to show poorer physical and cognitive results compared to other positions. Moreover, lower physical performance is associated with reduced attentional outcomes. These findings suggest that maintaining an optimal body mass index and body fat percentage compatible with higher physical and cognitive performance may improve competitive outcomes.

Effects of low muscle-to-fat ratio and high fat mass on all-cause mortality in patients with sarcopenia in central Taiwan: A comparative study.

Abstract Sarcopenia is defined as ‘age-related loss of muscle mass, plus low muscle strength, and/or low physical performance.’ In early older adults, it is rarely diagnosed based on physical performance, underscoring the importance of early intervention strategies. This study aimed to identify risk factors associated with sarcopenia in adults aged 65–75 years. Using the 2023 Korean National Health and Nutrition Examination Survey data, participants were categorized into three groups: sarcopenia (low muscle mass and low strength), sarcopenia risk (low muscle mass or low strength, excluding sarcopenia), and robust. The classification was based on appendicular skeletal muscle mass and handgrip strength, following the 2019 Asian Working Group for Sarcopenia criteria. Demographic characteristics and physical and psychological health-related factors were included as independent variables. Multinomial logistic regression was used to estimate odds ratios (OR) for factors associated with sarcopenia and sarcopenia risk. Among the 915 participants, the prevalence rates of sarcopenia and sarcopenia risk were 5.6% and 27.6%, respectively. Prevalence increased with age and lower BMI. Multivariate multinomial logistic regression analysis revealed that compared to the robust group, both sarcopenia and sarcopenia risk were significantly associated with not engaging in strength exercises at least once per week (OR = 2.598, OR = 1.858) and experiencing higher usual stress levels (OR = 3.034, OR = 1.710). However, not meeting the WHO’s recommended 2.5 hours of weekly moderate-intensity aerobic physical activity was not significantly associated with sarcopenia or sarcopenia risk. This finding suggests that strength exercises beyond walking, should be emphasized for early older adults.

Previous studies on sarcopenia and COVID-19 have primarily focused on pathophysiological mechanisms, leaving the effects of social isolation policies largely unexplored. Taiwan offers a unique environment to investigate this issue. This study investigates the association between COVID-19-related isolation and sarcopenia in older adults in Taiwan. Participants aged 65 and older were enrolled from annual geriatric health check-ups conducted between 2018 and 2023. The years from 2018 to 2020 were designated as the pre-COVID-19 period, while 2022-2023 was considered the post-COVID-19 era. Demographic data and health conditions were collected. The assessments encompassed body composition, muscle strength, and physical performance. The prevalence and trends of sarcopenia were analyzed. The prevalence of low muscle strength declined in 2021 but subsequently increased from 2022 to 2023 (pquadratic = 0.018). In 2023, compared with 2018-2020, the odds ratio for sarcopenia and severe sarcopenia was 1.3 (95% confidence interval [CI] 1.01-1.67), and the odds ratio for low physical performance was 1.73 (95% CI 1.39-2.15). This is the first report describing the association between COVID-19 pandemic-related policies and the prevalence of sarcopenia, revealing a significant increase in sarcopenia prevalence following the pandemic. Our results emphasize the necessity of tailored strategies to support older adults during and after health crises.

[Objective] Assess whether low protein intake is related to the development of sarcopenia in older adults. [Methods] This paper included primary studies focused on the relationship between protein intake and sarcopenia or its individual components (low muscle mass and strength and lower physical performance) in adults older than 60 years. The following studies were excluded: projects with no research design, studies with other nutritional interventions, and studies in older individuals with a sarcopenia diagnosis different than the one defined by the European Working Group on Sarcopenia in the Older People, with other comorbidities, or with pharmacological treatment. A systematic search was conducted in four databases, utilizing keywords in combination with Boolean operators. [Results] Out of the 15 studies included, 6 cross-sectional studies and 1 cohort study identified a significant association between low protein intake and an increased risk of sarcopenia, while 3 studies reported no significant association. Furthermore, 3 randomized controlled trials (RCTs) found no significant improvements in the sarcopenia-related components for the protein-supplemented intervention group compared to the control group. Only one randomized controlled study and one secondary data analysis study demonstrated significant improvements in muscle mass within the intervention group. [Conclusions] Low protein intake was significantly associated with a greater development of sarcopenia and lower muscle mass. This association was not observed on individual sarcopenia-related components.