Risk Of Sarcopenia Research Articles

Serum concentrations of different or multiple vitamins and Sarcopenia risk among US adults: insights from NHANES

BackgroundThe relationship between serum concentrations of different or multiple vitamins and sarcopenia remains underexplored. This investigation evaluates potential links between serum concentrations of different or multiple vitamins and sarcopenia prevalence among adults in the United States.MethodsUtilizing a cross-sectional design, this research draws from the National Health and Nutrition Examination Survey (NHANES) dataset of 2003–2006, encompassing 5,060 participants with comprehensive serum vitamin A, E, B9, B12, C, and D concentrations, alongside sarcopenia and covariate measurements. Participant stratification into distinct vitamin co-exposure clusters was achieved through K-means clustering. Analytical models, including weighted logistic regression, restricted cubic splines (RCS), weighted quantile sum regression (WQS), quantile g-computation (Q-gcomp), and Bayesian kernel machine regression (BKMR), were employed to evaluate the association between serum concentrations of different or multiple vitamins and sarcopenia risk, with an emphasis on nonlinearity.ResultsIn this study, sarcopenia was detected in 681 individuals (13.46%). Logistic regression results did not demonstrate any linear association between individual vitamin levels and sarcopenia risk (PFDR > 0.05). Contrastingly, the RCS model unveiled significant non-linear relationships for vitamins A and D (P_non-linear < 0.05). The K-means clustering results showed that participants in high-level vitamin exposure group had lower sarcopenia risk compared with those in low-level vitamin exposure group (OR (95% CI): 0.582 (0.397, 0.852)). Additionally, higher serum concentrations of different or multiple vitamins correlated inversely with sarcopenia risk (P_trend = 0.002). This inverse association was corroborated by WQS, Q-gcomp, and theBKMR models and remained consistent upon sensitivity analysis.ConclusionsThis study elucidates an inverse correlation between serum concentrations of different or multiple vitamins and sarcopenia risk, emphasizing a non-linear association, particularly with suboptimal vitamin D concentrations. Given the limitations of the NHANES study, further researches are required to clarify the existence of these relationships.

The finger-ring test as an indicator of muscle mass estimated by dual-energy X-ray absorptiometry in an adult community-dwelling population.

The finger-ring test (FRT) offers a simple method to screen older adults at increased risk of sarcopenia. To investigate the association between the FRT and lean soft tissue mass estimated by dual-energy X-ray absorptiometry (DXA), and to further elucidate the FRT as an indicator of muscle mass, while accounting for potential confounders, in a community-dwelling population. Within this cross-sectional study 430 community-dwelling individuals aged 18 to 79 (286 women (66.5%) and 144 men (33.5%)) were enrolled. Data regarding FRT and anthropometric measurements were collected. Whole-body composition was estimated using DXA. Binary and ordinal logistic regressions were performed. The frequency of smaller calf, just fits, and bigger calf was 17.7%, 33.7%, and 48.6%, respectively. Regardless of sex, higher appendicular lean soft tissue mass adjusted for height squared was observed for higher FRT categories (p < 0.001). For the ordinal logistic regression model, each unity of increment in appendicular lean soft tissue mass adjusted for height squared (kg/m2) was associated with a higher probability of being allocated to higher finger-ring test categories, in both genders. A higher cumulative adjusted odds ratio was found for women (7.53; 95% confidence interval: 4.58-12.38) than for men (2.99; 2.00-4.48). By demonstrating an association between the appendicular lean soft tissue mass estimated by DXA and the FRT, these results strengthen the utility of this simple self-test as an indicator of muscle mass, which can be used in the primary prevention of muscle mass decline and its recovery.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and sarcopenia based on NHANES

The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, or NHHR, has garnered increased attention because of its connection to metabolic diseases. It is yet unknown, nevertheless, how NHHR and sarcopenia relate to one another in the US population. Examining the relationship between NHHR and the prevalence of sarcopenia in the US population is the main goal of this study. Utilizing information gathered from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, a study was conducted to look at the connection between NHHR and sarcopenia in the US population. The individuals’ baseline features were categorized based on whether or not sarcopenia was present. We used subgroup analysis, restricted cubic spline (RCS), and weighted logistic regression to examine the connection between NHHR and sarcopenia prevalence. Sensitivity analysis was used to confirm that the study’s findings were reliable and consistent. R (version 4.2.3) was used for all analyses, and P < 0.05 was used to indicate statistical significance. There were 10,087 individuals in all, 9,187 of whom were not sarcopenic and 900 of whom were. Sarcopenic patients were generally older, predominantly of Mexican American descent, and had lower educational levels. These patients were generally less active and exhibited higher levels of total cholesterol and BMI, along with lower HDL levels. Following complete adjustment, the weighted logistic regression model indicated that a 7% increased risk of sarcopenia was linked to every unit rise in NHHR (OR = 1.07, 95% CI = 1.02–1.13). An inflection point was identified at 2.90 by RCS analysis, which revealed a nonlinear association between NHHR and the prevalence of sarcopenia. Subgroup analysis showed that, regardless of the demographic group, there was a continuous positive correlation between NHHR and the prevalence of sarcopenia. The results of the interaction test provided evidence in favor of NHHR functioning as a stand-alone risk factor for sarcopenia. Our research suggests that a higher prevalence of sarcopenia may be linked to an increase in NHHR. Consequently, NHHR may function as a separate risk factor for sarcopenia.

Association of preoperative nutritional status with sarcopenia in patients with gastrointestinal malignancies assessed by GLIM criteria: a prospective cohort study.

The Global Leadership Initiative in Malnutrition (GLIM) consensus highlights the importance of using the GLIM criteria as a standardized approach to diagnosing malnutrition, particularly in patients with cachexia. Although many existing studies have utilized the GLIM criteria to assess the association between malnutrition and malignant tumor patients, there remains relatively little research exploring the specific relationship between malnutrition and sarcopenia. This study aimed to investigate the correlation between malnutrition under the GLIM criteria and preoperative sarcopenia in patients with gastrointestinal malignancies. By looking into the relationship, we hope to find better ways to prevent and treat sarcopenia in these patients, which will lead to better clinical outcomes. In this study, we selected 210 patients with gastrointestinal malignant tumors from Northern Jiangsu People's Hospital between June 2022 to July 2023. We diagnosed and graded the nutritional status of these patients using the GLIM criteria. At the same time, body composition analysis, calf circumference, and grip strength were detected in all patients to observe whether they had sarcopenia. According to GLIM criteria, 30.1% of the patients were diagnosed with malnutrition, of which 25.1% were classified as moderate malnutrition and 15% as severe malnutrition. The risk of sarcopenia in patients with severe malnutrition was 2.5 times that of patients with good nutrition, and 1.19 times that of patients with moderate malnutrition. Patients with BMI <18.5 kg/m2 were 9.12 times more likely to develop sarcopenia than those with BMI≥18.5 kg/m2. Due to inadequate nutrient intake and resultant malnutrition in patients with malignant tumors, muscle protein synthesis is affected, exacerbating muscle protein breakdown and leading to an overall decline in muscle strength and function. This study highlights the urgent need for nutritional screening in early gastrointestinal tumor patients, revealing a strong link between sarcopenia and malnutrition. Higher malnutrition levels, low BMI, and high nutritional risk significantly predict sarcopenia, with risk increasing alongside worsening malnutrition and disease stage.

Risk of sarcopenia, frailty and malnutrition as predictors of postoperative delirium in surgery

BackgroundThe risk factors for postoperative delirium are numerous and complex. One approach to identifying patients at risk is to evaluate their nutritional status. The aim of this prospective study is to better understand nutrition as a potential risk factor for postoperative delirium.MethodsA comprehensive preoperative assessment (Clinical Frailty Scale (CFS), the SARC-F questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF)) were carried out as a prospective clinical study on 421 patients (70+) from 4 different surgical disciplines. Postoperatively, patients are examined daily for the presence of delirium using the 4AT screening tool (Arousal, Attention, Abbreviated Mental Test − 4, Acute change), the Nursing Delirium Screening Scale (NuDesc) and the Confusion Assessment Method (CAM) with its adaptation for the intensive care unit (CAM-ICU).ResultsIf there were indications of frailty or sarcopenia in the CFS or SARC-F, the association with delirium was increased 5.34-fold (OR of 5.34 [95% CI: 2.57;11.1]) and 5.56-fold (OR of 5.56 [95% CI: 2.97;10.4]) respectively. Delirium also occurred significantly more frequently with the risk of malnutrition or manifest malnutrition (MNA-SF) than with a normal nutritional status.ConclusionsPatients’ preoperative and nutritional status significantly impact the risk of developing postoperative delirium. Factors such as frailty, sarcopenia and possible malnutrition must be considered when implementing an effective and targeted preoperative assessment.Trail registrationGerman Clinical Trials Registry at https://www.drks.de/DRKS00028614, Registered 25 March 2022.

The ZJU index is associated with the risk of sarcopenia in American adults aged 20–59: a cross-sectional study

BackgroundThe ZJU index is an innovative computational method which integrates BMI, FBG, TG, and ALT to AST ratio. It strongly correlates with measures of lipid metabolism and glucose intolerance. No researches have yet explored the relationship between the ZJU index and sarcopenia.MethodsWe analyzed NHANES data from 2011 to 2018, dividing the ZJU index into quartiles. The association was investigated by adjusting for confounders using multivariable linear and logistic regression analysis. Results were visualized through RCS regression and threshold effect analyses. We conducted various subgroup and sensitivity analyses and plotted ROC curves to assess prediction efficacy, with the AUC as the measure of accuracy.ResultsAs the ZJU index increases, the prevalence of sarcopenia also rises. Following the control of potential confounders via logistic regression analysis, our research identified a distinct relationship between the ZJU index and sarcopenia, which was statistically significant (P < 0.001), with higher ZJU index values associated with increased risk (OR = 12.40, 95% CI: 8.46–18.17). Interaction analysis suggests that the relationship between the ZJU index and the risk of developing sarcopenia varies significantly between males and females across different ZJU index levels. ROC analysis for the ZJU index shows an AUC of 0.749. Conclusions: The ZJU index significantly correlates with a heightened risk of sarcopenia in Americans, suggesting its potential as a predictive marker for sarcopenia.

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.

The Association Between Time in Range %, Measured by Continuous Glucose Monitoring (CGM) and Physical Health Agility Status Indices Amongst Older People with T2D: A Cross-Sectional Study

Background: Individuals with diabetes face a higher risk of mobility disabilities, frailty, and sarcopenia (physical health agility). Studies have shown an association between HbA1C levels and physical health agility status. There is less information available about the relationship with time in range (%) (TIR). The aim of this study was to evaluate the cross-sectional relationship between time in range % (TIR %) and physical health agility status among older adults with type 2 diabetes (aerobic capacity, gait speed, strength, balance, and frailty). Methods: A cross-sectional study was conducted among individuals with diabetes over the age of 60. Participants were equipped with a blinded continuous glucose monitor (CGM) system (Medtronic iPro™2 and CareLink™, Medtronic, Northridge, CA, USA)) for 1 week and underwent an elaborate physical functional assessment (physical health agility) at the beginning and end of that week. The relationship between various physical health agility indices and both TIR (%) and HbA1c was evaluated using linear regression, with adjustments made for age and sex. Results: This analysis pertains to 139 individuals over the age of 60 with type 2 diabetes. After adjustment for age and sex, a 1% higher TIR (70–180 mg/dL) was associated with a 0.169 better score on aerobic capacity and endurance (p-value = 0.023), 0.119 better score on muscle strength of the upper limb (p-value = 0.039), 0.164 better score on dynamic balance (p-value = 0.039), and 0.165 better score on the evaluation of fall risk and balance (p-value = 0.037). Conclusions: In older individuals with diabetes, a higher percentage of time in range (TIR) is linked to better physical agility status indices. Future research is needed to determine whether glucose levels are simply a marker of disease severity or if there is a potential causal relationship.

Serum creatinine- and cystatin C-based indices are associated with the risk of subsequent sarcopenia: evidence from the China Health and Retirement Longitudinal Study.

Serum creatinine (Cr)- and cystatin C (CysC)-based indices have been suggested as alternative markers for sarcopenia, but their predictive value for sarcopenia risk is uncertain, which was investigated in the present study in the Chinese population with the middle and older ages. Data from the China Health and Retirement Longitudinal Study (CHARLS) were collected in the 2011 and 2015 waves. All participants were free of sarcopenia at the baseline. Sarcopenia was diagnosed when low muscle mass and grip strength or low physical performance were present. Four indices were computed: predictive skeletal muscle mass index (pSMI), total-body muscle mass (TBMM), creatinine-to-cystatin C ratio (CCR), and sarcopenia index (SI). Restricted cubic splines and logistic regression models were used to assess the effects of these indices on sarcopenia risk. Among 4,527 participants without sarcopenia at the baseline (2011), the median age was 58 year-old (IQR: 52-65), with 52.7% women. Followed up in year 2015, the incidence of sarcopenia was 20.8 per 1,000 person-years (376/4,527). Neither CCR nor SI showed linear or non-linear associations with the risk of subsequent sarcopenia. However, a decrease in pSMI and TBMM was significantly associated with an increased risk of sarcopenia [adjusted per-SD decrease OR, 2.93; 95% CI, 2.09-4.13, p < 0.001; adjusted per-SD decrease OR: 2.38, 95% CI: 1.80-3.16, p < 0.001, respectively]. In the middle and older age of Chinese population, decreased pSMI and TBMM were associated with an increased risk of subsequent sarcopenia, whereas CCR and SI showed no such correlation. Thus, pSMI and TBMM may serve as potential biological indicators for predicting the risk of sarcopenia, and decreased pSMI and TBMM may be the early biomarkers for diagnosis and intervention of sarcopenia.

Kegiatan Pengabdian Masyarakat Dalam Rangka Penapisan Kadar Protein Dan Profil Lipid Terhadap Sarkopenia Pada Kelompok Lanjut Usia

The risk of sarcopenia and metabolic complications in the elderly can be caused by the aging process and decreased muscle mass in the elderly group. Sarcopenia and obesity in the elderly also increase the risk of cardiovascular disease, diabetes, and physical disability, which have the potential to reduce quality of life and increase morbidity and mortality. The purpose of this community service activity is to screen protein levels and lipid profiles in the elderly group in order to detect the risk of sarcopenia and dyslipidemia early. This activity is carried out using the Plan-Do-Check-Action (PDCA) method which includes planning, implementation, supervision, and follow-up. The community service activity was carried out at Panti Bina Bhakti, South Tangerang, involving 93 elderly participants aged &gt;65 years. The results of the activity showed that 35 people (37.63%), 9 people (9.68%), 35 people (37.63%), and 7 people (7.53%) each had abnormal lipid profiles for HDL, Cholesterol, LDL, and Triglycerides. While 24 people (25.81%) had abnormal albumin levels. Therefore, it is necessary to monitor protein levels and lipid profiles regularly as well as early intervention through a healthy diet, regular exercise, and education for the elderly to maintain muscle mass and muscle strength.

Association between Pan‐Immune Inflammation Value and Sarcopenia in Hypertensive Patients, NHANES 1999–2018

ABSTRACTSarcopenia worsens the prognosis in hypertensive patients, leading to complications such as proteinuria, osteoporosis, disability, and cognitive impairment. Early screening and intervention for sarcopenia in these patients may improve outcomes. This cross‐sectional study utilized data from 9253 hypertensive patients in the 1999–2018 National Health and Nutrition Examination Survey (NHANES). We used logistic and linear regression models, restricted cubic splines (RCS), and subgroup analyses to evaluate the relationship between pan‐immune‐inflammation value (PIV) and sarcopenia. Patients were divided into quartiles based on PIV levels. After controlling for confounding factors, our study found that those in the highest PIV quartile faced a 36% greater risk of developing sarcopenia compared to those in the lowest quartile (OR = 1.36, 95% confidence interval [CI]: 1.04–1.77). The RCS analysis indicated a linear increase in sarcopenia risk as PIV levels rose (non‐linear p = 0.130). Subgroup analysis demonstrated that diabetes synergistically increased sarcopenia risk (p for interaction = 0.007). Elevated PIV levels were identified as an independent risk factor for sarcopenia, with diabetes amplifying this risk. These findings highlight the importance of early identification and management of elevated PIV levels to improve outcomes for hypertensive patients at risk of sarcopenia.

Urinary titin as a biomarker of sarcopenia in diabetes: a propensity score matching analysis.

Measuring urinary titin levels is expected to be useful in screening for muscle damage or injury in various diseases. We evaluated whether urinary titin levels were elevated in individuals with type 2 diabetes mellitus (T2DM) and how urinary titin levels were associated with the diagnosis of sarcopenia in T2DM. We performed a cross-sectional analysis of 114 controls and 515 patients with T2DM. Multivariate-adjusted models were used to determine the odds ratios (OR) of urinary titin cutoff values for diagnosing sarcopenia. Urinary titin levels were higher in the T2DM group than in the non-diabetes group after propensity score matching (median [IQR] 3.2 [2.3, 4.6] vs. 4.4 [2.7, 6.9] pmol/mg·creatinine). T2DM was associated with high titin levels after correction for comorbidities (odds ratio 2.46, 95% confidence interval (CI) 1.29-4.70, P = 0.006) but not after correction for sarcopenia-associated factors. Urinary titin levels above the cutoff value showed an odd ratio of 6.61 (age- and body mass index-adjusted, 1.26-34.6, P = 0.021) for the diagnosis of sarcopenia in men with T2DM aged ≥ 75 years. Results indicated that T2DM was associated with a high-titin state and that the urinary titin cutoff value could be useful for identifying candidates at high risk for sarcopenia, such as elderly men.

The impact of Life's Essentials 8 on sarcopenia prevalence among adults in the United States

BackgroundSarcopenia is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), with the presence of sarcopenia among US adults. MethodsThis population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005–2006 and 2011–2018, and included adults aged 20 years or older. LE8 score was measured according to American Heart Association definitions. Sarcopenia was measured according to the National Institutes of Health definition, the ratio of appendicular skeletal muscle mass (ASM) to body mass index (BMI). Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and sarcopenia. ResultsAmong the 11,078 participants, 1021 (9.22 %) were diagnosed with sarcopenia. After adjusting for potential confounders, higher LE8, health behavior and health factors scores were associated with reduced odds ratios (OR) of sarcopenia (OR for per 10 scores increase in LE8, 0.65; 95 % CI 0.61–0.70; OR for per 10 scores increase in health behaviors score, 0.90; 95 % CI 0.84–0.97; OR for per 10 scores increase in health factors score, 0.67; 95 % CI 0.63–0.71). A non-linear dose-response relationship was observed between LE8 scores, health factors scores, and sarcopenia. The inversed association between LE8 score and sarcopenia was significantly stronger among males and participants with a high school education or above. ConclusionsLE8 was negatively associated with the prevalence of sarcopenia in a nonlinear fashion. Promoting adherence to optimal CVH levels may benefit to reduce the risk of sarcopenia.

Low Serum Beta-2 Microglobulin Level: A Possible Biomarker for Sarcopenia in the Elderly Population.

Background and Objectives: One of the most critical problems regarding sarcopenia is the difficulty of the diagnosis process. This study aimed to determine the prevalence and investigate the role of serum beta-2 microglobulin level as a biomarker for diagnosing sarcopenia. Materials and Methods: This nested case-control study was conducted between 2023 and 2024 on 251 older adults. Muscle strength was measured using a hand dynamometer, and muscle mass was assessed using the bioelectrical impedance method. Individuals with low muscle strength and low muscle mass were accepted as having definitive sarcopenia. Results: The mean age of the 251 older adults included in the study was 72.19 ± 6.11 years. The prevalence of sarcopenia in individuals aged 65 years and over was found to be 5.2%. Serum beta-2 microglobulin levels were statistically significantly lower in sarcopenic participants compared to the control group (p = 0.002). The optimal cut-off value for serum beta-2 microglobulin level was 2.26 mcg/mL, and values lower than this point were found to be diagnostic for sarcopenia. Regarding the cut-off value, the sensitivity was 92.31% and the specificity was 80.77%, the positive predictive value was 70.59%, the negative predictive value was 95.45%, the Youden index was 0.731, and the area under the curve value was 0.901. Individuals who had beta-2 microglobulin levels below 2.26 mcg/mL were found to have a 10.75 times higher risk of sarcopenia. Conclusions: A low serum beta-2 microglobulin level has the potential to be an important candidate biomarker for the diagnosis of sarcopenia.

Sarcopenia risk in U.S. younger adults: the impact of physical activity intensity and occupational engagement—insights from a cross-sectional NHANES study

ObjectiveThis study aimed to investigate the associations between physical activity (PA) intensity, occupational PA engagement, and sarcopenia in younger adults.MethodsData from the National Health and Nutrition Examination Survey (NHANES) (from 2011 to 2018) were used for the study. PA data were extracted for the Global Physical Activity Questionnaire, and the ratio of limb muscle mass (ALM) to body mass index (BMI) was used to determine sarcopenia. Multiple logistic regression was performed, and dose-response curves were drawn to evaluate the associations.ResultsOf the 8802 adults aged 20 to 59 years, 770 (8.7%) were identified as having sarcopenia. Compared to those in the reference group, the participants in the “low”, “moderate”, and “high” total METs groups had lower risks of sarcopenia (low: OR = 0.730, 95% CI = 0.583; 0.915; moderate: OR = 0.643, 95% CI = 0.485; 0.853; high: OR = 0.560, 95% CI = 0.457; 0.687). The risk of sarcopenia decreased in the high-intensity recreational PA group; however, such a significant association was observed only in the high-intensity occupational PA group. The relationship between total METs and sarcopenia showed a nonlinear U-shaped trend.ConclusionsA greater intensity of PA is associated with a lower risk of sarcopenia among younger adults, regardless of whether moderate or vigorous PA is performed. Moreover, recreational PA may particularly advantageously contrast with occupational PA in lowering the risk of sarcopenia.

The causal relationships between iron status and sarcopenia in Europeans: a bidirectional two-sample Mendelian randomization study.

Previous studies have indicated potential associations between metals, lifestyle factors, and sarcopenia. However, the specific causal relationships between iron status, lifestyle factors, and sarcopenia remain unclear. Therefore, we conducted a bidirectional two-sample Mendelian Randomization (MR) approach to investigate these relationships. The exposure variables included iron status, living alone, coffee intake, alcohol taken with meals, and moderate physical activity, while the outcome variable was sarcopenia, assessed by grip strength in both hands and usual walking pace. We employed the Weighted Median (WM), the Inverse Variance-Weighted (IVW), and other MR methods to explore these problems for analysis. Simultaneously, we conducted a bidirectional MR analysis to assess whether sarcopenia has a reverse causal relationship with internal iron status. In our present research, we found serum iron (P = 0.033), ferritin (P = 0.001), transferrin saturation (P = 0.029) and coffee intake (P = 0.002) revealed a negative trend for sarcopenia, living alone (P = 0.022) and alcohol taken with meal (P = 0.006) showed a opposite trend for sarcopenia. Whereas sarcopenia showed negative trend for ferritin (P = 0.041) and transferrin saturation (P = 0.043), showed the opposite trend for transferrin (P = 0.021). Our study suggested that higher serum iron levels might reduce the risk of sarcopenia. Moreover, living alone and alcohol consumption might increase the sarcopenia risk, while coffee intake and moderate physical activity could reduce the sarcopenia risk.

Gait abnormalities and longitudinal fall risk in older patients with end-stage kidney disease and sarcopenia

BackgroundSarcopenia, gait disturbance, and intradialytic hypotension are among the various factors that contribute to fall risk. This study aimed to investigate the relationship between risk of sarcopenia, hemodialysis (HD) session, and long-term fall risk in older end-stage kidney disease (ESKD) patients by analyzing their spatiotemporal gait characteristics.MethodsWe recruited 22 non-demented patients aged ≥ 65 years who were undergoing maintenance HD. Participants were divided into two groups based on their SARC-F score (< 4 and ≥ 4) to identify those with higher and lower risk of sarcopenia. Demographics, comorbidities, and renal parameters were compared between groups. Inertial measurement unit-based technology equipped with triaxial accelerometry and gyroscope was used to evaluate gait characteristics. The gait task was assessed both before and after dialysis using the Timed-Up and Go (TUG) test and a 10-meter walking test at a regular pace. Essential gait parameters were thoroughly analyzed, including gait speed, stride time, stride length, double-support phase, stability, and symmetry. We investigated the interaction between the dialysis procedure and gait components. Outcome of interest was any occurrence of injurious fall during follow-up period. Logistic regression models were employed to examine the relationship between baseline gait markers and long-term fall risk.ResultsThe SARC-F ≥ 4 group showed various gait abnormalities, including longer TUG time, slower gait speed, longer stride time, shorter stride length, and longer double support time compared to counterpart (SARC-F < 4). After HD sessions, the SARC-F ≥ 4 group showed a 2.0-second decrease in TUG task time, an 8.0 cm/s increase in gait speed, an 11.6% lower stride time, and a 2.4% increase in gait symmetry with significant group-time interactions. Shorter stride length and longer double support time were associated with injurious falls during the two-year follow-up.ConclusionOur study demonstrated the utility of triaxial accelerometers in extracting gait characteristics in older HD patients. High-risk sarcopenia (SARC-F ≥ 4) was associated with various gait abnormalities, some of which partially improved after HD sessions. These gait abnormalities were predictive of future falls, highlighting their prognostic significance.

Lessons learned from a combined, personalized lifestyle intervention in hospitalized patients at risk for sarcopenia: a feasibility study

Purpose To examine the feasibility of a combined, personalized exercise and nutrition intervention in hospitalized patients at risk of sarcopenia. Methods The study is part of the FITFOOD randomized controlled trial. Eligible patients were randomized into two groups: receiving a personalized nutrition and exercise intervention, or receiving usual care. The intervention entailed a high-protein diet with daily protein supplementation combined with functional training with strength and aerobic exercises. Feasibility was assessed using quantitative data, such as recruitment rate, and qualitative data retrieved from focus group and individual semi-structured interviews. Results In total, 14 out of 115 eligible patients participated. The recruitment rate was 12%, and the dropout rate was 50% (7 out of 14 participants). Patients at risk for sarcopenia found it difficult to be involved in a lifestyle intervention, because they were often preoccupied with their recovery, had little interest in changing their diet or level of exercise, and were often unable to participate fully due to health issues and mobility difficulty. Conclusions The evaluated combined, personalized lifestyle intervention had limited feasibility in hospitalized patients at risk for sarcopenia, with low recruitment and high dropout rates. The current lifestyle intervention might be too challenging for this vulnerable population. Trial registration The trial associated with this feasibility study was pre-registered on ClinicalTrials.gov under the registration number NCT05413616 on 07 June 2022.

Predicting sarcopenia in community-dwelling older adults through comprehensive physical fitness tests

BackgroundSarcopenia is typically assessed through hand grip strength, walking speed, and chair stand tests. However, it has been inadequately examined in terms of other physical fitness (PF) components in community-dwelling older adults. Thus, in this study, we explored factors influencing the risk of sarcopenia in community-dwelling older adults. In addition, we analyzed the clinicodemographic characteristics of older adults with or without sarcopenia and investigated the effect of sex on their PF.MethodsThis cross-sectional study included 745 older adults from a community health promotion program in Taiwan. Their clinicodemographic characteristics were recorded. PF was assessed through various tests, such as hand grip strength evaluation, 8-foot up-and-go test (8-UGT), 2-min step test, and 6-m walk test. PF and factors influencing sarcopenia risk were compared between older adults with sarcopenia (sarcopenia group) and those without it (nonsarcopenia group). A logistic regression model was performed to identify key factors associated with sarcopenia. Its predictive performance was evaluated by calculating the area under the receiver operating characteristic curve (ROC) curve.ResultsRegardless of sex, the sarcopenia group performed worse in almost all components of PF—for example, upper and lower limb muscular strength and endurance, cardiopulmonary fitness, and balance—than did the nonsarcopenia group. However, for men, no significant between-group difference was observed in flexibility. The logistic regression model indicated age (odds ratio [OR]: 1.107), sex (OR: 2.881), Mini Nutritional Assessment—Short Form scores (OR: 0.690), and performance in 8-UGT (OR: 1.346) as factors influencing the risk of sarcopenia. The model exhibited excellent discriminative ability in predicting sarcopenia, as indicated by an area under the curve value of 0.867 (95% confidence interval: 0.827–0.906; p < 0.05).ConclusionOlder adults without sarcopenia tend to outperform those with sarcopenia in almost all PF measures, regardless of sex. Older age, male sex, low Mini Nutritional Assessment—Short Form scores, and poor performance in 8-UGT are associated with a high risk of sarcopenia.

Association between cardiovascular disease risk and sarcopenia in community-dwelling Japanese older adults.

Sarcopenia's high prevalence in older adults with cardiovascular disease (CVD) suggests that the risk of comorbidity in sarcopenia might also be increased during the at-risk phase of CVD. However, the relationship between CVD risk and sarcopenia has not been elucidated. Therefore, the purpose of this cross-sectional study was to investigate the association between CVD risk and sarcopenia in community-dwelling Japanese older adults. The participants in this cross-sectional study included 14 923 community-dwelling Japanese older adults (mean age 73.2 ± 5.6 years). The present study estimated the CVD risk using the revised World Health Organization risk chart, and classified CVD risk into "low" (<10%) and "mid-high" (≥10%). Assessments of sarcopenia, muscle mass, muscle strength and gait speed were measured based on the clinical definitions. Among the participants, 654 people (4.4%) had sarcopenia, and 4857 (32.6%) had CVD mid-high risk. A multiple logistic model showed that the CVD mid-high risk was associated with sarcopenia (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.28-1.89). In addition, CVD mid-high risk was associated with low muscle mass (OR 1.74, 95% CI 1.50-2.01), low muscle strength (OR 1.25, 95% CI 1.14-1.37) and slow gait speed (OR 1.17, 95% CI 1.07-1.27) in the adjusted model. Among community-dwelling older adults, high or moderate CVD risk was associated with an increased risk of sarcopenia. Our findings could help identify older adults with a future high risk for sarcopenia. Geriatr Gerontol Int 2024; ••: ••-••.