Sarcopenia In Elderly People Research Articles

The Risk of Malnutrition and Sarcopenia in Elderly People Living with HIV during the COVID-19 Pandemic.

Malnutrition is a risk factor of sarcopenia in the elderly. During the COVID-19 pandemic, limited transportation and supply chain disruptions restricted access to nutritious foods. We assessed the nutritional status and sarcopenia risk in older people living with HIV (PLWH) on combination antiretroviral therapy in Thailand. This study was a hospital-based cohort among virally suppressed older PLWH who came for routine HIV clinic visits. The mini nutritional assessment (MNA), body composition analysis and 5-time chair stand test (CST) were performed to assess the nutritional status, muscle mass and physical performance, respectively. A total of 177 PLWH were enrolled (57.60% male). The median age was 58 years (IQR 55-62 years). Thirty-five participants (19.8%) were at risk of developing sarcopenia, and 28.2% had abnormal nutritional status. Muscle mass correlated positively with nutritional scores (r = 0.355, p < 0.001) but negatively with 5-time CST duration (r = -0.173, p = 0.021). In the multivariate model, muscle mass was associated with age, sex, mid-arm circumference, calf circumference and 5-time CST duration. In a well-viral-suppressed older Asian PLWH cohort, given the positive correlation between nutritional status and muscle mass, the nutritional status of older PLWH should be routinely evaluated and monitored.

Dietary Protein and Physical Exercise for the Treatment of Sarcopenia.

Sarcopenia is a multifactorial age-related disorder that causes a decrease in muscle mass, strength, and function, leading to alteration of movement, risk of falls, and hospitalization. This article aims to review recent findings on the factors underlying sarcopenia and the strategies required to delay and counteract its symptoms. We focus on molecular factors linked to ageing, on the role of low-grade chronic and acute inflammatory conditions such as cancer, which contributes to the onset of sarcopenia, and on the clinical criteria for its diagnosis. The use of drugs against sarcopenia is still subject to debate, and the suggested approaches to restore muscle health are based on adequate dietary protein intake and physical exercise. We also highlight the difference in the amount and quality of amino acids within animal- and plant-based diets, as studies have often shown varying results regarding their effect on sarcopenia in elderly people. In addition, many studies have reported that non-pharmacological approaches, such as an optimization of dietary protein intake and training programs based on resistance exercise, can be effective in preventing and delaying sarcopenia. These approaches not only improve the maintenance of skeletal muscle function, but also reduce health care costs and improve life expectancy and quality in elderly people.

Body composition characteristics and influencing factors of different parts of sarcopenia in elderly people: A community-based cross-sectional survey.

This study aims to describe the differences in body composition among different body parts of the elderly in the community and its relationship with sarcopenia. Elderly people aged ≥65 underwent bioelectric impedance analysis testing and were categorized into a sarcopenia group, possible sarcopenia group, and control group. The characteristics of body composition indicators in different parts and their relationship with different stages of sarcopenia were analyzed. The sarcopenia group illustrated the lowest values of FFM, FFM%, BFM, BFM%, ICW, and limb PhA, along with higher ECW/TBW in the trunk and left leg compared to the control group. The possible sarcopenia group showed lower FFM% in limbs and trunk, and higher BFM% compared to the control group. Gender differences in elderly body composition were observed, with an increase in BFM% in various body parts posing a risk factor for possible sarcopenia in elderly males, whereas an increase in BFM% except in the left arm was a protective factor for sarcopenia in elderly females. The body composition of the elderly in the community varied significantly in different stages of sarcopenia and genders, which correlated with sarcopenia.

The Effect of Vitamin D Supplementation to Parameter of Sarcopenia in Elderly People: a Systematic Review and Meta-Analysis.

Vitamin D plays an essential role in promoting skeletal muscle metabolism. Several studies show that vitamin D may help the elderly prevent sarcopenia. Nevertheless, the outcome remains debatable. Our meta-analysis aimed to summarize the effect of vitamin D supplementation on sarcopenia-related parameters. We searched PubMed, Cochrane, Springer, SAGE Journals, and Scopus abstracts on 10th December 2021 for relevant studies. We included articles that studied the effect of vitamin D on muscle mass, muscle strength, and physical performance. The aim was to measure the muscle mass, muscle strength, and physical performance both at baseline and at the end of the intervention. A total of 6,628 participants from 35 studies were included. Most of the studies used oral vitamin D, whereas only one study used intramuscular injection. The effect of vitamin D supplementation showed no effect on appendicular skeletal muscle mass (SMD = .05 [95% CI, .33 - .44], p = .79). Regarding muscle strength, vitamin D supplementation did not have a significant effect on muscle strength which is handgrip strength (p = .26). Respecting physical performance, vitamin D supplementation did not affect TUG (Timed Up and Go) (p = .45). Vitamin D supplementation had minimal effect on sarcopenia-related parameters. Further research into understanding the role of Vitamin D in preventing the progressivity of sarcopenia still needs to be explored.

Evaluation of clinical manifestations of sarcopenia in elderly people in the Tyumen region

Evaluation of clinical manifestations of sarcopenia in elderly people in the Tyumen region

Self-determined sequence exercise program for elderly with sarcopenia: A Randomized controlled trial with clinical assistance from explainable artificial intelligence

To improve and even reverse sarcopenia in elderly people, this study developed a self-determined sequence exercise program consisting of strength training exercise, Yijinjing exercise (a traditional Chinese exercise), and hybrid strength training with Yijinjing exercise. Ninety-four community-dwelling older adults screened for sarcopenia using the Asian Working Group for Sarcopenia criteria were randomly assigned to 24 weeks of a control group (CG, n = 30), self-determined sequence exercise program group (SDSG, n = 34) or strength training group (STG, n = 30). The study examined the effects of three interventions on participantsL3 skeletal muscle fat density, L3 skeletal muscle fat area, L3 skeletal muscle density, L3 skeletal muscle area, muscle fat infiltration, relative skeletal muscle mass index, and grip strength using a repeated-measures ANOVA to evaluate the experimental data. To evaluate the real effect of this model in reversing sarcopenia after the intervention, nine classification models were trained. Significant interaction effects were observed with grip strength, RSMI, L3 SMD, and L3 SMA. At the 24th week, participants’ grip strength, L3 SMFA, L3 SMA, and RSMI were improved significantly in the SDSG and STG. The SDSG achieved significantly greater RSMI and grip strength than the STG and CG after the intervention. The self-determined sequence exercise program exhibited better performance than the single type of exercise modality in reversing sarcopenia and improving older adults’ skeletal muscle area. Consequently, the stacking model is feasible to make a prediction as to whether or not sarcopenia may be reversed in older adults.

SIOG2023-3-P-245 - Frequency of probable sarcopenia in elderly people with cancer in a Chilean Oncological Institute

SIOG2023-3-P-245 - Frequency of probable sarcopenia in elderly people with cancer in a Chilean Oncological Institute

Association of physical performance and sarcopenia with use of health services in elderly people living in rural riverside areas in the Amazon: a cross-sectional study.

Access is considered one of the necessary conditions for achieving effectiveness and quality in health services. However, it represents a complex construct, with several interpretations, and can be understood as the ease or degree of difficulty with which people obtain effective and timely care. Barriers to access can be related to individual characteristics and those of health systems and services. Regarding elderly people living in rural riverine localities, these limitations are exacerbated due to the territorial dispersion of households and the difficulty of obtaining the necessary care near their homes. The aim of this study was to describe and test the association of sarcopenia and physical performance with primary healthcare attributes and the use of health services by elderly people living in rural riverside areas in the Amazon, Brazil. This cross-sectional observational study was carried out in households with individuals aged 60 years or older living in nine communities located on the left bank of the Negro River, in the rural riverside area of the municipality of Manaus, Amazonas, Brazil. The study evaluated socioeconomic and demographic conditions, health services utilization and the primary care attributes related to the use of and access to services, assessed by components of the Primary Care Assessment Tool instrument (PCATool-Brazil), a reduced version validated for Brazilian adult users. Physical performance was assessed using the Short Physical Performance Battery scale, and handgrip strength was also assessed, according to a dynamometer. The Sarcopenia Formulary (SARC-F) and calf circumference (CC) were used to assess sarcopenia (SARC-CalF). The association of sarcopenia and physical performance with the study outcomes was evaluated using hierarchical logistic regression for health services utilization (having had a medical consultation in the last year), and hierarchical linear regression for the continuous outcomes of the PCATool-Brazil (total score and each of the domains). The sociodemographic variables were inserted in model 1 and the clinical variables in model 2. Variables with p<0.20 were kept in the models. A total of 98 elderly people (55.1% men; mean age 70&plusmn;7.4 years) were included in the study. Low physical performance and suggestive signs of sarcopenia were observed in 52.5% and 28.9% of the study participants, respectively. Elderly with better physical performance reported more health services utilization (odds ratio (OR)=1.37; 95% confidence interval (CI)=1.03-1.81) and higher scores in the affiliation (&beta;=1.67; 95%CI=0.37-2.98), utilization (&beta;=1.19; 95%CI=0.06-2.33) and longitudinality (&beta;=0.99; 95%CI=0.09-1.90) domains of the PCATool-Brazil. The study findings showed high prevalence of impairment in physical performance and suggestive signs of sarcopenia in elderly people living in the studied rural riverside localities. Better physical performance was associated with use of health services in the previous year and with better evaluation of some primary care attributes.

Ефективність корекції ознак саркопенії у осіб похилого віку з ендопротезом колінного суглоба

The purpose of the study was to evaluate the effectiveness of the developed physical therapy program on the parameters of sarcopenia in elderly people with total knee arthroplasty in the remote period after surgery. Materials and methods. During the research, 80 elderly people were examined. The control group consisted of 13 men and 15 women who did not undergo total endoprosthetic surgery of the joints of the lower limbs, without signs of sarcopenia. The comparison group consisted of 11 men and 16 women with total knee arthroplasty and diagnosed sarcopenia with low therapeutic (rehabilitation) compliance with the active rehabilitation intervention recommended based on the results of the initial examination. The main group consisted of 9 men, 16 women with total knee arthroplasty and diagnosed sarcopenia with a high level of therapeutic (rehabilitation) alliance regarding the active rehabilitation intervention recommended by the results of the initial examination. For them, a 6-month long physical therapy program was developed and implemented, which included the following elements: therapeutic exercises, functional training, massage of the lower limbs and lower back, kinesiological taping of the operated limbs; dietary recommendations; patient education. The effectiveness of the program was evaluated by the dynamics of the grip strength indicators, the Edmonton Frail Scale, and the SarQoL questionnaire. Results and discussion. In elderly patients with knee arthroplasty and sarcopenia, low strength (according to the value of grip strength), subjective physical weakness, difficulties in performing activities of daily living (according to the Edmonton Frail Scale questionnaire), were revealed, which led to a deterioration in the quality of life (according to the SarQoL questionnaire). The developed physical therapy program revealed a statistically significantly better effect on strength indicators, the state of physical weakness and quality of life parameters in comparison with the initial indicators for all studied parameters (р &lt;0.05). Low rehabilitation compliance in elderly patients with knee arthroplasty and sarcopenia, despite being aware of the risks of this polymorbidity, was associated with a lack of improvement over a similar follow-up period. Conclusion. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and impaired performance of activities of daily life, which increases the quality of life of this contingent of patients

Impact of Vitamin D Level on Sarcopenia in Elderly People: A Critical Review

AbstractVitamin D insufficiency is a widespread health issue globally, particularly among the elderly. Vitamin D controls and affects the metabolism and functionality of several human systems, including muscle tissue. The action of vitamin D on muscles has been extensively studied, with evidence indicating that this vitamin can increase the osteogenic differentiation of muscle fibers, hence preserving and enhancing muscular strength and athletic performance. Low hormone levels are more common in older people as a result of poor food intake and decreased skin ultraviolet irradiation. As a result, elderly persons who are deficient in vitamin D may be at risk of developing sarcopenia, a geriatric condition defined by gradual loss of skeletal muscle mass and strength that is frequently accompanied by adverse events such as falls, incapacity hospitalization, and mortality. As a result, these activities are seen to be crucial in illuminating the underlying functional condition of the aged, and functional mobility is employed as a technique for assessing fall risk and frailty. Several randomized controlled studies have been done to explore the efficacy of oral treatment in elderly people to prevent or cure sarcopenia; however, the results are still debatable. We describe the biochemical, clinical, and epidemiological data supporting the idea of a causal relationship between vitamin D insufficiency and a higher likelihood of sarcopenia in elderly adults in this narrative review. The muscular system, the biggest organ in the body, contributing to around 40% of body composition, is vital in exercising and glycogen depletion. Sarcopenia, a steady deterioration in muscle mass and strength, and function in the aged can result in prolonged circumstances, wheelchair confinement, and a reduction in quality of life. Diagnosis and control of muscle wasting are vital for improving health and quality of life in industrialized nations with aging populations. Vitamin D, a fat-soluble vitamin, has gained popularity in recent years because of its relevance in sarcopenia. The role of vitamin D deficiency and fortification on muscle wasting will be the focus of this review.

Relationship between healthy eating index and sarcopenia in elderly people

BackgroundData on the association of Alternative Healthy Eating Index-2010 (AHEI-2010) with sarcopenia are scarce. We aimed to evaluate the association between adherence to AHEI-2010 and sarcopenia and its components including low muscle mass, low muscle strength, and low muscle performance among elderly people.MethodsIn this cross-sectional study, which was conducted on 300 older people (150 men and 150 women) aged ≥55 years. Dietary information was done using a valid 117-item food frequency questionnaire (FFQ). To construct AHEI-2010 score, earlier studies were used. Sarcopenia and its components were described based on both former and new European Working Group on Sarcopenia in Older People (EWGSOP) guidelines.ResultsWe found no significant association between AHEI-2010 score and odds of EWGSOP2-sarcopenia, either before (OR for the highest vs. lowest tertiles: 0.55; 95% CI: 0.19, 1.55) or after (OR: 0.44; 95% CI: 0.14, 1.34) adjustment for confounders. In gender-stratified analyses, we found a significant protective association between adherence to the AHEI-2010 score and odds of EWGSOP2-sarcopenia among women after controlling for confounders (0.20; 95%CI: 0.04, 0.91).ConclusionsIn conclusion, healthy eating was inversely associated with odds of sarcopenia among women, but not in men. Further studies with a large sample size and prospective design are needed to examine this association.

Frequency and risk factors of sarcopenia in the elderly people

Aim. To determine the frequency and assess the risk factors of sarcopenia (SP) in elderly people living at home.Materials and methods. The study included 230 people aged 65 years and older who lived at home and were observed in outpatient clinic. To detect SP, grip strength was measured and muscle mass was determined using dual-energy absorptiometry (DXA). Severe SP was diagnosed based on the results of Short physical performance battery (SPPB) and the “Up and Go” test. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determination of the level of 25 (OH) D.Results. Probable SP was found in 64.8 %, confirmed SP – in 28.7 %, and severe SP – in 21.3 % of older people. The frequency of SP increased with age from 19.6 % in 65–74 years to 52.9 % in 85 years and older (p &lt;0.05). The results of multivariate analysis showed that the probability of SP increased with a BMI of less than 25 kg / m2 (OR 5,459; 95 % CI: 1,939–15,369; p = 0.0013), severe comorbidity calculated by the Charlson index (OR 5,178; 95 % CI: 1,597–14,128; p = 0.0030) and the presence of such laboratory indicators like level 25 (OH) D less than 20 ng / ml (OR 4,989; 95 % CI: 1,321–12,626; p = 0.0420), total protein less than 64 g / l (OR 8,567; 95 % CI: 2,658–27,617; p = 0.00032), CRP more than 5 mg / l (OR 14,279; 95 % CI: 3,511–58,071; p = 0.00020) and moderately reduced renal function (GFR &lt;60 ml / min / 1.73 m (OR 12,108; 95 % CI: 3,944–37,170; p = 0.00001).Conclusions. Among elderly people, a high frequency (28.7 %) of SP was detected, which increased with age. A BMI of less than 25 kg / m2, a deficiency of 25(OH)D, total protein level of less than 64 g / l and CRP of more than 5 mg / l, a decrease in GFR of less than 60 ml / min were associated with the presence of SP.

The Prevalence Of Sarcopenia And Related Factors In The Elderly Population Aged 60 Years Or Older In Nursing Homes

PURPOSE: The aim of this study is to investigate the prevalence of sarcopenia in elderly people in nursing homes in Hebei and to investigate the factors associated with its occurrence. METHODS: Through recruitment,326 subjects aged 60 years or older were selected for the study in nursing homes from June to August 2021.A questionnaire was designed to investigate the daily behavior related factors of elderly patients with sarcopenia, including demographic data,disease-related data and nutritional state. Determining the presence of sarcopenia according to the updated diagnostic criteria of the Asian Working Group for Sarcopenia 2019 (AWGS 2019). A stratified analysis of the prevalence of sarcopenia and a multifactorial analysis using logistic regression were performed by comparing general sociodemographic characteristics and lifestyle habits in male and female gender groups. RESULTS: The prevalence of sarcopenia in the elderly population in nursing homes was 29.7%. In the stratified analysis of the prevalence of sarcopenia, there was no significant difference in the prevalence of sarcopenia between males(33.9%) and females(27.5%)(P > 0.05).Multifactorial logistic regression showed that depression(OR = 1.130,95%CI:1.013 ~ 1.286) and increasing age (OR = 1.191, 95% CI: 1.172 to 1.210) were risk factors for sarcopenia(P < 0.05). In addition, BMI (OR = 0.715,95%CI:0.664 ~ 0.769), calf circumference(OR = 0.658,95%CI:0.562 ~ 0.769),grip strength(OR = 0.918,95%CI:0.859 ~ 0.977) and gait speed(OR = 0.080,95%CI:0.008 ~ 0.702) were the protective factors of sarcopenia (P < 0.05). CONCLUSIONS: The prevalence of sarcopenia in the elderly in nursing homes is very high. The main influencing factors are aging,BMI,depression,calf circumference,grip strngth and gait speed. Health workers should take scientific and reasonable measures to help the elderly prevent and treat sarcopenia, reduce the incidence of sarcopenia related adverse events.

Metabolic changes in elderly people with sarcopenia

Sarcopenia is a special condition that develops in older people. Sarcopenia represents a loss of muscle strength and mass in the elderly and is a common disease and is also associated with several adverse health effects. Due to the impact of sarcopenia on quality of life, disability and mortality, greater awareness is needed to correctly identify this condition and in particular its biological immunoendocrine markers. The purpose of the study was to study the characteristics of metabolism in sarcopenia in elderly people at the molecular, cellular and organizational levels. Material and methods. The study included 402 elderly people (199 men and 203 women, average age 68.9 ± 1.2 years), who are divided into three groups depending on the presence or absence of arterial hypertension and sarcopenia. The state of adipose and muscle tissue was studied using anthropometric measurements, bioimpedansometry and dynamometry. Results and discussion. The present study revealed a significant increase in energy exchange tension in patients with arterial hypertension, expressed in the increase in ADP content, but it was not enough to maintain the ATP/ADP ratio at the proper level. In patients with arterial hypertension and sarcopenia, a pronounced deficiency in ATP and ADP content, as well as ATP/ADP ratio was observed. The energy deficiency can also be explained by increase in lactate dehydrogenase activity in patients with arterial hypertension to compensate for energy deficiency by enhancing glycolysis processes. However, when sarcopenia was attached, this sanogenetic compensatory mechanism no longer worked. Conclusions. Dysfunction of adipose tissue in patients with arterial hypertension precedes the development of sarcopenia, while there is an increase in tension in energy exchange, expressed in elevation of ADP content, but when sarcopenia joins, there is a pronounced deficiency in both ATP and ADP content, as well as ATP/ADP ratio.

Muscle Weakness and Walking Slowness for the Identification of Sarcopenia in the Older Adults from Northern Brazil: A Cross-Sectional Study.

Background: This study aimed to analyze the prevalence of sarcopenia in elderly people from Northern Brazil according to muscle weakness or walking slowness. Methods: The sample consisted of 312 elderly people (72.6 ± 7.8 years). For walking slowness, a gait speed ≤ 0.8 m/s was used as a cut-off value, and for muscle weakness the following handgrip strength criteria were used for men and women, respectively: CI: <27.0/16.0 kg; CII: <35.5/20.0 kg; CIII: grip strength corrected for body mass index (BMI) < 1.05/0.79; CIV: grip strength corrected for total fat mass: <1.66/0.65; CV: grip strength corrected for body mass: <0.45/0.34. Results: Walking speed was reduced in 27.0% of women and 15.2% of men (p < 0.05). According to grip strength criteria, 28.5% of women and 30.4% of men (CI), 58.0% of women and 75.0% of men (CII), 66.0% of women and 39.3% of men (CIII), 28.8% of women and 19.6% of men (CIV), and 56.5% of women and 50.0% of men (CV) were identified as having sarcopenia. Conclusions: Walking slowness is more prevalent in women and muscle weakness is more prevalent in men in Northern Brazil. Walking slowness proved to be more concordant with muscle weakness in both sexes when the CI for handgrip strength was adopted.

Altered levels of circulating mitochondrial DNA in elderly people with sarcopenia: Association with mitochondrial impairment.

Age-related chronic inflammatory process is often referred to as "inflammaging", which had been described in several human disorders, including sarcopenia. Recently, mitochondrial DNA (MtDNA) has moved into the spotlight as a "damage-associated molecular pattern" (DAMP) agent that can potentially elicit inflammation. Yet, the roles of this mitochondrial DAMP have never been investigated in sarcopenia. Cross-sectional study. From January 2021 to June 2021, elderly outpatients ≥65years and able to finish a comprehensive geriatric assessment were recruited in our study. Participants were divided into sarcopenia group and non-sarcopenia group according to the DXA scans and grip strength. Genomic DNA was extracted from plasma and peripheral blood mononuclear cells (PBMCs), and changes in MtDNA copies were quantified using qPCR. Plasma levels of inflammatory cytokines were measured using ELISA kits. Loss of mitochondrial membrane potential (Δψm) in PBMCs was analyzed using the fluorescent probe JC-1. Participants with sarcopenia were significantly older, more likely to be physically inactive, and had higher levels of circulating cell-free MtDNA (ccf-MtDNA) (all p<0.05). After adjusting for potential confounders, ccf-MtDNA was independently associated with increased odds of sarcopenia (adjusted odds ratio (AOR), 1.576; p=0.009). Furthermore, ROC curve analysis showed that ccf-MtDNA had an area under the curve (AUC) of 0.726 (95% CI: 0.607-0.844; p<0.05) for distinguishing elderly subjects from sarcopenia. Compared with non-sarcopenia subjects, plasma interleukin (IL)-6 and IL-8 were significantly higher in sarcopenia subjects (both p<0.05). By performing a correlation test, it was found that the level of IL-6 was positively correlated with ccf-MtDNA (r=0.301; p<0.05). Then, PBMCs were used as surrogates for mitochondria-rich cells, and the results showed that the relative amplification of MtDNA in PBMCs was significantly reduced (p<0.05), whereas the depolarization of Δψm was significantly increased in sarcopenia subjects (p<0.05). Taken together, our data suggested that circulating MtDNA might be a novel and important source of inflammatory stimuli potentially relevant for sarcopenia in elderly people, and this would provide an attractive therapeutic target to improve this disease.

Interventions to Improve Physical Capability of Older Adults with Mild Disabilities: A Case Study.

Ageing is related to changes in physical health, including loss of mobility and muscle function. It can lead to impaired physical capability and reduced quality of life. The purpose of this study was to investigate whether a physical activity rehabilitation program (PARP) could improve range of joint motion (ROM), grip strength, and gait speed of older adults with mild disabilities. Forty older adults in a long-term care center in Taiwan joined as human participants and were split into control and experimental groups. The participants in the experimental group joined a PARP for eight weeks. The ROM of bodily joints, grip strength, and gait speed of all participants were measured both before and after the eight-week period. The results showed that all the ROMs, grip strength, and gait speed of the participants in the experimental group increased significantly after attending the program. The improvement of the ROMs for male and female participants in the experimental group ranged from 3.8% to 71% and from 7.8% to 75%, respectively. Male participants had greater improvement on gait speed (50%) than their female counterparts (22.9%). Female participants, on the other hand, had greater improvement on grip strength (25.4%) than their male counterparts (20.3%). The ROM, grip strength, and gait speed of the control group, on the other hand, did not change significantly during the same period. The results showed that the PARP adopted in this study was effective in increasing the ROM, grip strength, and gait speed of those who had joined the PARP. This study shows that an eight-week PARP without the use of gym machines was beneficial in reducing sarcopenia in elderly people with mild disabilities.

Sarcopenia in hemodialysis patients from Buenos Aires, Argentina

ObjectivesSarcopenia is the loss of skeletal muscle mass and function that occurs with aging that can lead to greater morbidity and mortality. Chronic kidney disease and hemodialysis (HD) favors the development of sarcopenia. We studied the prevalence of sarcopenia and its components using European Working Group on Sarcopenia in Elderly People 2 proposed criteria and risk factors for its development in HD patients. MethodsIn 100 adult HD patients, we evaluated: hand grip strength (HGS), muscle mass by dual energy X-ray absorptiometry and physical performance (gait-speed and sit-stand test). ResultsSixty patients were male and 40 were female; mean age 55.6 years. Prevalence of sarcopenia was 16% (11.1% in males and 25% in females; P = 0.05); 7% had severe sarcopenia. Prevalence of low HGS was 33% in males and 28% in females; low muscle mass was 30% in males but 70% in females and low physical performance 23% in males and 45% in females. Falls were reported by 23 patients. Patients with lower HGS had a higher prevalence of falls in the last year (40% two or more falls; P = 0.03). Only females with sarcopenia had lower bone mineral content. Neither age, body mass index, time on dialysis, or prevalence of diabetes predicted sarcopenia. ConclusionsA significant proportion of dialysis patients had sarcopenia, more frequent in females. Low HGS was associated with a higher prevalence of falls. Only females with sarcopenia had lower bone mineral content.

Evaluation of sarcopenia in long-lived elderly patients: comparison between the muscle mass index and the calf circumference

Introduction: With population aging, many elderly citizens have been achieving extreme longevity (≥ 90 years). Sarcopenia is related to several adverse outcomes, such as disability, falls, hospitalization and death; hence, its early identification is important. Several methods can be used for its evaluation, with dual-energy x-ray absorptiometry (DXA) being the most accurate. Nevertheless, due to low availability and high cost, other methods are routinely adopted for screening in Primary Health Care (PHC), such as the evaluation of the Muscle Mass Index (MMI) and the Calf Circumference (CC).Objective: To evaluate sarcopenia in elderly people with extreme longevity, and then compare it by means of MMI and CC.Methodology: Cross-sectional and quantitative study, performed in 2019/2020, with n = 69 individuals aged ≥ 90 years, of both genders, users of the Unified Health System in the town of Três Lagoas – MS. We collected sociodemographic and anthropometric data in triplicate. For CC, we used a cutoff score ≤ 31 centimeters as a sign of sarcopenia. We determined MMI based on the calculation of skeletal muscle mass, using the formula of Lee and collaborators, which considers height, body mass, gender, age and ethnicity. The classification of sarcopenia adopted was that of Janssen and collaborators (women: ≤ 5.75 kg/m2 = severe sarcopenia; 5.76 – 6.75 kg/m2 = moderate sarcopenia; and ≥ 6.76 kg/m2 = normal muscle mass. Men: ≤ 8.50 kg/m2 = severe sarcopenia; 8.51 – 10.75 kg/m2 = moderate sarcopenia; and ≥ 10.76 kg/ m2 = normal muscle mass). In order to relate the variables, we applied the Spearman’s correlation test. Results: A total of 52.2% of the participants were women, with an average age of 93.5 years old and 1.3 years of schooling. The average CC was 31.2 centimeters, with 46.1% being considered sarcopenic patients according to this parameter. The average MMI was 5.1 kg/m2, with 100% of the elderly patients being considered sarcopenic through this method. There was no relationship between CC and MMI (p = 0.213).Discussion: We found a high prevalence of sarcopenia in the long-lived elderly patients, mainly using MMI. This data is worrying, since these elderly people may have several limitations due to sarcopenia. The absence of a relationship between the CC and MMI variables highlights the need to use more reliable methods to evaluate sarcopenia in long-lived elderly people, since the identification from CC, despite being easy and fast, may not be sensitive in this age group. Conclusion: We should highlight the need for personalization of public policies and evaluation recommendations for elderly people with extreme longevity in PHC, as they constitute a group that has unique characteristics.

Association between Masticatory Function and Sarcopenia in Elderly People: A Systematic Review and Meta-Analysis

Background: The purpose of this systematic review was to explore the association between masticatory function (subjective and objective assessment) and sarcopenia in elderly people. Methods: Multiple electronic databases including PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched for all years up to October 1, 2019. Articles that evaluated occlusal force or chewing ability or difficulties in eating scores to explore the association between sarcopenia in elderly patients and healthy elderly peoples were included. A modified version of the Newcastle Ottawa Scale was used to assess study quality. The pooled standardized effect size with its corresponding 95% confidence interval for each parameter was calculated. Results: Of the 45 articles identified, three retrospective observational comparison studies, which had a lower risk of bias, were included: objective (occlusal force or chewing gum) and subjective (difficulties in eating scores) assessment were reported. Meta-analysis revealed that maximum occlusal force (standardized mean difference (SMD) = 0.36, confidence interval (CI) = 0.19-0.53, p ＜ 0.001)was significantly lower in subjects who were diagnosed with sarcopenia than in control groups. There were significant associations between sarcopenia and chewing ability using chewing gum (odds ratio (OR) = 2.34, CI = 1.09-5.02, p = 0.03) and difficulties in eating score (OR = 2.21, CI = 1.65-2.97, p ＜ 0.001). Conclusions: We found some limited evidence for an association between sarcopenia and masticatory function. Our meta-analysis supports an association between sarcopenia and subjective and objective masticatory function. More evidence is needed to demonstrate the association between masticatory function and sarcopenia in elderly people.