Sarcopenic Obesity and Risk of Disability in Community-Dwelling Japanese Older Adults: A 5-Year Longitudinal Study

ObjectivesPrevious studies have indicated that sarcopenic obesity is a risk factor for disability onset. However, these studies had disparities in terms of criteria for sarcopenia, study design, or study population. No longitudinal study has investigated the effect of sarcopenic obesity on disability onset in an Asian population using the Asian Working Group for Sarcopenia 2019 criteria for sarcopenia definition. Herein, we aimed to investigate the longitudinal effect of sarcopenic obesity on disability onset in Japanese older adults and extend the generalizability of results to other populations.DesignLongitudinal cohort study.Setting and ParticipantsA total of 4197 Japanese older adults (mean age 74.6 ± 5.0 years, 54.2% women) formed our study population.MeasurementsSarcopenia was identified using the Asian Working Group for Sarcopenia 2019 algorithm. Obesity was determined when body fat percentage was ≥25%, or when visceral fat content was ≥100 cm² for either sex. Disability onset was defined as a new case of long-term care insurance system certification for 5 years from baseline. Missing values were managed with multi-imputation. Cox proportional hazard regression analysis was used with disability onset as dependent variable and group (nonsarcopenia/nonobesity as a reference, nonsarcopenia/obesity, sarcopenia/non-obesity, possible sarcopenia/obesity, possible sarcopenia/non-obesity, sarcopenic obesity) as explanatory variable, and was adjusted for potential confounding factors.ResultsWhen the nonsarcopenia/nonobesity group was used as the reference category, other groups such as possible-sarcopenia/nonobesity [hazard ratio (HR) 1.38, 95% confidential interval (95% CI) 1.29‒1.47, P < .028], possible-sarcopenia/obesity (HR 1.54, 95% CI 1.46‒1.62 P < .001), sarcopenia/nonobesity (HR 2.09, 95% CI 1.96‒2.23, P < .001), and sarcopenic obesity (HR 2.48, 95% CI 2.24‒2.75, P < .001) showed significantly increased HRs.Conclusions and ImplicationsThe risk of disability onset because of sarcopenic obesity was exceedingly higher compared with sarcopenia alone among community-dwelling older adults in Japan The health providers should consider assessing the co-existence of sarcopenia and obesity to screen for the risk of disability onset in the community-dwelling population.     

Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Sarcopenic obesity is closely associated with knee osteoarthritis (KOA) and has high risk of total knee replacement (TKR). In addition, poor nutrition status may lead to sarcopenia and physical frailty in KOA and is negatively associated with surgery outcome after TKR. This study investigated the effects of sarcopenic obesity and its confounding factors on recovery in range of motion (ROM) after total knee replacement (TKR) in older adults with KOA. A total of 587 older adults, aged ≥60 years, who had a diagnosis of KOA and underwent TKR, were enrolled in this retrospective cohort study. Sarcopenia and obesity were defined based on cutoff values of appendicular mass index and body mass index for Asian people. Based on the sarcopenia and obesity definitions, patients were classified into three body-composition groups before TKR: sarcopenic-obese, obese, and non-obese. All patients were asked to attend postoperative outpatient follow-up admissions. Knee flexion ROM was measured before and after surgery. A ROM cutoff of 125 degrees was used to identify poor recovery post-surgery. Kaplan-Meier curve analysis was performed to measure the probability of poor ROM recovery among study groups. Cox multivariate regression models were established to calculate the hazard ratios (HRs) of postoperative poor ROM recovery, using potential confounding factors including age, sex, comorbidity, risk of malnutrition, preoperative ROM, and outpatient follow-up duration as covariates. Analyses results showed that patients in the obese and sarcopenic-obese groups had a higher probability of poor ROM recovery compared to the non-obese group (all p < 0.001). Among all body-composition groups, the sarcopenic-obese group yielded the highest risk of postoperative physical difficulty (adjusted HR = 1.63, p = 0.03), independent to the potential confounding factors. Sarcopenic obesity is likely at the high risk of poor ROM outcome following TKR in older individuals with KOA.     

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

ObjectiveTo compare clinical characteristics of sarcopenia defined by the International Working Group on Sarcopenia (IWGS) and European Working Group on Sarcopenia in Older People (EWGSOP) criteria among older people in Taiwan.DesignA prospective population-based community study.SettingI-Lan County of Taiwan.ParticipantsA total of 100 young healthy volunteers and 408 elderly people.InterventionNone.MeasurementsAnthropometry, skeletal muscle mass measured by dual x-ray absorptiometry, relative appendicular skeletal muscle index (RASM), percentage skeletal muscle index (SMI), 6-meter walking speed, and handgrip strength.ResultsThe prevalence of sarcopenia was 5.8% to 14.9% in men and 4.1% to 16.6% in women according to IWGS and EWGSOP criteria by using RASM or SMI as the muscle mass indices. The agreement of sarcopenia diagnosed by IWGS and EWGSOP criteria was only fair by using either RASM or SMI (kappa = 0.448 by RASM, kappa = 0.471 by SMI). The prevalence of sarcopenia was lower by the IWGS definition than the EWGSOP definition, but it was remarkably lower by using RASM than SMI in both criteria. Overall, sarcopenic individuals defined by SMI were older, had a higher BMI but similar total skeletal muscle mass, and had poorer muscle strength and physical performance than nonsarcopenic individuals. However, by using RASM, sarcopenic individuals had less total skeletal muscle mass but similar BMI than nonsarcopenic individuals. Multivariable logistic regression showed that age was the strongest associative factor for sarcopenia in both IWGS and EWGSOP criteria. Obesity played a neutral role in sarcopenia when it is defined by using RASM, but significantly increased the risk of sarcopenia in both criteria by using SMI.ConclusionThe agreement of sarcopenia defined by IWGS and EWGSOP was only fair, and the prevalence varied largely by using different skeletal muscle mass indices. Proper selections for cutoff values of handgrip strength, walking speed, and skeletal muscle indices with full considerations of gender and ethnic differences were of critical importance to reach the universal diagnostic criteria for sarcopenia internationally.     

Sarcopenic Obesity Is Associated With Activities of Daily Living and Home Discharge in Post-Acute Rehabilitation

ObjectiveThe aim of this study was to evaluate the effect of sarcopenic obesity on activities of daily living and home discharge rates in adults undergoing convalescent rehabilitation. In addition, we evaluated diagnostic criteria for sarcopenic obesity to predict outcomes.DesignA retrospective cohort study.Setting and ParticipantsIn total, 971 Japanese patients in a post-acute rehabilitation hospital between 2014 and 2016.MethodsSarcopenic obesity was defined as the presence of both sarcopenia and obesity. Sarcopenia was diagnosed using muscle mass index and handgrip strength according to the criteria of the European Working Group on Sarcopenia in Older People, with the cut-off values of the Asian Working Group for Sarcopenia. Obesity was diagnosed exploratively using several definitions: percentage of body fat (FAT%), body mass index (>25 kg/m²), and fat mass index (4th quartile). Study outcomes included Functional Independence Measure-motor efficacy (score gain between admission and discharge divided by the length of stay) and the rate of home discharge. Multivariate analyses were used to determine whether sarcopenic obesity was associated with outcomes and which obesity definition was suitable for outcome prediction. P values of <.05 were considered statistically significant.ResultsAfter enrollment, 917 patients (mean age 74.7 ± 13.5 years; 59% women) were included in the final analyses. The frequency of sarcopenic obesity varied greatly depending on the sex and method of obesity diagnosis: 2.1% when body mass index >25 kg/m² was used for obesity diagnosis in men, and 40.7% when FAT% >25% was used in women. Further, FAT% >35% and FAT% >30% used in women and men, respectively, had the strongest association with Functional Independence Measure-motor efficacy. FAT% of >30% and >35% in women and >30 in men was associated with the rate of home discharge.Conclusions and ImplicationsSarcopenic obesity was negatively associated with functional improvement and home discharge in post-acute rehabilitation. Clinical thresholds for diagnosing sarcopenic obesity should include FAT% >35 and >30% in women and men, respectively, in defining obesity in this population.     

Associations between Sarcopenic Obesity and Cognitive Impairment in Elderly Chinese Community-Dwelling Individuals

Introduction

This study aimed to estimate the prevalence of sarcopenic obesity (SO) and the association between cognitive impairment and SO in a cohort of elderly Chinese community-dwelling individuals.

Methods

A total of 948 elderly Chinese community-dwelling individuals aged 60–92 years were recruited. The participants were categorized into the following four groups according to their sarcopenia and obesity status: sarcopenic obese, sarcopenic, obese and non-sarcopenic, and non-obese group. Sarcopenia was defined as appendicular skeletal muscle index of <7.0 kg/m² in men and <5.7 kg/m² in women; obesity was defined as values greater than the upper two quintiles for body fat percentage stratified by gender of the study population; cognitive impairment was measured using the Mini-Mental State Examination and defined as a score of <24.

Results

A total of 945 participants were included in the statistical analyses with a mean age of 68.76 ± 6.50 years. The prevalence of SO was 6.0% (7.3% in men and 4.8% in women). The sarcopenic obese (odds ratio [OR]: 2.550, 95% confidence interval [CI], 1.196-5.435) and obese (ORs: 2.141, 95% CI, 1.230-3.728) groups had significantly increased risk for cognitive impairment in fully adjusted model, respectively.

Conclusion

The SO prevalence in elderly Chinese community-dwelling individuals was relatively low (6.0%). The present study suggested SO was independently associated with cognitive impairment.

     

Incident Impaired Cognitive Function in Sarcopenic Obesity: Data From the National Health and Aging Trends Survey

ObjectivesThe prevalence of obesity with sarcopenia is increasing in adults aged ≥65 years. This geriatric syndrome places individuals at risk for synergistic complications that leads to long-term functional decline. We ascertained the relationship between sarcopenic obesity and incident long-term impaired global cognitive function in a representative US population.DesignA longitudinal, secondary data set analysis using the National Health and Aging Trends Survey.SettingCommunity-based older adults in the United States.ParticipantsParticipants without baseline impaired cognitive function aged ≥65 years with grip strength and body mass index measures.MethodsSarcopenia was defined using the Foundation for the National Institutes of Health Sarcopenia Project grip strength cut points (men <35.5 kg; women <20 kg), and obesity was defined using standard body mass index (BMI) categories. Impaired global cognition was identified as impairment in the Alzheimer's Disease-8 score or immediate/delayed recall, orientation, clock-draw test, date/person recall. Proportional hazard models ascertained the risk of impaired cognitive function over 8 years (referent = neither obesity or sarcopenia).ResultsOf the 5822 participants (55.7% women), median age category was 75 to 80, and mean grip strength and BMI were 26.4 kg and 27.5 kg/m², respectively. Baseline prevalence of sarcopenic obesity was 12.9%, with an observed subset of 21.2% participants having impaired cognitive function at follow-up. Compared with those without sarcopenia or obesity, the risk of impaired cognitive function was no different in obesity alone [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82–1.16]), but was significantly higher in sarcopenia (HR 1.60; 95% CI 1.42–1.80) and sarcopenic obesity (HR 1.20; 95% CI 1.03–1.40). There was no significant interaction term between sarcopenia and obesity.ConclusionsBoth sarcopenia and sarcopenic obesity are associated with an increased long-term risk of impaired cognitive function in older adults.     

Effect of Sarcopenia Status on Disability Incidence Among Japanese Older Adults

ObjectivesThe updated definition of sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP2) recommends both low muscle mass and quality to diagnose sarcopenia; concurrent poor physical performance is considered indicative of severe sarcopenia; however, the relationship between the revised definition and disability incidence among Japanese older adults is unclear. Therefore, we aimed to examine the associations between EWGSOP2-defined sarcopenia and disability incidence among community-dwelling older Japanese adults.DesignNationwide study.Setting and participantsWe included 4561 individuals aged ≥65 years and enrolled in the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes (NCGG-SGS).MethodsSkeletal muscle mass was assessed using a bioimpedance analysis device; handgrip strength and walking speed were measured as physical performance indicators. We used the Asian Working Group for Sarcopenia cutoffs to define low muscle mass and poor physical performance. We stratified all participants into nonsarcopenia, sarcopenia, and severe sarcopenia groups. Disability incidence was prospectively determined over 49 months using data extracted from the Japanese long-term care insurance system.ResultsThe prevalence of sarcopenia and severe sarcopenia was 3.4% and 1.7%, respectively. Participants with any form of sarcopenia were at a higher risk of disability [hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.27-2.49]. Although participants with severe sarcopenia showed a higher risk of disability (HR 2.00, 95% CI 1.32-3.02), there was no significant disability risk in the sarcopenia group (HR 1.54, 95% CI 0.97-2.46). Grip strength (HR 0.96, 95% CI 0.94-0.98) and walking speed (HR 0.19, 95% CI 0.12-0.30) negatively correlated with disability incidence.Conclusions and implicationsSevere sarcopenia, involving low muscle mass and poor physical performance, might increase disability risk in older adults, as opposed to low muscle mass alone. Further studies are needed to determine whether sarcopenia without poor physical performance increases disability risk.     

Inflammation in Relation to Sarcopenia and Sarcopenic Obesity among Older Adults Living with Chronic Comorbidities: Results from the National Health and Nutrition Examination Survey 1999–2006

Loss of muscle mass and waning in muscle strength are common in older adults, and inflammation may play a key role in pathogenesis. This study aimed to examine associations of C-reactive protein (CRP) and systemic immune-inflammation index (SII) with sarcopenia and sarcopenic obesity in older adults with chronic comorbidities. Cross-sectional data from the National Health and Nutrition Examination Survey (1999–2006) were obtained for participants aged ≥60 years. Sarcopenia was defined by a lean mass and body height (males < 7.26 kg/m², females < 5.45 kg/m²). Sarcopenic obesity was defined by the concurrent presence of sarcopenia and obesity (defined by relative fat mass). Logistic regression was used to assess the associations of CRP and SII with sarcopenia and sarcopenic obesity. The dose–response relationship was examined via restricted cubic splines. Of the participants (n = 2483), 23.1% (n = 574) and 7.7% (n = 190) had sarcopenia and sarcopenic obesity, respectively. The multivariable logistic regression models suggested a positive association of SII with sarcopenia and sarcopenic obesity, but a positive statistically significant association was not consistently observed for CRP. Dose–response curves suggested similar association patterns for these biomarkers. In clinical practice, measures to prevent sarcopenia and sarcopenic obesity are needed for older vulnerable people with high systemic inflammation.     

Prevalence of Sarcopenia in Geriatric Hospitalized Patients

ObjectivesSarcopenia, a common syndrome in older individuals, is characterized by a progressive loss of muscle mass and muscle strength. Although data exist on the prevalence of sarcopenia in community-dwelling older individuals and nursing home residents, there has been no systematic research in hospitalized older patients according to newly developed criteria.DesignCross-sectional study design.SettingAcute geriatric ward of a general hospital.ParticipantsGeriatric inpatients.MeasurementsHand grip strength was measured with the Jamar dynamometer, skeletal muscle index was calculated from raw data obtained from the bioelectrical impedance analysis, and physical function was assessed with the Short Physical Performance Battery. Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP).ResultsThis study involved 198 patients from a geriatric acute ward. Mean age was 82.8 ± 5.9 years and 70.2% (n = 139) of the study participants were women. Thirteen patients (6.6%) were defined as sarcopenic and 37 (18.7%) were defined as severely sarcopenic. In a group comparison, patients with sarcopenia had a poorer nutritional status. In a binary logistic regression analysis, only body mass index was associated with sarcopenia, whereas gender, age, length of stay, cognitive function, and self-care capacity were not.ConclusionThe prevalence of sarcopenia in geriatric hospitalized patients is high and does not differ from those of other older individuals. Nutritional status is associated with sarcopenia. The predictive value of sarcopenia regarding outcome for older individuals still requires evaluation.     

Differential Association of Frailty and Sarcopenia With Mortality and Disability: Insight Supporting Clinical Subtypes of Frailty

ObjectivesSarcopenia and frailty have been shown separately to predict disability and death in old age. Our aim was to determine if sarcopenia may modify the prognosis of frailty regarding both mortality and disability, raising the existence of clinical subtypes of frailty depending on the presence of sarcopenia.DesignA Spanish longitudinal population-based study.Setting and ParticipantsThe population consists of 1531 participants (>65 years of age) from the Toledo Study of Health Aging.MethodsSarcopenia and frailty were assessed following Foundation for the National Institutes of Health criteria and the Fried Frailty Phenotype, respectively. Mortality was assessed using the National Death Index. Functional status was determined using Katz index. We ran multivariate logistics and proportional hazards models adjusting for age, sex, baseline function, and comorbidities.ResultsMean age was 75.4 years (SD 5.9). Overall, 70 participants were frail (4.6%), 565 prefrail (36.9%), and 435 sarcopenic (28.4%). Mean follow-up was 5.5 and 3.0 years for death and worsening function, respectively. Furthermore, 184 participants died (12%) and 324 worsened their functioning (24.8%). Frailty and prefrailty were associated with mortality and remained significant after adjustment by sarcopenia [hazard risk (HR) 3.09, 95% confidence interval (CI) 1.84-5.18; P < .001; HR 1.58, 95% CI 1.12-2.24, P = .01]. However, the association of sarcopenia with mortality was reduced and became nonsignificant (HR 1.43, 95% CI 0.99-2.07, P = .057) when both frailty and sarcopenia were included in the same model. In the disability model, frailty and sarcopenia showed a statistically significant interaction (P = .016): both had to be present to predict worsening of disability.Conclusions and ImplicationsSarcopenia plays a relevant role in the increased risk of functional impairment associated to frailty, but that seems not to be the case with mortality. This finding raises the need of assessing sarcopenia as a cornerstone of the clinical work after diagnosing frailty.     

Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength

Objectives:

We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome.

Methods:

Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models.

Results:

The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships.

Conclusions:

The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases.     

Sarcopenia Is Associated with Cognitive Impairment in Older Adults: A Systematic Review and Meta-Analysis

Background and Objectives

There is little evidence in the literature about the possible relationship between sarcopenia and cognition in older adults. Our objective was to investigate the association between cognitive impairment and sarcopenia in older adults living in the community through a systematic review of published studies.

Research Design and Methods

We performed a systematic review with meta-analysis through Pubmed, LILACS, Scielo and Web of Science databases between March 1, 2001 and December 18, 2018. We included longitudinal and cross-sectional studies that evaluated sarcopenia and cognition as a primary objective.

Results

Of the 274 studies identified by the systematic review, 10 were included in qualitative analysis (total of 9,703 participants), and 6 were eligible for the meta-analysis (n = 7,045). Mean prevalence of sarcopenia was 10.5%. Cognitive impairment was observed in 269 participants with sarcopenia (40%), compared with 1,616 in non-sarcopenic participants (25.3%). Sarcopenia was significantly associated with cognitive impairment (pooled OR = 2.50, 95% CI = 1.26–4.92; p = 0.008). Heterogeneity across the studies was high and significant (I² = 84%).

Discussion and Implications

Our analyzes confirmed that sarcopenic older adults presented a higher prevalence of cognitive impairment. Sarcopenia may represent a risk factor for cognitive decline, but longitudinal studies are needed to explore causality.

     

Effect of Interaction Between Dynapenic Component of the European Working Group on Sarcopenia in Older People Sarcopenia Criteria and Obesity on Activities of Daily Living in the Elderly

ObjectivesTo examine the effects of interaction between dynapenic component of the European Working Group on Sarcopenia in Older People (EWGSOP) sarcopenia and obesity (dynapenia × obesity) on activities of daily living (ADL) in older participants.DesignCross-sectional analysis of the Validity and Reliability of Korean Frailty Index and the Validity and Reliability of the Kaigo-Yobo Checklist in Korean Elderly studies.SettingSix welfare facilities operated by government in South Korea.ParticipantsFour hundred eighty-seven community-dwelling individuals (157 males, 330 females) >65 years of age.MeasurementDynapenic component of the EWGSOP sarcopenia was defined as usual gait speed <0.8 m/s or grip strength lower than cut-off value (male <25.3 kg, female <12.0 kg). Obesity was defined as body mass index ≥27.5 kg/m². ADL were assessed using the Barthel index.ResultsThere were 14 obese with dynapenic component cases (2 males, 12 females) of the 487 participants. Interaction of dynapenia and obesity was significant on multivariate generalized linear model analysis (P = .015).ConclusionsDynapenic component of the EWGSOP sarcopenia and obesity in the elderly is associated with multiplicative interactions rather than additive interactions in ADL.     

Sarcopenia Identified According to the EWGSOP2 Definition in Community-Living People: Prevalence and Clinical Features

BackgroundThe European Working Group on Sarcopenia in Older People (EWGSOP2) recently updated the definition of sarcopenia in order to reflect scientific and clinical evidences.ObjectiveThe aim is to explore the prevalence of sarcopenia (according to the new EWGSOP2 definition) and related risk factors among an unselected sample of subjects living in community.Setting and ParticipantsThe Longevity Check-up 7+ project is an ongoing cross-sectional study started in June 2015 and conducted in unconventional settings (ie, exhibitions, malls, and health promotion campaigns). Candidate participants are eligible for enrollment if they are at least 18 years of age.MethodsMuscle strength was assessed by handgrip strength and physical performance was evaluated by chair stand test.ResultsThe mean age of 11,253 subjects was 55.6 (standard deviation 11.5, from 18 to 98 years) years, and 6356 (56%) were women. Using the EWGSOP2 algorithm, 973 participants (8.6%) were identified as affected by sarcopenia, and the prevalence of sarcopenia significantly increased with age. Sarcopenia was associated with diabetes prevalence ratio (PR) 1.42, 95% confidence interval (CI) 1.06-1.89, impairment in 400-m walking performance (PR 2.16, 95% CI 1.74-2.17), and self-reported unhealthy status (PR 1.77, 95% CI 1.45-2.17). Conversely, a decreased probability of being sarcopenic was detected among subjects following a healthy diet (PR 0.79, 95% CI 0.63-0.98) and involved in regular physical activity (PR 0.79, 95% CI 0.64-0.99).Conclusions and ImplicationsMuscle strength and physical performance assessment should be considered as the recommended methods for the early detection of individuals at risk of probable sarcopenia.     

Association of the Baltic Sea and Mediterranean diets with indices of sarcopenia in elderly women,OSPTRE-FPS study

Purpose

To examine whether higher adherence to Baltic Sea diet (BSD) and Mediterranean diet (MED) have beneficial association with sarcopenia indices in elderly women.

Methods

In total 554 women, aged 65–72 years belonging to OSTPRE-FPS study answered a questionnaire on lifestyle factors and 3-day food record at baseline in 2002. Food consumptions and nutrient intakes were calculated. Nine components were selected to calculate BSD score. MED score was calculated using eight components. Body composition was measured by dual-energy X-ray absorptiometry. Physical function measures included walking speed 10 m, chair rises, one leg stance, knee extension, handgrip strength and squat at baseline and at year 3. Sarcopenia and short physical performance battery (SPPB) score were defined based on the European working group on sarcopenia criteria. Lower body muscle quality (LBMQ) was calculated as walking speed 10 m/leg muscle mass.

Results

Women in the higher quartiles of BSD and MED scores lost less relative skeletal muscle index and total body lean mass (LM) over 3-year follow-up (P _trend ≤ 0.034). At the baseline, women in the higher BSD score quartiles had greater LM, faster walking speed 10 m, greater LBMQ, higher SPPB score (P _trend ≤ 0.034), and higher proportion of squat test completion. Similarly, women in the higher quartiles of MED sore had significantly faster walking speed 10 m, greater LBMQ (P _trend ≤ 0.041) and higher proportion of squat test completion.

Conclusions

Better diet quality as measured by higher adherence to BSD and MED might reduce the risk of sarcopenia in elderly women.

     

Multimodal Diagnostic Approaches to Advance Precision Medicine in Sarcopenia and Frailty

Sarcopenia, defined as the loss of muscle mass, strength, and function with aging, is a geriatric syndrome with important implications for patients and healthcare systems. Sarcopenia increases the risk of clinical decompensation when faced with physiological stressors and increases vulnerability, termed frailty. Sarcopenia develops due to inflammatory, hormonal, and myocellular changes in response to physiological and pathological aging, which promote progressive gains in fat mass and loss of lean mass and muscle strength. Progression of these pathophysiological changes can lead to sarcopenic obesity and physical frailty. These syndromes independently increase the risk of adverse patient outcomes including hospitalizations, long-term care placement, mortality, and decreased quality of life. This risk increases substantially when these syndromes co-exist. While there is evidence suggesting that the progression of sarcopenia, sarcopenic obesity, and frailty can be slowed or reversed, the adoption of broad-based screening or interventions has been slow to implement. Factors contributing to slow implementation include the lack of cost-effective, timely bedside diagnostics and interventions that target fundamental biological processes. This paper describes how clinical, radiographic, and biological data can be used to evaluate older adults with sarcopenia and sarcopenic obesity and to further the understanding of the mechanisms leading to declines in physical function and frailty.     

Prevalence and Mortality of Sarcopenia in a Community-dwelling Older Japanese Population: The Hisayama Study

BackgroundThe prevalence of sarcopenia defined using the Asian Working Group for Sarcopenia (AWGS) criteria in Asian communities has not been fully addressed. Moreover, few studies have addressed the influence of sarcopenia on mortality.MethodsA total of 1,371 and 1,597 residents aged 65 years or older participated in health surveys in 2012 and 2017. Sarcopenia was determined using the AWGS definition. Factors associated with the presence of sarcopenia were assessed using a logistic regression model in participants in the 2012 survey. Subjects in the 2012 survey were followed-up prospectively for a median of 4.3 years. Mortality risk for subjects with sarcopenia was examined using the Cox proportional hazards model.ResultsThe crude prevalence of sarcopenia was 7.4% and 6.6% in participants at the 2012 and 2017 surveys, respectively; there was no significant difference between surveys (P = 0.44). The prevalence of sarcopenia increased significantly with age in both sexes (both P for trend <0.001). Subjects with sarcopenia were more likely to exercise less regularly, to intake less total energy, and to exhibit a disability in activity of daily living than those without. The multivariable-adjusted hazard ratio for all-cause mortality was 2.20 (95% confidence interval, 1.25–3.85) in subjects with sarcopenia, compared to those without.ConclusionsApproximately 7% of older subjects had sarcopenia in a community-dwelling older Japanese population. Moreover, subjects with sarcopenia had an increased mortality risk. Our findings suggest that a public health strategy for sarcopenia is needed to extend healthy life expectancy.Key words: sarcopenia, Asian Working Group for Sarcopenia, prevalence, mortality     

Biomarkers Profile of People With Sarcopenia: A Cross-sectional Analysis From UK Biobank

ObjectiveThis study aimed to characterize the biomarker profile of sarcopenic vs nonsarcopenic men and women, using the current European Working Group on Sarcopenia in Older People (EWGSOP2) definition in the UK Biobank study.DesignCross-sectional study.Setting and ParticipantsA total of 396,707 (68.8% women, age 38 to 73) participants from UK Biobank.MeasuresThirty-three biomarkers, standardized to sex-specific z-scores, were included in the analysis. Associations between these biomarkers and sarcopenia, defined using EWGSOP2 criteria, were examined using multiple linear regression.ResultsHigher concentrations of rheumatoid factor, C-reactive protein, cystatin C, sex hormone-binding globulin, gamma-glutamyltransferase, alkaline phosphatase, and total protein, as well as lower concentrations of insulin-like growth factor-1, albumin, creatinine, sodium, and systolic blood pressure, were associated with sarcopenia in both men and women. However, some of the associations differed by sex. Sarcopenia was associated with higher concentrations of phosphate, lipoprotein A, and lower of diastolic blood pressure, HbA1c, urea, glucose, total bilirubin, and testosterone in women only, and with higher concentrations of high-density lipoprotein, aspartate aminotransferase, and direct bilirubin and lower values of apolipoprotein A, vitamin D, and apolipoprotein B in men only.Conclusions and ImplicationsSeveral biomarkers were associated with sarcopenia in men and women using the new EWGSOP2 statement. However, some of these associations and their magnitude differed between men and women. Considering the EWGSOP2 updated its statement on the definition of sarcopenia in 2019, this study enables us to update the study of the biomarkers profile of people with sarcopenia.     

Prevalence of Sarcopenia Among the Elderly in Korea: A Meta-Analysis

ObjectivesSarcopenia is a common disease in the elderly population that causes disability, poor quality of life, and a high risk of death. In the current study, we conducted a meta-analysis to report basic knowledge about the prevalence of sarcopenia in the elderly in Korea.MethodsWe searched for articles in the MEDLINE, Cochrane Library, Embase, and Scopus databases published until December 28, 2020. Studies investigating the prevalence of sarcopenia in elderly Koreans aged ≥65 years were included. The methodological quality of the studies was evaluated using the Newcastle-Ottawa scale. Publication bias was evaluated using the Egger test and funnel plots.ResultsIn total, 3 studies and 2922 patients were included in the meta-analysis. All 3 studies used the European Working Group on Sarcopenia in Older People criteria for the diagnosis of sarcopenia. The total prevalence of sarcopenia was 13.1-14.9% in elderly men and 11.4% in elderly women.ConclusionsThis meta-analysis is the first to estimate the pooled prevalence of sarcopenia in elderly Koreans, and its findings suggest that sarcopenia is common in this population. Therefore, attention should be paid to the prevention and control of sarcopenia.