Sarcopenic obesity using the ESPEN and EASO consensus statement criteria of 2022 – Results from the German KORA-Age study

ObjectiveThe recent consensus statement of ESPEN and EASO recommends reviewing existing datasets to assess the prevalence of sarcopenic obesity based on the new definition and diagnostic criteria. Therefore, this study aimed to determine the prevalence of sarcopenic obesity in a population-based study and to assess the association of this new definition with clinical traits.MethodsThe KORA (Cooperative Health Research in the Region of Augsburg)-Age baseline examination (2008/2009) comprised 1079 participants aged 65 years and older from southern Germany. Sarcopenic obesity was defined in 998 participants (mean age 75.6 years, 498 women) with complete data according to the 2022 ESPEN and EASO algorithm, which includes reduced handgrip strength, reduced skeletal muscle mass per weight, and elevated fat mass. Body composition was measured using bioelectrical impedance analysis. Associations between sarcopenic obesity and physical activity, disability, multimorbidity, and polypharmacy were assessed using logistic regression analysis.ResultsThe overall prevalence of sarcopenic obesity was 4.5 % (5.0 % in men, 4.0 % in women). Sarcopenic obesity was associated with disability (2.87 [CI 1.84–4.48]), multimorbidity (≥ 2 comorbidities; 2.59 [CI 1.23–5.46]), polypharmacy (≥ 5 drugs; 1.96 [CI 1.05–3.63]), cognitive impairment (3.03 [CI 1.51–6.06]) and arthritis (2.66 [CI 1.39–5.07]) after adjusting for age, sex and marital status.ConclusionSarcopenic obesity is prevalent in the older German population and is associated with several clinical traits. Future longitudinal studies are needed to further elucidate whether the observed associations could be causal.     

老年人跌倒相关药物管理的研究进展

老年人群跌倒发生率较高，跌倒是老年人发生伤残、失能和死亡的重要原因。开展跌倒风险评估和管理，对降低跌倒发生率、减少伤害严重程度具有重要意义。药物因素是跌倒风险评估的重要组成部分，药物干预则是预防跌倒管理中必不可少的环节，但跌倒的药物干预在处理决策和管理上尚无统一标准，受重视程度不足。近年来有学者针对老年人跌倒药物干预的必要性和可行性进行了相关研究，现就药物干预方式和手段进行综述，以期对药物干预的开展提供思路和借鉴。     

Clinical pharmacology of oncology agents in older adults: A comprehensive review of how chronologic and functional age can influence treatment-related effects

Unique challenges exist when managing older adults with cancer. Associations between cancer and age-related physiologic changes have a direct impact on pharmacokinetics and pharmacodynamics of cancer therapies and can affect drug dosing, dose intensity, efficacy, safety and quality of life. The breadth and depth of these issues, however, have not been fully evaluated because the majority of clinical trials have focused on a younger and healthier population. As a consequence, little information is available to support clinicians in making evidence-based decisions regarding treatment with cancer therapies in older adults, especially those over age 75. Prior clinical pharmacology reviews summarized the literature on how age-related physiologic changes can influence and affect conventional and targeted anti-cancer treatments. Our article provides an updated review with expanded information that includes small molecule kinase inhibitors, monoclonal antibodies, immunotherapies, hormonal, conventional, and miscellaneous agents. Additionally, our article integrates how functional age, determined by the geriatric assessment (GA), can also influence treatment-related effects and health outcomes. Broadening cancer therapy trials to capture not only chronologic age but also functional age would allow clinicians to better identify subsets of older adults who benefit from treatment versus those most vulnerable to morbidity and/or mortality.