A robust neuromuscular system protects rat and human skeletal muscle from sarcopenia.

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Pannérec, Alice; Springer, Margherita; Migliavacca, Eugenia; Ireland, Alex; Piasecki, Mathew; Karaz, Sonia; Jacot, Guillaume; Métairon, Sylviane; Danenberg, Esther; Raymond, Frédéric; Descombes, Patrick; McPhee, Jamie S; Feige, Jerome N

2016-04-01

Declining muscle mass and function is one of the main drivers of loss of independence in the elderly. Sarcopenia is associated with numerous cellular and endocrine perturbations, and it remains challenging to identify those changes that play a causal role and could serve as targets for therapeutic intervention. In this study, we uncovered a remarkable differential susceptibility of certain muscles to age-related decline. Aging rats specifically lose muscle mass and function in the hindlimbs, but not in the forelimbs. By performing a comprehensive comparative analysis of these muscles, we demonstrate that regional susceptibility to sarcopenia is dependent on neuromuscular junction fragmentation, loss of motoneuron innervation, and reduced excitability. Remarkably, muscle loss in elderly humans also differs in vastus lateralis and tibialis anterior muscles in direct relation to neuromuscular dysfunction. By comparing gene expression in susceptible and non-susceptible muscles, we identified a specific transcriptomic signature of neuromuscular impairment. Importantly, differential molecular profiling of the associated peripheral nerves revealed fundamental changes in cholesterol biosynthetic pathways. Altogether our results provide compelling evidence that susceptibility to sarcopenia is tightly linked to neuromuscular decline in rats and humans, and identify dysregulation of sterol metabolism in the peripheral nervous system as an early event in this process.

Butyryl-cholinesterase is related to muscle mass and strength. A new biomarker to identify elderly subjects at risk of sarcopenia.

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Cacciatore, Francesco; Della-Morte, David; Basile, Claudia; Curcio, Francesco; Liguori, Ilaria; Roselli, Mario; Gargiulo, Gaetano; Galizia, Gianluigi; Bonaduce, Domenico; Abete, Pasquale

2015-01-01

To determine the relationship between Butyryl-cholinesterase (α-glycoprotein synthesized in the liver, b-CHE) and muscle mass and strength. Muscle mass by bioimpedentiometer and muscle strength by grip strength were evaluated in 337 elderly subjects (mean age: 76.2 ± 6.7 years) admitted to comprehensive geriatric assessment. b-CHE levels were lower in sarcopenic than in nonsarcopenic elderly subjects (p elderly subjects. Thus, b-CHE may be considered to be a fair biomarker for identifying elderly subjects at risk of sarcopenia.

[Transdisciplinary Approach for Sarcopenia. Sarcopenia : definition and the criteria for Asian elderly people].

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Yuki, Atsumu; Ando, Fujiko; Shimokata, Hiroshi

2014-10-01

Sarcopenia is a syndrome characterized by loss of skeletal muscle mass and function (strength and physical performance) with a risk of adverse outcomes. Asian criteria have been decided recently by the Asia Working Group for Sarcopenia (AWGS) . AWGS defined sarcopenia as low skeletal muscle mass plus low muscle strength and/or low physical performance based on the previous reports. AWGS recommend cutoff values for muscle mass (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioelectrical impedance analysis) , handgrip strength (sarcopenia in Japanese elderly men and women diagnosed using Asian criteria was 9.6% and 7.7%, respectively. The estimated number of prevalent cases of sarcopenia in Japanese elderly men and women was approximately 1.3 million and 1.4 million, respectively.

Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

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Chen, Liang-Kung; Liu, Li-Kuo; Woo, Jean; Assantachai, Prasert; Auyeung, Tung-Wai; Bahyah, Kamaruzzaman Shahrul; Chou, Ming-Yueh; Chen, Liang-Yu; Hsu, Pi-Shan; Krairit, Orapitchaya; Lee, Jenny S W; Lee, Wei-Ju; Lee, Yunhwan; Liang, Chih-Kuang; Limpawattana, Panita; Lin, Chu-Sheng; Peng, Li-Ning; Satake, Shosuke; Suzuki, Takao; Won, Chang Won; Wu, Chih-Hsing; Wu, Si-Nan; Zhang, Teimei; Zeng, Ping; Akishita, Masahiro; Arai, Hidenori

2014-02-01

Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis

Respiratory muscle strength in relation to sarcopenia in elderly cardiac patients.

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Izawa, Kazuhiro P; Watanabe, Satoshi; Oka, Koichiro; Kasahara, Yusuke; Morio, Yuji; Hiraki, Koji; Hirano, Yasuyuki; Omori, Yutaka; Suzuki, Norio; Kida, Keisuke; Suzuki, Kengo; Akashi, Yoshihiro J

2016-12-01

Little information exists on the relation between respiratory muscle strength such as maximum inspiratory muscle pressure (MIP) and sarcopenia in elderly cardiac patients. The present study aimed to determine the differences in MIP, and cutoff values for MIP according to sarcopenia in elderly cardiac patients. We enrolled 63 consecutive elderly male patients aged ≥65 years with cardiac disease in this cross-sectional study. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People algorithm, and, accordingly, the patients were divided into two groups: the sarcopenia group (n = 24) and non-sarcopenia group (n = 39). The prevalence of sarcopenia in cardiac patients and MIP in the patients with and without sarcopenia were assessed to determine cutoff values of MIP. After adjustment for body mass index, the MIP in the sarcopenia group was significantly lower than that in the non-sarcopenia group (54.7 ± 36.8 cmH 2 O; 95 % CI 42.5-72.6 vs. 80.7 ± 34.7 cmH 2 O; 95 % CI 69.5-92.0; F = 4.89, p = 0.029). A receiver-operating characteristic curve analysis of patients with and without sarcopenia identified a cutoff value for MIP of 55.6 cmH 2 O, with a sensitivity of 0.76, 1-specificity of 0.37, and AUC of 0.70 (95 % CI 0.56-0.83; p = 0.01) in the study patients. Compared with elderly cardiac patients without sarcopenia, MIP in those with sarcopenia may be negatively affected. The MIP cutoff value reported here may be a useful minimum target value for identifying elderly male cardiac patients with sarcopenia.

SARCOPENIA: DIAGNOSIS, STAGES AND TREATMENT

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Pasca Luminita Aurelia

2015-02-01

Full Text Available Sarcopenia is defined as the age-related loss of skeletal muscle mass and decline of function. The causes of sarcopenia are multi-factorial. The diagnosis of sarcopenia should be considered in all older patients who present with declines in physical function, because of potential consequences for the development of frailty and disability. There are numerous techniques to assess muscle mass, muscle strength and physical performance. Treatment consists of nutritional (macro- and micronutrients and physical activity (resistance exercise regimens adapted to person. There is an emerging role for testosterone and anabolic steroids in severe sarcopenia.

Sarcopenia and Sarcopenic Obesity

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Kyung Mook Choi

2013-06-01

Full Text Available The aging process is associated with progressive loss of muscle mass and strength, as well as decline in physical functioning. Although consensus diagnosis has not been reached, sarcopenia is increasingly defined by both loss of muscle mass and loss of muscle function or strength. The cause of sarcopenia is suggested as multifactorial, including hormonal changes, inflammatory pathway activation, fatty infiltration, poor nutrition, and decreased physical activity. Sarcopenia is often associated with visceral obesity. Sarcopenic obesity in the elderly impacts metabolic complications and represents a major public health challenge in a rapidly aging society. Further research about sarcopenia and sarcopenic obesity may be needed to confront the influence of aging society in Korea.

Type 2 diabetes mellitus is associated with increased risks of sarcopenia and pre-sarcopenia in Chinese elderly.

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Wang, Taotao; Feng, Xiao; Zhou, Jingjing; Gong, Hongyan; Xia, Song; Wei, Qing; Hu, Xu; Tao, Ran; Li, Lei; Qian, Frank; Yu, Li

2016-12-13

Sarcopenia is a condition characterized by progressive and generalized loss of skeletal muscle mass and function. In this study, we used a cross-sectional study with 1090 community-dwelling Chinese citizens aged 60 years and older to evaluate the association of type 2 diabetes mellitus (T2DM) with the risk of sarcopenia and pre-sarcopenia. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) criteria that include both muscle mass and muscle function/physical activity. Pre-sarcopenia was defined as having low skeletal muscle index but with normal muscle/physical activity. The prevalence of sarcopenia and pre-sarcopenia was significantly higher in T2DM patients than in healthy controls (14.8% vs. 11.2%, p = 0.035 for sarcopenia, and 14.4% vs. 8.4%, p = 0.002 for pre-sarcopenia). In multivariate logistic regression analyses adjusting by age, gender, anti-diabetic medication, energy intake, protein intake, physical activity, and visceral fat area, we found that Chinese elderly with T2DM exhibited significantly increased risks of sarcopenia (OR = 1.37, 95% CI = 1.02-2.03) and pre-sarcopenia (OR = 1.73, 95% CI = 1.10-2.83) compared to non-diabetic individuals. This is the first study to evaluate the association of T2DM with the risks of sarcopenia and pre-sarcopenia in China. Among a group of community-dwelling Chinese elderly, T2DM was significantly associated with increased risks of sarcopenia and pre-sarcopenia.

Type 2 diabetes mellitus is associated with increased risks of sarcopenia and pre-sarcopenia in Chinese elderly

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Wang, Taotao; Feng, Xiao; Zhou, Jingjing; Gong, Hongyan; Xia, Song; Wei, Qing; Hu, Xu; Tao, Ran; Li, Lei; Qian, Frank; Yu, Li

2016-01-01

Sarcopenia is a condition characterized by progressive and generalized loss of skeletal muscle mass and function. In this study, we used a cross-sectional study with 1090 community-dwelling Chinese citizens aged 60 years and older to evaluate the association of type 2 diabetes mellitus (T2DM) with the risk of sarcopenia and pre-sarcopenia. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) criteria that include both muscle mass and muscle function/physical activity. Pre-sarcopenia was defined as having low skeletal muscle index but with normal muscle/physical activity. The prevalence of sarcopenia and pre-sarcopenia was significantly higher in T2DM patients than in healthy controls (14.8% vs. 11.2%, p = 0.035 for sarcopenia, and 14.4% vs. 8.4%, p = 0.002 for pre-sarcopenia). In multivariate logistic regression analyses adjusting by age, gender, anti-diabetic medication, energy intake, protein intake, physical activity, and visceral fat area, we found that Chinese elderly with T2DM exhibited significantly increased risks of sarcopenia (OR = 1.37, 95% CI = 1.02–2.03) and pre-sarcopenia (OR = 1.73, 95% CI = 1.10–2.83) compared to non-diabetic individuals. This is the first study to evaluate the association of T2DM with the risks of sarcopenia and pre-sarcopenia in China. Among a group of community-dwelling Chinese elderly, T2DM was significantly associated with increased risks of sarcopenia and pre-sarcopenia. PMID:27958337

Comprehensive proteome analysis of human skeletal muscle in cachexia and sarcopenia: a pilot study.

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Ebhardt, H Alexander; Degen, Simone; Tadini, Valentina; Schilb, Alain; Johns, Neil; Greig, Carolyn A; Fearon, Kenneth C H; Aebersold, Ruedi; Jacobi, Carsten

2017-08-01

Cancer cachexia (cancer-induced muscle wasting) is found in a subgroup of cancer patients leaving the patients with a poor prognosis for survival due to a lower tolerance of the chemotherapeutic drug. The cause of the muscle wasting in these patients is not fully understood, and no predictive biomarker exists to identify these patients early on. Skeletal muscle loss is an inevitable consequence of advancing age. As cancer frequently occurs in old age, identifying and differentiating the molecular mechanisms mediating muscle wasting in cancer cachexia vs. age-related sarcopenia are a challenge. However, the ability to distinguish between them is critical for early intervention, and simple measures of body weight may not be sufficiently sensitive to detect cachexia early. We used a range of omics approaches: (i) undepleted proteome was quantified using advanced high mass accuracy mass spectrometers in SWATH-MS acquisition mode; (ii) phospho epitopes were quantified using protein arrays; and (iii) morphology was assessed using fluorescent microscopy. We quantified the soluble proteome of muscle biopsies from cancer cachexia patients and compared them with cohorts of cancer patients and healthy individuals with and without age-related muscle loss (aka age-related sarcopenia). Comparing the proteomes of these cohorts, we quantified changes in muscle contractile myosins and energy metabolism allowing for a clear identification of cachexia patients. In an in vitro time lapse experiment, we mimicked cancer cachexia and identified signal transduction pathways governing cell fusion to play a pivotal role in preventing muscle regeneration. The work presented here lays the foundation for further understanding of muscle wasting diseases and holds the promise of overcoming ambiguous weight loss as a measure for defining cachexia to be replaced by a precise protein signature. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on

Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.

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Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Tamaki, Junko

2014-01-01

This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis.

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Bhanji, Rahima A; Narayanan, Praveena; Allen, Alina M; Malhi, Harmeet; Watt, Kymberly D

2017-12-01

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Up to one third of individuals with NAFLD will develop nonalcoholic steatohepatitis (NASH), which is associated with progression to cirrhosis and is rapidly becoming the leading indication for liver transplantation. Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. It is observed in up to 60% of patients with end-stage liver disease and portends a poor prognosis. Recent studies have shown that sarcopenia is a novel risk factor for developing NAFLD. Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. It also exacerbates proteolysis and leads to muscle depletion. Chronic inflammation leads to liver injury and progression of fibrosis. The inflammatory milieu also stimulates protein catabolism. Viewing skeletal muscle as an endocrine organ that secretes various salutary myokines may help us understand its role in the development of steatosis. A better understanding of the pathophysiology will aid in developing physical and pharmacological therapeutic interventions. In this review, we will explore the complex inter-relationships between sarcopenia and NASH. We will discuss the impact of sarcopenia in patients with NASH and therapeutic options for the management of sarcopenia. (Hepatology 2017;66:2055-2065). © 2017 by the American Association for the Study of Liver Diseases.

Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia

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Julie L Woods

2011-03-01

Full Text Available Julie L Woods1, Sandra Iuliano-Burns2, Susannah J King1, Boyd J Strauss1, Karen Z Walker11Nutrition and Dietetics Department, Monash University, Victoria, Australia; 2Endocrine Centre of Excellence, Department of Medicine, Austin Health, University of Melbourne, West Heidelberg, AustraliaPurpose: To determine the prevalence of sarcopenia and investigate relationships among body composition, muscle strength, and physical function in elderly women in low-level aged care.Subjects and methods: Sixty-three ambulatory women (mean age 86 years participated in this cross-sectional study where body composition was determined by dual energy X-ray absorptiometry (DXA; ankle, knee, and hip strength by the Nicholas Manual Muscle Tester; and physical function by ‘timed up and go’ (TUG and walking speed (WS over 6 meters. Body composition data from a female reference group (n = 62, mean age 29 years provided cut-off values for defining sarcopenia.Results: Elderly women had higher body mass index (P < 0.001, lower lean mass (P < 0.001, and higher fat mass (P < 0.01 than the young reference group. Only a small proportion (3.2% had absolute sarcopenia (defined by appendicular skeletal muscle mass/height squared whereas 37% had relative sarcopenia class II (defined by percentage skeletal muscle mass. Scores for TUG and WS indicated relatively poor physical function, yet these measures were not associated with muscle mass or indices of sarcopenia. In multivariate analysis, only hip abductor strength predicted both TUG and WS (both P = 0.01.Conclusion: Hip strength is a more important indicator of physical functioning than lean mass. Measurement of hip strength may therefore be a useful screening tool to detect those at risk of functional decline and requirement for additional care. Further longitudinal studies with a range of other strength measures are warranted.Keywords: aged care, body composition, muscle strength, sarcopenia 

Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia.

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Woods, Julie L; Iuliano-Burns, Sandra; King, Susannah J; Strauss, Boyd J; Walker, Karen Z

2011-01-01

To determine the prevalence of sarcopenia and investigate relationships among body composition, muscle strength, and physical function in elderly women in low-level aged care. Sixty-three ambulatory women (mean age 86 years) participated in this cross-sectional study where body composition was determined by dual energy X-ray absorptiometry (DXA); ankle, knee, and hip strength by the Nicholas Manual Muscle Tester; and physical function by 'timed up and go' (TUG) and walking speed (WS) over 6 meters. Body composition data from a female reference group (n = 62, mean age 29 years) provided cut-off values for defining sarcopenia. Elderly women had higher body mass index (P sarcopenia (defined by appendicular skeletal muscle mass/height squared) whereas 37% had relative sarcopenia class II (defined by percentage skeletal muscle mass). Scores for TUG and WS indicated relatively poor physical function, yet these measures were not associated with muscle mass or indices of sarcopenia. In multivariate analysis, only hip abductor strength predicted both TUG and WS (both P = 0.01). Hip strength is a more important indicator of physical functioning than lean mass. Measurement of hip strength may therefore be a useful screening tool to detect those at risk of functional decline and requirement for additional care. Further longitudinal studies with a range of other strength measures are warranted.

Nutrition for Sarcopenia

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Yanai, Hidekatsu

2015-01-01

Aging-related sarcopenia means that muscle mass, strength, and physical performance tend to decline with age, and malnutrition is associated with sarcopenia. Therefore, nutritional interventions may make an important contribution to prevent the development of sarcopenia. Here I reviewed published articles about the effects of nutritional factors on sarcopenia in elderly people. A growing body of evidence suggests that metabolic factors associated with obesity and diabetes induce the progressi...

Exploring the Link between Serum Phosphate Levels and Low Muscle Strength, Dynapenia, and Sarcopenia.

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Chen, Yuan-Yuei; Kao, Tung-Wei; Chou, Cheng-Wai; Wu, Chen-Jung; Yang, Hui-Fang; Lai, Ching-Huang; Wu, Li-Wei; Chen, Wei-Liang

2018-02-23

Emerging evidences addressed an association between phosphate and muscle function. Because little attention was focused on this issue, the objective of our study was to explore the relationship of phosphate with muscle strength, dynapenia, and sarcopenia. From the National Health and Nutrition Examination Survey, a total of 7421 participants aged 20 years or older were included in our study with comprehensive examinations included anthropometric parameters, strength of the quadriceps muscle, and appendicular lean masses. Within the normal range of serum phosphate, we used quartile-based analyses to determine the potential relationships of serum phosphate with dynapenia, and sarcopenia through multivariate regression models. After adjusting for the pertinent variables, an inverse association between the serum phosphate quartiles and muscle strength was observed and the linear association was stronger than other anthropometric parameters. Notably, the significant association between phosphate and muscle strength was existed in >65 years old age group, not in 20-65 years old. The higher quartiles of phosphate had higher likelihood for predicting the presence of dynapenia rather than sarcopenia in entire population. Our study highlighted that higher quartiles of phosphate had significant association with lower muscle strength and higher risks for predicting the presence of dynapenia.

Sarcopenia: designing phase IIb trials: international working group on sarcopenia

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Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty and increased health care costs. The development of interventions aimed at preventing and/or treating sarcopenia is complex, requiring the adoption of assu...

Pathogenesis and Management of Sarcopenia.

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Dhillon, Robinder J S; Hasni, Sarfaraz

2017-02-01

Sarcopenia represents a loss of muscle strength and mass in older individuals. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training. There are no pharmacologic agents for the treatment of sarcopenia. Published by Elsevier Inc.

Insulinotropic and Muscle Protein Synthetic Effects of Branched-Chain Amino Acids: Potential Therapy for Type 2 Diabetes and Sarcopenia

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Darren G. Candow; Scott C. Forbes; Jonathan P. Little; Ralph J. Manders

2012-01-01

The loss of muscle mass and strength with aging (i.e., sarcopenia) has a negative effect on functional independence and overall quality of life. One main contributing factor to sarcopenia is the reduced ability to increase skeletal muscle protein synthesis in response to habitual feeding, possibly due to a reduction in postprandial insulin release and an increase in insulin resistance. Branched-chain amino acids (BCAA), primarily leucine, increases the activation of pathways involved in muscl...

Risk of Malnutrition Evaluated by Mini Nutritional Assessment and Sarcopenia in Noninstitutionalized Elderly People.

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Liguori, Ilaria; Curcio, Francesco; Russo, Gennaro; Cellurale, Michele; Aran, Luisa; Bulli, Giulia; Della-Morte, David; Gargiulo, Gaetano; Testa, Gianluca; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

2018-02-13

Malnutrition indices and muscle mass and strength in the elderly are poorly investigated. Moreover, malnutrition seems to be 1 of the more important factors in the cause of sarcopenia. The presence of sarcopenia and its relationship with malnutrition indices were studied in noninstitutionalized elderly people who underwent Comprehensive Geriatric Assessment (CGA). A total of 473 elderly subjects (mean age, 80.9 ± 6.6 years) admitted to CGA were studied. Malnutrition risk was evaluated with Mini Nutritional Assessment (MNA) score, whereas muscle mass and muscle strength were evaluated by bioimpedentiometry and hand grip, respectively. Sarcopenia was assessed as indicated in the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Overall prevalence of sarcopenia was 13.1%, and it increased from 6.1% to 31.4% as MNA decreased (P elderly subjects with sarcopenia (15.4 ± 4.2) than without sarcopenia (22.0 ± 4.0) (P = .024). Linear regression analysis showed that MNA score is linearly related both with muscle mass (r = 0.72; P elderly subjects with sarcopenia, and it is linearly related to muscle mass and muscle strength. These data indicate that MNA score, when evaluated with muscle mass and strength, may recognize elderly subjects with sarcopenia. © 2018 American Society for Parenteral and Enteral Nutrition.

Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)

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Cruz-Jentoft, Alfonso J.; Landi, Francesco; Schneider, Stéphane M.; Zúñiga, Clemente; Arai, Hidenori; Boirie, Yves; Chen, Liang-Kung; Fielding, Roger A.; Martin, Finbarr C.; Michel, Jean-Pierre; Sieber, Cornel; Stout, Jeffrey R.; Studenski, Stephanie A.; Vellas, Bruno; Woo, Jean; Zamboni, Mauro; Cederholm, Tommy

2014-01-01

Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: PubMed and Dialog databases were searched (January 2000–October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected. Results: prevalence of sarcopenia was, with regional and age-related variations, 1–29% in community-dwelling populations, 14–33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function. Conclusion: prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes. PMID:25241753

Nonalcoholic fatty liver disease and sarcopenia in a Western population (NHANES III): The importance of sarcopenia definition.

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Peng, Tao-Chun; Wu, Li-Wei; Chen, Wei-Liang; Liaw, Fang-Yih; Chang, Yaw-Wen; Kao, Tung-Wei

2017-12-08

Recent epidemiological studies have shown that sarcopenia is associated with non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis in an Asian population. We investigated whether NAFLD is associated with a higher risk of sarcopenia using a different definition in elderly patients. A population-based cross-sectional survey of US patients was conducted, involving 2551 participants aged 60-75 years. NAFLD was measured by ultrasound. Sarcopenia was defined by both a low muscle mass and poor muscle function. In addition, the skeletal muscle index (SMI) was calculated as the absolute muscle mass (kilograms) divided by height 2 (meters) or total body mass (kilograms). A multivariable logistic regression was conducted to estimate the relationship between sarcopenia and NAFLD in the elderly. After adjusting for age, sex, and race/ethnicity, severe hepatic steatosis was associated with a decreased risk of sarcopenia as defined by the height-adjusted SMI (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.46-0.87). In contrast, severe hepatic steatosis was associated with an increased risk of sarcopenia as defined by the weight-adjusted SMI (OR 1.73; 95% CI 1.31-2.28). These significant associations remained after further adjustments for other potential confounding variables. NAFLD is associated with a lower risk of sarcopenia when using the height-adjusted SMI. In contrast, it showed the opposite result when using the weight-adjusted SMI. The definition of sarcopenia may be an important factor when examining its relationship with NAFLD. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia.

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Biolo, Gianni; Cederholm, Tommy; Muscaritoli, Maurizio

2014-10-01

Skeletal muscle is the most abundant body tissue accounting for many physiological functions. However, muscle mass and functions are not routinely assessed. Sarcopenia is defined as skeletal muscle loss and dysfunction in aging and chronic diseases. Inactivity, inflammation, age-related factors, anorexia and unbalanced nutrition affect changes in skeletal muscle. Mechanisms are difficult to distinguish in individual subjects due to the multifactorial character of the condition. Sarcopenia includes both muscle loss and dysfunction which induce contractile impairment and metabolic and endocrine abnormalities, affecting whole-body metabolism and immune/inflammatory response. There are different metabolic trajectories for muscle loss versus fat changes in aging and chronic diseases. Appetite regulation and physical activity affect energy balance and changes in body fat mass. Appetite regulation by inflammatory mediators is poorly understood. In some patients, inflammation induces anorexia and fat loss in combination with sarcopenia. In others, appetite is maintained, despite activation of systemic inflammation, leading to sarcopenia with normal or increased BMI. Inactivity contributes to sarcopenia and increased fat tissue in aging and diseases. At the end of the metabolic trajectories, cachexia and sarcopenic obesity are paradigms of the two patient categories. Pre-cachexia and cachexia are observed in patients with cancer, chronic heart failure or liver cirrhosis. Sarcopenic obesity and sarcopenia with normal/increased BMI are observed in rheumatoid arthritis, breast cancer patients with adjuvant chemotherapy and in most of patients with COPD or chronic kidney disease. In these conditions, sarcopenia is a powerful prognostic factor for morbidity and mortality, independent of BMI. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Diagnostic criteria for sarcopenia relate differently to insulin resistance

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Bijlsma, A.Y.; Meskers, C.G.M.; van Heemst, D.; Westendorp, R.G.J.; Craen, A.J.M.; Maier, A.B.

2013-01-01

Skeletal muscle is important in insulinstimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in

Prevalence of sarcopenia in a media and long stay Unit.

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Rubio-Maicas, C; Duarte-Alfonso, E; Beseler-Soto, M R; Moreno-Muñoz, I; Moral-Moral, P; Merino-Torres, J F

2014-01-01

Sarcopenia is characterized by the loss of skeletal muscle mass and strength and represents a risk factor for frailty, loss of independence and physical disabilities. This study aimed to assess the prevalence of sarcopenia in a population of patients admitted to a media and long-stay unit. Descriptive, cross-sectional observational study that included 166 patients over 18 years who were admitted consecutively for a year to palliative care, convalescence or rehabilitation. Administrative and anthropometric data were recorded. Sarcopenia detection was performed by assessing the strength in the scapular and pelvic girdle muscles, grip strength in the hands, muscle mass and physical functional capacity. The overall prevalence of sarcopenia was 77.6%. Most patients had severe sarcopenia (91.2%), with reduced levels of the 3 assessed parameters: muscle strength (88.2%), muscle mass (85.5%) and physical performance (94.70%). The prevalence of sarcopenia in patients admitted to our media and long-stay unit is higher than that reported in noninstitutionalized populations, and often has a significant degree of severity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis.

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Kumar, Avinash; Davuluri, Gangarao; Silva, Rafaella Nascimento E; Engelen, Marielle P K J; Ten Have, Gabrie A M; Prayson, Richard; Deutz, Nicolaas E P; Dasarathy, Srinivasan

2017-06-01

Sarcopenia or skeletal muscle loss is a frequent, potentially reversible complication in cirrhosis that adversely affects clinical outcomes. Hyperammonemia is a consistent abnormality in cirrhosis that results in impaired skeletal muscle protein synthesis and breakdown (proteostasis). Despite the availability of effective ammonia-lowering therapies, whether lowering ammonia restores proteostasis and increases muscle mass is unknown. Myotube diameter, protein synthesis, and molecular responses in C2C12 murine myotubes to withdrawal of ammonium acetate following 24-hour exposure to 10 mM ammonium acetate were complemented by in vivo studies in the hyperammonemic portacaval anastomosis rat and sham-operated, pair-fed Sprague-Dawley rats treated with ammonia-lowering therapy by l-ornithine l-aspartate and rifaximin orally for 4 weeks. We observed reduced myotube diameter, impaired protein synthesis, and increased autophagy flux in response to hyperammonemia, which were partially reversed following 24-hour and 48-hour withdrawal of ammonium acetate. Consistently, 4 weeks of ammonia-lowering therapy resulted in significant lowering of blood and skeletal muscle ammonia, increase in lean body mass, improved grip strength, higher skeletal muscle mass and diameter, and an increase in type 2 fibers in treated compared to untreated portacaval anastomosis rats. The increased skeletal muscle myostatin expression, reduced mammalian target of rapamycin complex 1 function, and hyperammonemic stress response including autophagy markers normally found in portacaval anastomosis rats were reversed by treatment with ammonia-lowering therapy. Despite significant improvement, molecular and functional readouts were not completely reversed by ammonia-lowering measures. Ammonia-lowering therapy results in improvement in skeletal muscle phenotype and function and molecular perturbations of hyperammonemia; these preclinical studies complement previous studies on ammonia-induced skeletal muscle

Low Muscle Mass and Breast Cancer Survival

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In a new study, researchers compared the risk of death for women with breast cancer who had low skeletal muscle mass, or sarcopenia, at diagnosis and women who had adequate muscle mass. Learn what they found and what it might mean for patients in this Cancer Currents blog post.

Limb muscle quality and quantity in elderly adults with dynapenia but not sarcopenia: An ultrasound imaging study.

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Chang, Ke-Vin; Wu, Wei-Ting; Huang, Kuo-Chin; Jan, Wei Han; Han, Der-Sheng

2018-03-28

Dynapenia is prevalent in people with reduced skeletal muscle mass, i.e. sarcopenia, but a certain population develops muscle strength loss despite having normal skeletal muscle volume. To date, studies investigating muscle quality and quantity in groups with dynapenia but not sarcopenia are limited. Echogenicity and thickness of the biceps brachii, triceps brachii, rectus femoris, and medial gastrocnemius muscles were measured using high-resolution ultrasonography in 140 community-dwelling elderly adults. Participants with decreased handgrip strength but normal muscular volume were diagnosed as having dynapenia without sarcopenia. A multivariate regression model was used to analyze the association between dynapenia and ultrasound indicators of the sampled muscle expressed as odds ratio (OR) and 95% confidence interval (CI). A total of 140 participants were recruited for the study, 12.6% (n = 18) of whom had dynapenia. The dynapenia group had a higher mean age, higher proportion of women, slower fast gait speed, reduced handgrip strength, and decreased thicknesses of the biceps brachii, rectus femoris, and medial gastrocnemius muscles. On multivariate logistic regression analysis, dynapenia was associated with older age (OR, 1.18; 95% CI, 1.05 to 1.33), higher body mass index (OR, 1.28; 95% CI, 1.05 to 1.64), and decreased thicknesses of the rectus femoris (OR, 0.01; 95% CI, <0.01 to 0.24) and medial gastrocnemius muscles (OR, 0.03; 95% CI, <0.01 to 0.61). Dynapenia without sarcopenia is associated with decreased thicknesses of the rectus femoris and medial gastrocnemius muscles, an association that remains significant after adjustment for demographics, body composition, and physical performance. Ultrasound measurements of lower-limb muscle thickness can be considered an auxiliary criterion for evaluating dynapenia. Copyright © 2018 Elsevier Inc. All rights reserved.

The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

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Reijnierse, Esmee M.; Trappenburg, Marijke C.; Leter, Morena J.; Blauw, Gerard Jan; de van der Schueren, Marian A. E.; Meskers, Carel G. M.; Maier, Andrea B.

2015-01-01

Objectives Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the association between parameters of malnutrition, as a risk factor in sarcopenia, and diagnostic measures of sarcopenia in geriatric outpatients. Material and Methods This study is based on data from a cross-sectional study conducted in a geriatric outpatient clinic including 185 geriatric outpatients (mean age 82 years). Parameters of malnutrition included risk of malnutrition (assessed by the Short Nutritional Assessment Questionnaire), loss of appetite, unintentional weight loss and underweight (body mass index malnutrition (independent variables) and diagnostic measures of sarcopenia (dependent variables) were analysed using multivariate linear regression models adjusted for age, body mass, fat mass and height in separate models. Results None of the parameters of malnutrition was consistently associated with diagnostic measures of sarcopenia. The strongest associations were found for both relative and absolute muscle mass; less stronger associations were found for muscle strength and physical performance. Underweight (p = malnutrition relate differently to diagnostic measures of sarcopenia in geriatric outpatients. The association between parameters of malnutrition and diagnostic measures of sarcopenia was strongest for both relative and absolute muscle mass, while less strong associations were found with muscle strength and physical performance. PMID:26284368

Sarcopenia and its determinants among Iranian elderly (SARIR: study protocol

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Hashemi Rezvan

2012-11-01

Full Text Available Abstract Background The elderly populations increase in world because of improved health status in communities, so health and independency of seniors has become and will be one of the main priorities of public health systems. Ageing have been associated with changes in body composition, including loss of muscle mass, loss of bone mass and increase fat mass. Involuntary age related loss of muscle mass, sarcopenia,has been linked to functional impairment and physical disability. Several definitions for sarcopenia have been presented based on the method of measuring body composition, but an internationally accepted definition doesn’t presently exist yet. In 2010, the European working group on sarcopenia developed a new definition for sarcopenia according to measure muscle mass and muscle function. Several studies have been done about sarcopenia in world, but to our knowledge this study is the first in Iran which is one of the largest countries of the Middle East that faces a fast growing elderly population. The aim of this study is to evaluate sarcopenia and related risk factors in Iran according new definition of sarcopenia. Methods This study will be conducted in two phase among elderly men and women over 55 years in the 6th district of TehranThe first phase will be a population-based cross-sectional study to determine the frequency of sarcopenia in the study population, and to conduct case finding for the second phase. The second phase will be a case–control study to comparison the metabolic and inflammatory factors in sarcopenic and non sarcopenic groups. The association between sarcopenia and major dietary pattern will be evaluated using factor analysis. Conclusion This study is the first study that evaluates sarcopenia and its risk factor in Iranian elderlies. We discuss details of how we collect the data and appropriate instruments to measure muscle mass, muscle power and muscle strength, and suitable cut- off to define sarcopenia in

Sarcopenia, a Neurogenic Syndrome?

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Ping Kwan

2013-01-01

Full Text Available Sarcopenia is an aging-associated condition, which is currently characterized by the loss of muscle mass and muscle strength. However, there is no consensus regarding its characterization hitherto. As the world older adult population is on the rise, the impact of sarcopenia becomes greater. Due to the lack of effective treatments, sarcopenia is still a persisting problem among the global older adults and should not be overlooked. As a result, it is vital to investigate deeper into the mechanism underlying the pathogenesis of sarcopenia in order to develop more effective therapeutic interventions and to inscribe a more uniform characterization. The etiology of sarcopenia is currently found to be multifactorial, and most of the pharmacological researches are focused on the muscular factors in aging. Although the complete mechanism underlying the development of sarcopenia is still waiting to be elucidated, we propose in this article that the primary trigger of sarcopenia may be neurogenic in origin based on the intimate relationship between the nervous and muscular system, namely, the motor neuron and its underlying muscle fibers. Both of them are affected by the cellular environment and their physiological activity.

Subclinical hypothyroidism has little influences on muscle mass or strength in elderly people.

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Moon, Min Kyong; Lee, You Jin; Choi, Sung Hee; Lim, Soo; Yang, Eun Joo; Lim, Jae-Young; Paik, Nam-Jong; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak C; Cho, Bo Youn; Park, Young Joo

2010-08-01

Sarcopenia, the age-related decline in muscle mass, affects the muscle strength and muscle quality, and these changes decrease functional capacity. The prevalence of thyroid dysfunction increases with age, and changes in thyroid hormone level lead to neuromuscular deficits. We investigated the effects of subclinical hypothyroidism on the muscle mass, strength or quality in elderly people. One thousand one hundred eighteen subjects aged > or = 65 yr were randomly selected from a local population and classified into a euthyroid (280 men and 358 women), subclinically hypothyroid (61 men and 75 women), or overtly hypothyroid (7 men and 16 women) group. Although women with subclinical hypothyroidism had a higher prevalence of sarcopenia, defined according to the ratio of appendicular skeletal muscle mass to the square of height, muscle mass, strength or quality did not differ in relation to thyroid status in men or in women. Multivariate analysis including age, diabetes, hypertension, acute coronary event, alcohol, smoking, presence of pain, physical activity score, and lipid profile, showed that thyroid-stimulating hormone level was not associated with muscle mass, strength or quality. In conclusion, subclinical hypothyroidism has little influences on muscle mass, strength or quality, and may not be associated with sarcopenia.

Bioelectrical impedance analysis for diagnosing sarcopenia and cachexia: what are we really estimating?

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Gonzalez, Maria Cristina; Heymsfield, Steven B

2017-04-01

As reference methods are not available for identifying low skeletal muscle mass in clinical practice, the European Group on Sarcopenia in Older People the Asian Working Group for Sarcopenia and the International Consensus for Cancer Cachexia guidelines accept bioelectrical impedance analysis (BIA) as an option for sarcopenia and cachexia assessment. Using different BIA equations, several components that represent 'muscularity' can be assessed. Total skeletal muscle mass or appendicular skeletal muscle mass normalized in relation to height (skeletal muscle mass index or appendicular skeletal muscle index, respectively) is the most common term used in the consensus. These terms are similar, but they should not be used as synonymous. Both terms can be used to define sarcopenia, but adequate equations and cut-off values should be used according to the studied population. However, there is a disagreement between the sarcopenia definition assessed by using BIA from the European Group on Sarcopenia in Older People and Cachexia Consensus, and this can lead to an overestimation of sarcopenia and, consequently, cachexia. An effort should be made to standardize the terminology employed by the Societies to define low muscularity and sarcopenia by using BIA. Future validation studies may show the need for specific cut-off values for each population using this method. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

The assessment and impact of sarcopenia in lung cancer: a systematic literature review.

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Collins, Jemima; Noble, Simon; Chester, John; Coles, Bernadette; Byrne, Anthony

2014-01-02

There is growing awareness of the relationship between sarcopenia (loss of muscle mass and function), and outcomes in cancer, making it a potential target for future therapies. In order to inform future research and practice, we undertook a systematic review of factors associated with loss of muscle mass, and the relationship between muscle function and muscle mass in lung cancer, a common condition associated with poor outcomes. We conducted a computerised systematic literature search on five databases. Studies were included if they explored muscle mass as an outcome measure in patients with lung cancer, and were published in English. Secondary care. Patients with lung cancer. Factors associated with loss of muscle mass and muscle function, or sarcopenia, and the clinical impact thereof in patients with lung cancer. We reviewed 5726 citations, and 35 articles were selected for analysis. Sarcopenia, as defined by reduced muscle mass alone, was found to be very prevalent in patients with lung cancer, regardless of body mass index, and where present was associated with poorer functional status and overall survival. There were diverse studies exploring molecular and metabolic factors in the development of loss of muscle mass; however, the precise mechanisms that contribute to sarcopenia and cachexia remain uncertain. The effect of nutritional supplements and ATP infusions on muscle mass showed conflicting results. There are very limited data on the correlation between degree of sarcopenia and muscle function, which has a non-linear relationship in older non-cancer populations. Loss of muscle mass is a significant contributor to morbidity in patients with lung cancer. Loss of muscle mass and function may predate clinically overt cachexia, underlining the importance of evaluating sarcopenia, rather than weight loss alone. Understanding this relationship and its associated factors will provide opportunities for focused intervention to improve clinical outcomes.

One size may not fit all: anti-aging therapies and sarcopenia.

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Burks, Tyesha N; Cohn, Ronald D

2011-12-01

Sarcopenia refers to age-related loss of muscle mass and function. Several age-related changes occur in skeletal muscle including a decrease in myofiber size and number and a diminished ability of satellite cells to activate and proliferate upon injury leading to impaired muscle remodeling. Although the molecular mechanisms underlying sarcopenia are unknown, it is tempting to hypothesize that interplay between biological and environmental factors cooperate in a positive feedback cycle contributing to the progression of sarcopenia. Indeed many essential biological mechanisms such as apoptosis and autophagy and critical signaling pathways involved in skeletal muscle homeostasis are altered during aging and have been linked to loss of muscle mass. Moreover, the environmental effects of the sedentary lifestyle of older people further promote and contribute the loss of muscle mass. There are currently no widely accepted therapeutic strategies to halt or reverse the progression of sarcopenia. Caloric restriction has been shown to be beneficial as a sarcopenia and aging antagonist. Such results have made the search for caloric restriction mimetics (CRM) a priority. However given the mechanisms of action, some of the currently investigated CRMs may not combat sarcopenia. Thus, sarcopenia may represent a unique phenotypic feature of aging that requires specific and individually tailored therapeutic strategies.

Pathogenesis and Management of Sarcopenia

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Dhillon, Robinder JS; Hasni, Sarfaraz

2016-01-01

SYNOPSIS Sarcopenia represents a loss of muscle strength and mass in older individuals and is a major determinant of fall risk and impaired ability to perform activities of daily living, often leading to disability, loss of independence and death. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality and healthcare expenditure. Despite its clinical importance, sarcopenia remains under recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training. There are no pharmacological agents currently approved for the treatment of sarcopenia. PMID:27886695

The Effect of Physiological Stimuli on Sarcopenia; Impact of Notch and Wnt Signaling on Impaired Aged Skeletal Muscle Repair

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Arthur, Susan Tsivitse; Cooley, Ian D.

2012-01-01

The age-related loss of skeletal muscle mass and function that is associated with sarcopenia can result in ultimate consequences such as decreased quality of life. The causes of sarcopenia are multifactorial and include environmental and biological factors. The purpose of this review is to synthesize what the literature reveals in regards to the cellular regulation of sarcopenia, including impaired muscle regenerative capacity in the aged, and to discuss if physiological stimuli have the potential to slow the loss of myogenic potential that is associated with sarcopenia. In addition, this review article will discuss the effect of aging on Notch and Wnt signaling, and whether physiological stimuli have the ability to restore Notch and Wnt signaling resulting in rejuvenated aged muscle repair. The intention of this summary is to bring awareness to the benefits of consistent physiological stimulus (exercise) to combating sarcopenia as well as proclaiming the usefulness of contraction-induced injury models to studying the effects of local and systemic influences on aged myogenic capability. PMID:22701343

Osteoporosis and Sarcopenia in Older Age

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Edwards, MH; Dennison, EM; Sayer, A Aihie; Fielding, R; Cooper, C

2015-01-01

Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties including the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. PMID:25886902

Prevalence of pre-sarcopenia and sarcopenia in Hong Kong Chinese geriatric patients with hip fracture and its correlation with different factors.

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Ho, A Wh; Lee, M Ml; Chan, E Wc; Ng, H My; Lee, C W; Ng, W S; Wong, S H

2016-02-01

Sarcopenia and osteoporosis are age-related declines in the quantity of muscle and bone, respectively. Both contribute in disability, fall, and hip fracture in the elderly. This study reported the prevalence of sarcopenia in Chinese geriatric patients with hip fracture, and the correlation between relative appendicular skeletal muscle mass index and other factors. This case series was conducted in Kowloon West Cluster Orthopaedic Rehabilitation Centre in Hong Kong. Data of all geriatric patients with primary hip fracture admitted to the above Centre from June to December 2014 were studied. Isometric grip strength, the maximal handgrip strength, was measured using a JAMAR hand dynamometer. Body composition including appendicular and whole-body lean body mass was measured using dual-energy X-ray absorptiometry. Pearson's correlation was used to examine the correlation between relative appendicular skeletal muscle mass index and other factors. A total of 239 patients with a mean age of 82 years were included in the study. Stratifying patients as male or female, the mean (± standard deviation) hand grip strength was 20.6 ± 7.3 kg and 13.6 ± 4.5 kg, the mean relative appendicular skeletal muscle mass index was 5.72 ± 0.83 kg/m(2) and 4.87 ± 0.83 kg/m(2), and the mean hip bone mineral density was 0.696 ± 0.13 g/cm(2) and 0.622 ± 0.12 g/cm(2), respectively. The prevalence of sarcopenia based on relative appendicular skeletal muscle mass index and hand grip strength according to the Asian Working Group for Sarcopenia definition was 73.6% in males and 67.7% in females. According to the European Working Group on Sarcopenia definition, the prevalence of pre-sarcopenia was 20.8% in males and 12.4% in females. Relative appendicular skeletal muscle mass index was positively correlated with hand grip strength, body weight, hip bone mineral density, body mass index, and total fat mass in males; and hand grip strength, body weight, body height, body mass index, and total fat

Tools in the assessment of sarcopenia

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Cooper, C; Fielding, R; Visser, M; van Loon, LJ; Rolland, Y; Orwoll, E; Reid, K; Boonen, S; Dere, W; Epstein, S; Mitlak, B; Tsouderos, Y; Sayer, AA; Rizzoli, R; Reginster, JY; Kanis, JA

2013-01-01

Summary This review provides a framework for development of an operational definition of sarcopenia and of the potential endpoints that might be adopted in clinical trials among older adults. Introduction While the clinical relevance of sarcopenia is widely recognized, there is currently no universally accepted definition of the disorder. The development of interventions to alter the natural history of sarcopenia also requires consensus on the most appropriate endpoints for determining outcomes of clinical importance which might be utilised in intervention studies. Methods and results We review current approaches to the definition of sarcopenia, and the methods used for the assessment of various aspects of physical function in older people. The potential endpoints of muscle mass, muscle strength, muscle power and muscle fatigue, as well as the relationships between them, are explored with reference to the availability and practicality of the available methods for measuring these endpoints in clinical trials. Conclusions Based on current evidence, none of the four potential outcomes in question is sufficiently comprehensive to recommend as a uniform single outcome in randomised clinical trials. We propose that sarcopenia may be optimally defined (for the purposes of clinical trial inclusion criteria, as well as epidemiological studies) using a combination of measures of muscle mass and physical performance. The choice of outcome measures for clinical trials in sarcopenia is more difficult; co-primary outcomes, tailored to the specific intervention in question, may be the best way forward in this difficult but clinically important area. PMID:23842964

[Transdisciplinary approach for sarcopenia. Sarcopenic Dysphagia].

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Wakabayashi, Hidetaka

2014-10-01

Sarcopenic dysphagia is difficulty swallowing due to sarcopenia of generalized skeletal muscles and swallowing muscles. Presbyphagia refers to age-related changes in the swallowing mechanism in the elderly associated with a frailty in swallowing. Presbyphagia is different from dysphagia. The most common cause of dysphagia is stroke. However, sarcopenic dysphagia may be common in the elderly with sarcopenia and dysphagia. Frail elderly with aspiration pneumonia can simultaneously experience activity-, disease-, and nutrition-related sarcopenia of generalized skeletal muscles and swallowing muscles, resulting in the development of sarcopenic dysphagia. Consensus diagnostic criteria for sarcopenic dysphagia were proposed at the 19th Annual Meeting of the Japanese Society of Dysphagia Rehabilitation. The concept of rehabilitation nutrition as a combination of both rehabilitation and nutrition care management is useful for treatment of sarcopenic dysphagia. Therapy for sarcopenic dysphagia includes dysphagia rehabilitation, nutrition improvement and sarcopenia treatment. The core components of dysphagia rehabilitation are oral health care, rehabilitative techniques, and food modification. Nutrition improvement is important, because malnutrition contributes to the etiology of secondary sarcopenia and sarcopenic dysphagia. Assessment of the multi-factorial causes of primary and secondary sarcopenia is important because rehabilitation nutrition for sarcopenia differs depending on its etiology. Treatment of age-related sarcopenia should include resistance training and dietary supplements of amino acids. Therapy for activity-related sarcopenia includes reduced bed rest time and early mobilization and physical activity. Treatment for disease-related sarcopenia requires therapies for advanced organ failure, inflammatory disease, or malignancy, while therapy for nutrition-related sarcopenia involves appropriate nutrition management to increase muscle mass.

Sarcopenia: what should a pharmacist know?

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Alfonso J. Cruz-Jentoft

2017-07-01

Full Text Available Sarcopenia (or muscle insufficiency is a geriatric syndrome characterized by a progressive and generalized loss of skeletal muscle mass and function which has adverse consequences, particularly physical disability, falls and death. It can develop slowly, as a chronic condition that emerges over many years, or acutely, generally due to immobilization associated with an acute disease. The physiopathology of sarcopenia is complex, and affects both the muscle and its neurological and hormonal regulation. The prevalence of sarcopenia increases with age and in certain healthcare settings (nursing homes, hospitals, rehabilitation centres. Its diagnosis is based on the documentation of a low muscle mass associated with low muscle strength and/or low physical performance. Once confirmed, a syndromic approach is needed, based on a comprehensive geriatric assessment in order to determine its causes and prepare a treatment plan which addresses the treatment of symptoms as well as the etiology. Prevention of sarcopenia starts in the adult age, through the promotion of adequate nutritional habits, an increase in physical activity and, ideally, resistance exercise. Sarcopenia treatment must necessarily include resistance exercises (that can be associated with other types of exercise and an improvement in diet, increasing protein intake up to 1.2-1.5 g/kg/day and covering caloric requirements. In some cases, this will require the use of nutritional supplements, which can contain leucine, beta-hydroxy beta-methylbutyrate acid (HMB and vitamin D, in order to optimize its effects on the muscle. There are still no medications available to treat sarcopenia

Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men.

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Pereira, Fernando Borges; Leite, André Ferreira; de Paula, Ana Patrícia

2015-02-01

Analyze the influence of sarcopenia in bone health of elderly men. This cross-sectional study evaluated 198 men aged over 60 years. Body composition was measured by dual energy X-ray absorptiometry. The BMD was measured at the femoral neck, total hip, lumbar spine and 33% radius. The diagnosis of abnormal BMD was defined for men who presented densitometric diagnosis of osteopenia or osteoporosis defined by T-score of femoral neck, total hip and lumbar spine. The pre-sarcopenia and sarcopenia were defined according to the European Working Group on Sarcopenia in Older People. The group diagnosed with normal BMD, compared to the group of abnormal BMD, have significantly higher body weight, body mass index, grip strength, lean mass, fat mass, and relative appendicular skeletal muscle mass (RASM). However, after multiple linear regression analysis, we found that only the RASM, lean mass, and handgrip strength in the dominant hand influenced the variability of the BMD after adjustment for age and weight. Regression analyzes showed a positive association between greater appendicular lean mass and a smaller number of elderly patients with abnormal BMD diagnostic. The regression analyzes showed that elderly men diagnosed with pre-sarcopenia and sarcopenia had more abnormal BMD than non-sarcopenic elderly men. We concluded that pre-sarcopenia and sarcopenia were associated with abnormal BMD. The lean mass, compared to fat mass, has a greater positive influence on the BMD of elderly men. This result suggests the importance of the increase in lean mass for the bone health of elderly men.

Significance of Sarcopenia Evaluation in Acute Decompensated Heart Failure.

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Tsuchida, Keiichi; Fujihara, Yuki; Hiroki, Jiro; Hakamata, Takahiro; Sakai, Ryohei; Nishida, Kota; Sudo, Koji; Tanaka, Komei; Hosaka, Yukio; Takahashi, Kazuyoshi; Oda, Hirotaka

2018-01-27

In patients with chronic heart failure (HF), the clinical importance of sarcopenia has been recognized in relation to disease severity, reduced exercise capacity, and adverse clinical outcome. Nevertheless, its impact on acute decompensated heart failure (ADHF) is still poorly understood. Dual-energy X-ray absorptiometry (DXA) is a technique for quantitatively analyzing muscle mass and the degree of sarcopenia. Fat-free mass index (FFMI) is a noninvasive and easily applicable marker of muscle mass.This was a prospective observational cohort study comprising 38 consecutive patients hospitalized for ADHF. Sarcopenia, derived from DXA, was defined as a skeletal muscle mass index (SMI) two standard deviations below the mean for healthy young subjects. FFMI (kg/m 2 ) was calculated as 7.38 + 0.02908 × urinary creatinine (mg/day) divided by the square of height (m 2 ).Sarcopenia was present in 52.6% of study patients. B-type natriuretic peptide (BNP) levels were significantly higher in ADHF patients with sarcopenia than in those without sarcopenia (1666 versus 429 pg/mL, P sarcopenia as a predictor of higher BNP level (OR = 18.4; 95% CI, 1.86-181.27; P = 0.013).Sarcopenia is associated with increased disease severity in ADHF. SMI based on DXA is potentially superior to FFMI in terms of predicting the degree of severity, but FFMI is also associated with ADHF severity.

[Transdisciplinary Approach for Sarcopenia. Effect of nutritional support for the prevention of sarcopenia].

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Nishioka, Hiroaki

2014-10-01

Sarcopenia is defined as the age-related loss of muscle mass and function. Sarcopenia is closely related with decreased physical function, fall, bone fracture, osteoporosis, and insulin resistance, which lead to increased morbidity and mortality in elderly people. The pathogenesis of sarcopenia is complex and multifactorial, which remains not to be fully understood. Inappropriate food intake and reduced physical activity are known to increase the risk of developing sarcopenia. Resistance training and nutritional support have been shown to be an effective intervention for prevention of sarcopenia. Protein, especially branched chain amino acid, and vitamin D have been reported to improve sarcopenia. The intervention together with nutrition and exercise are more effective.

Signalling pathways regulating muscle mass in ageing skeletal muscle. The role of the IGF1-Akt-mTOR-FoxO pathway

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Sandri, M.; Barberi, L.; Bijlsma, A.Y.; Blaauw, B.; Dyar, K.A.; Milan, G.; Mammucari, C.; Meskers, C.G.M.; Pallafacchina, G.; Paoli, A.; Pion, D.; Roceri, M.; Romanello, V.; Serrano, A.L.; Toniolo, L.; Larsson, L.; Maier, A.B.; Munoz-Canoves, P.; Musaro, A.; Pende, M.; Reggiani, C.; Rizzuto, R.; Schiaffino, S.

2013-01-01

During ageing skeletal muscles undergo a process of structural and functional remodelling that leads to sarcopenia, a syndrome characterized by loss of muscle mass and force and a major cause of physical frailty. To determine the causes of sarcopenia and identify potential targets for interventions

Serum markers of inflammation and oxidative stress in sarcopenia.

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Can, Busra; Kara, Ozgur; Kizilarslanoglu, Muhammet Cemal; Arik, Gunes; Aycicek, Gozde Sengul; Sumer, Fatih; Civelek, Ramazan; Demirtas, Canan; Ulger, Zekeriya

2017-08-01

Sarcopenia is a geriatric syndrome characterized by the presence of low muscle mass and function. Possible mechanisms underlying sarcopenia include oxidative stress and elevation of inflammatory cytokines. The aim of the study was to evaluate the relationship between sarcopenia and biomarkers that may be involved in its pathogenesis and hence early detection. A total of 72 patients (36 sarcopenic and 36 non-sarcopenic) were included in the study. An experienced geriatric team applied comprehensive geriatric assessment to all patients. Anthropometric measures, gait speed and handgrip strength were recorded. Bioelectrical impedance analysis was used to assess skeletal muscle mass. In addition to routine clinical laboratory tests, serum adiponectin, thioredoxin-1 and pentraxin-3 levels were measured. Sarcopenia was defined according to the European Working Group on Sarcopenia in older Adults as the presence of low muscle mass and low muscle function or muscle performance. Sarcopenic patients were more likely to be functionally dependent and had lower scores on comprehensive geriatric assessment tools. Erythrocyte sedimentation rate (ESR) and C-reactive protein levels were significantly higher in the sarcopenic group. There was no significant difference in serum levels of thioredoxin-1 and pentraxin-3. Sarcopenic patients had lower levels of hemoglobin, albumin, total protein, calcium, triglycerides, uric acid and adiponectin (p sarcopenia whereas ESR was positively correlated. The present study demonstrated an association of sarcopenia with inflammatory markers CRP, ESR and adiponectin. Long-term prospective studies are warranted to confirm the relationship between markers oxidative stress and age related muscle decline.

Muscle wasting and resistance of muscle anabolism: the "anabolic threshold concept" for adapted nutritional strategies during sarcopenia.

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Dardevet, Dominique; Rémond, Didier; Peyron, Marie-Agnès; Papet, Isabelle; Savary-Auzeloux, Isabelle; Mosoni, Laurent

2012-01-01

Skeletal muscle loss is observed in several physiopathological situations. Strategies to prevent, slow down, or increase recovery of muscle have already been tested. Besides exercise, nutrition, and more particularly protein nutrition based on increased amino acid, leucine or the quality of protein intake has generated positive acute postprandial effect on muscle protein anabolism. However, on the long term, these nutritional strategies have often failed in improving muscle mass even if given for long periods of time in both humans and rodent models. Muscle mass loss situations have been often correlated to a resistance of muscle protein anabolism to food intake which may be explained by an increase of the anabolic threshold toward the stimulatory effect of amino acids. In this paper, we will emphasize how this anabolic resistance may affect the intensity and the duration of the muscle anabolic response at the postprandial state and how it may explain the negative results obtained on the long term in the prevention of muscle mass. Sarcopenia, the muscle mass loss observed during aging, has been chosen to illustrate this concept but it may be kept in mind that it could be extended to any other catabolic states or recovery situations.

Sarcopenia according to the european working group on sarcopenia in older people (EWGSOP) versus Dynapenia as a risk factor for disability in the elderly.

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da Silva Alexandre, T; de Oliveira Duarte, Y A; Ferreira Santos, J L; Wong, R; Lebrão, M L

2014-05-01

Sarcopenia, defined as low muscle mass (LMM), and dynapenia have been associated with adverse outcomes in elderly. Contrast the association of sarcopenia versus dynapenia with incidence of disability. A four-year prospective study (2006-2010). São Paulo, Brazil. 478 individuals aged 60 and older from the Saúde, Bem-Estar e Envelhecimento (SABE) study who were non-disabled at baseline. Sarcopenia, measured according to the European Working Group on Sarcopenia in Older People (EWGSOP), includes: LMM assessed by skeletal muscle mass index ≤8.90kg/m2 (men) and ≤6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength sarcopenia required LMM plus LMS or LPP. Dynapenia was defined as handgrip strength sarcopenia or dynapenia status. After controlling for all covariates, sarcopenia was associated with mobility or IADL disability (relative risk ratio = 2.23, 95%Confidence Interval: 1.03-4.85). Dynapenia was not associated with disability. Sarcopenia according to the EWGSOP definition can be used in clinical practice as a screening tool for early functional decline (mobility or IADL disability).

Sarcopenia and androgens: A link between pathology and treatment

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Carla eBasualto-Alarcón

2014-12-01

Full Text Available Sarcopenia, the age-related loss of skeletal muscle mass and function, is becoming more prevalent as the lifespan continues to increase in most populations. As sarcopenia is highly disabling, being associated with increased risk of dependence, falls, fractures, weakness, disability, and death, development of approaches to its prevention and treatment are required. Androgens are the main physiologic anabolic steroid hormones and normal testosterone levels are necessary for a range of developmental and biological processes, including maintenance of muscle mass. Testosterone concentrations decline as age increase, suggesting that low plasma testosterone levels can cause or accelerate muscle- and age-related diseases, as sarcopenia. Currently, there is increasing interest on the anabolic properties of testosterone for therapeutic use in muscle diseases including sarcopenia. However, the pathophysiological mechanisms underlying this muscle syndrome and its relationship with plasma level of androgens are not completely understood. This review discusses the recent findings regarding sarcopenia, the intrinsic and extrinsic mechanisms involved in the onset and progression of this disease and the treatment approaches that have been developed based on testosterone deficiency and their implications.

[Sarcopenia in the elderly: diagnosis and treatment].

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Chang, Shu-Fang

2014-04-01

The proportion of the population aged 65 years and older in Taiwan was 11.15% in 2012. This is expected to rise to 20% in 2026, at which time, the country would become a super-aged society. Sarcopenia, with a worldwide prevalence among people 65 years of age and older between 9.5% and 50%, has gained increasing attention in recent years. It is estimated that two-hundred million people worldwide will suffer from sarcopenia within 40 years. The various causes of sarcopenia include aging, inappropriate diet, a bedridden or sedentary lifestyle, chronic diseases, and hormones. The definition and interpretation of sarcopenia uses a cutoff point of 2 standard deviations below the muscle mass in young adults between the ages of 18 and 40 years. The quadriceps muscles are most commonly used to assess sarcopenia. A bioimpedance analyzer is appropriate for community-based assessment work because this instrument is inexpensive, easily operated, and portable. Decreased muscle mass in the elderly causes sarcopenia, which leads to movement disorders, fall events, fractures, loss of the capacity to live independently, frailty, and increased mortality risk. Therefore, developing a comprehensive care program for sarcopenia, including resistance training and sufficient protein and vitamin D intake, should be a priority task and important research focus for nursing professionals.

Defining sarcopenia : The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort

NARCIS (Netherlands)

Bijlsma, A. Y.; Meskers, C. G M; Ling, C. H Y; Narici, M.; Kurrle, S. E.; Cameron, I. D.; Westendorp, R. G J; Maier, A. B.

Sarcopenia, low muscle mass, is an increasing problem in our ageing society. The prevalence of sarcopenia varies extremely between elderly cohorts ranging from 7% to over 50%. Without consensus on the definition of sarcopenia, a variety of diagnostic criteria are being used. We assessed the degree

[Factors related to sarcopenia in community-dwelling elderly subjects in Japan].

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Tanimoto, Yoshimi; Watanabe, Misuzu; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2013-01-01

This study aimed at determining the factors associated with sarcopenia, defined as low muscle mass and strength and low physical performance, in community-dwelling elderly subjects in Japan. The subjects included 1,074 elderly, community-dwelling Japanese people aged 65 years or older. We measured appendicular muscle mass (AMM) by bioelectrical impedance analysis, grip strength, and usual walking speed. A low muscle mass was defined by the AMM index (AMI, weight [kg]/height [m(2)] as >2 standard deviations below the mean AMI for normal young subjects. The lowest quartile for grip strength and usual walking speed were classified as low muscle strength and low physical performance, respectively. "Sarcopenia" was characterized by a low muscle mass, combined with either a low muscle strength or low physical performance. Subjects without low muscle mass or strength and low physical performance were classified as "normal." Subjects were classified as being "intermediate" if they were neither "sarcopenic" nor "normal." Items in the questionnaire included residential status, past medical history, admission during the past year, smoking and drinking habits, leisure-time physical activity, health status, depression, masticatory ability, and dietary variety score. Sarcopenia was identified in 13.7% of men and 15.5% of women. Among men, a large proportion of subjects with sarcopenia had poor masticatory ability and a low dietary variety score compared with normal or intermediate subjects. Among women, a large proportion of the subjects with sarcopenia lived alone, had poor exercise habits, considered themselves to be unhealthy, and had poor masticatory ability compared with normal or intermediate subjects. A multiple logistic regression analysis showed that age and dietary variety in men and age and masticatory ability in women were associated with sarcopenia. The present study carried out in Japan showed that sarcopenia, assessed by muscle mass, muscle strength, and physical

Sarcopenia and impairment in cognitive and physical performance

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Tolea MI

2015-03-01

Full Text Available Magdalena I Tolea,1 James E Galvin1–3 1Alzheimer’s Disease Center, Department of Neurology, 2Department of Psychiatry, 3Department of Population Health, New York University School of Medicine, New York, NY, USA Background: Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength.Methods: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2, physical impairment (Mini Physical Performance Test <12, both, or neither by ordinal logistic regression. Results: Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07–11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11–11.72 for Ascertaining Dementia 8. Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass. Conclusion: Individuals with sarcopenia are not only more likely to have single but also to have dual

Molecular mechanism of sarcopenia and cachexia: recent research advances.

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Sakuma, Kunihiro; Aoi, Wataru; Yamaguchi, Akihiko

2017-06-01

Skeletal muscle provides a fundamental basis for human function, enabling locomotion and respiration. Muscle loss occurs as a consequence of several chronic diseases (cachexia) and normal aging (sarcopenia). Although many negative regulators (atrogin-1, muscle ring finger-1, nuclear factor-kappaB (NF-κB), myostatin, etc.) have been proposed to enhance protein degradation during both sarcopenia and cachexia, the adaptation of these mediators markedly differs within both conditions. Sarcopenia and cachectic muscles have been demonstrated to be abundant in myostatin-linked molecules. The ubiquitin-proteasome system (UPS) is activated during rapid atrophy model (cancer cachexia), but few mediators of the UPS change during sarcopenia. NF-κB signaling is activated in cachectic, but not in sarcopenic, muscle. Recent studies have indicated the age-related defect of autophagy signaling in skeletal muscle, whereas autophagic activation occurs in cachectic muscle. This review provides recent research advances dealing with molecular mediators modulating muscle mass in both sarcopenia and cachexia.

Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis?

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El Maghraoui, Abdellah; Ebo'o, François Bertin; Sadni, Siham; Majjad, Abderrahim; Hamza, Toufik; Mounach, Aziza

2016-07-11

Osteoporosis is a well-known complication of ankylosing spondylitis (AS). However, data about body composition modifications and muscle performance showed conflicting results. The aim of the study was to determine the prevalence and risk factors of pre-sarcopenia, sarcopenia and cachexia in patients with AS and analyze its relationship with bone loss and symptomatic and severity parameters of the disease. Sixty-seven consecutive male patients with AS (mean age of 40.9 ± 11.0 years) and 67 healthy controls were studied. Body composition and bone mineral density (BMD) scans were obtained using DXA. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent of fat mass (%FM) were calculated. Pre-sarcopenia was defined by low skeletal muscle mass (SMI 10 s) and cachexia by a BMI 5 mg/l, SMI cachexia, and osteoporosis prevalences were (50.4, 34.3, 11.9, and 16.0) respectively. Patients had a mean 3 kg significant decrease in FFM and a 1 kg/m(2) decrease in appendicular mass vs. healthy controls. Pre-sarcopenia, sarcopenia and cachexia were significantly associated to higher BASDAI levels and low BMD. Our study showed that men with AS had a statistically significant reduction in total and appendicular lean mass that is related to higher disease activity and significantly associated to bone loss.

Association of sarcopenia with functional decline in community-dwelling elderly subjects in Japan.

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Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Tanimoto, Keiji; Shishikura, Kanako; Sugiura, Yumiko; Kusabiraki, Toshiyuki; Kono, Koichi

2013-10-01

The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2-year cohort study of community-dwelling elderly Japanese people. Participants were 743 community-dwelling elderly Japanese people aged 65 years or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. Functional disability was defined using an activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale at baseline and during follow-up examinations 2 years later. Logistic regression analysis, adjusted for age and body mass index, was used to examine the association between sarcopenia and the occurrence of functional disability. In the present study, 7.8% of men and 10.2% of women were classified as having sarcopenia. Among sarcopenia patients in the baseline study, 36.8% of men and 18.8% of women became dependent in ADL at 2-year follow up. From the logistic regression analysis adjusted by age and body mass index, sarcopenia was significantly associated with the occurrences of physical disability compared with normal subjects in both men and women. Sarcopenia, defined by muscle mass, muscle strength and physical performance, was associated with functional decline over a 2-year period in elderly Japanese. Interventions to prevent sarcopenia are very important to prevent functional decline among elderly individuals. © 2013 Japan Geriatrics Society.

Sarcopenia: assessment of disease burden and strategies to improve outcomes

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Liguori, Ilaria; Russo, Gennaro; Aran, Luisa; Bulli, Giulia; Curcio, Francesco; Della-Morte, David; Gargiulo, Gaetano; Testa, Gianluca; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

2018-01-01

Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength – a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed. PMID:29785098

Relationship between Handgrip Strength and Muscle Mass in Female Survivors of Breast Cancer: A Mediation Analysis.

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Benavides-Rodríguez, Lorena; García-Hermoso, Antonio; Rodrigues-Bezerra, Diogo; Izquierdo, Mikel; Correa-Bautista, Jorge Enrique; Ramírez-Vélez, Robinson

2017-07-04

This study explored the mediating factors of sarcopenia in a group of women survivors of breast cancer in Bogotá, Colombia. This was a descriptive cross-sectional study with 98 women survivors of breast cancer, who were registered with the SIMMON (Integrated Synergies to Improve Oncological Management in Colombia) Foundation. Body weight, height, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Body composition (percentage of fat and muscle mass) was evaluated via four-pole bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass plus low grip strength or low gait speed (European Working Group on Sarcopenia in Older People (EWGSOP) criteria). A "causal" mediation analysis with the Baron & Kenny procedure (PROCESS ® macro, Columbus, OH, USA) was used to explore variables related to sarcopenia. Analyses were performed with the IBM SPSS 21 statistical package (SPSS Inc., Chicago, IL, USA). The significance level of the results obtained in the hypothesis contrast was p < 0.05. The mean age of the sample was 65.5 ± 5.9 years, with a BMI of 27.8 ± 4.7 kg/m². The prevalence of sarcopenia was 22.4%. Linear regression models suggest a partial mediation of anthropometric parameters (body mass, body mass index and waist circumference) in the association between handgrip strength and muscle mass. In conclusion, one in every five women survivors of breast cancer had sarcopenia. The findings seem to emphasize the importance of obesity prevention in women survivors of breast cancer, suggesting that high handgrip strength may not relate closely to greater muscle mass and therefore would not exclude the risk of sarcopenia.

Nutrition and sarcopenia of ageing

OpenAIRE

Fujita, Satoshi; Volpi, Elena

2004-01-01

Sarcopenia, the loss of muscle mass and function with ageing, is a multifactorial condition that slowly develops over decades and becomes a significant contributor to disability in the older population. Malnutrition and alterations in the muscle anabolic response to nutritional stimuli have been identified as potentially preventable factors that may significantly contribute to sarcopenia. In the present article we review the most recent findings regarding the role of nutritional factors in th...

Evaluation of Sarcopenia in Elderly Women of China

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Lufang Chen

2017-09-01

Conclusion: Our findings suggested that both aging and menopause contributes to the decline of muscle strength and physical function rather primarily than the loss of muscle mass in the process of sarcopenia in Chinese older women. Hand-grip strength criteria is more sensitive to diagnose sarcopenia in elderly women of China.

Sarcopenia and sarcopenic obesity in patients with muscular dystrophy

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Luciano eMerlini

2014-10-01

Full Text Available Aging sarcopenia and muscular dystrophy are two conditions characterized by lower skeletal muscle quantity, lower muscle strength, and lower physical performance. Aging is associated with a peculiar alteration in body composition called sarcopenic obesity characterized by a decrease in lean body mass and increase in fat mass. To evaluate the presence of sarcopenia and obesity in a cohort of adult patients with muscular dystrophy we have used the measurement techniques considered golden standard for sarcopenia that is for muscle mass dual energy X-ray absorptiometry (DXA, for muscle strength hand held dynamometry, and for physical performance gait speed. The study involved 14 adult patients with different types of muscular dystrophy. We were able to demonstrate that all patient were sarcopenic-obese. We showed in fact that all were sarcopenic based on appendicular lean, fat & bone free, mass index (ALMI. In addition all resulted obese according to the % of body fat determined by DXA in contrast with their body mass index ranging from underweight to obese. Skeletal muscle mass determined by DXA was markedly reduced in all patients and correlated with residual muscle strength determined by hand held dynamometry, and physical performances determined by gait speed and respiratory function. Finally we showed that ALMI was the best linear explicator of muscle strength and physical function. Altogether, our study suggest the relevance of a proper evaluation of body composition in muscular dystrophy and we propose to use, both in research and practice, the measurement techniques that has already been demonstrated effective in aging sarcopenia.

Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia.

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Chen, Liang-Kung; Lee, Wei-Ju; Peng, Li-Ning; Liu, Li-Kuo; Arai, Hidenori; Akishita, Masahiro

2016-08-01

Sarcopenia was recently classified a geriatric syndrome and is a major challenge to healthy aging. Affected patients tend to have worse clinical outcomes and higher mortality than those without sarcopenia. Although there is general agreement on the principal diagnostic characteristics, initial thresholds for muscle mass, strength, and physical performance were based on data from populations of predominantly Europid ancestry and may not apply worldwide. The Asian Working Group for Sarcopenia (AWGS) issued regional consensus guidelines in 2014, and many more research studies from Asia have since been published; this review summarizes recent progress. The prevalence of sarcopenia estimated by the AWGS criteria ranges between 4.1% and 11.5% of the general older population; however, prevalence rates were higher in Asian studies that used European Working Group on Sarcopenia in Older People cut-offs. Risk factors include age, sex, heart disease, hyperlipidemia, daily alcohol consumption, and low protein or vitamin intake; physical activity is protective. Adjusting skeletal muscle mass by weight rather than height is better in showing the effect of older age in sarcopenia and identifying sarcopenic obesity; however, some Asian studies found no significant skeletal muscle loss, and muscle strength might be a better indicator. Although AWGS 2014 diagnostic cut-offs were generally well accepted, some may require further revision in light of conflicting evidence from some studies. The importance of sarcopenia in diverse therapeutic areas is increasingly evident, with strong research interest in sarcopenic obesity and the setting of malignancy. Pharmacologic interventions have been unsatisfactory, and the core management strategies remain physical exercise and nutritional supplementation; however, further research is required to determine the most beneficial approaches. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc

Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

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Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2012-01-01

This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

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Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

2015-04-01

Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, plevels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Insulinotropic and Muscle Protein Synthetic Effects of Branched-Chain Amino Acids: Potential Therapy for Type 2 Diabetes and Sarcopenia

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Darren G. Candow

2012-11-01

Full Text Available The loss of muscle mass and strength with aging (i.e., sarcopenia has a negative effect on functional independence and overall quality of life. One main contributing factor to sarcopenia is the reduced ability to increase skeletal muscle protein synthesis in response to habitual feeding, possibly due to a reduction in postprandial insulin release and an increase in insulin resistance. Branched-chain amino acids (BCAA, primarily leucine, increases the activation of pathways involved in muscle protein synthesis through insulin-dependent and independent mechanisms, which may help counteract the “anabolic resistance” to feeding in older adults. Leucine exhibits strong insulinotropic characteristics, which may increase amino acid availability for muscle protein synthesis, reduce muscle protein breakdown, and enhance glucose disposal to help maintain blood glucose homeostasis.

Muscle Wasting and Resistance of Muscle Anabolism: The “Anabolic Threshold Concept” for Adapted Nutritional Strategies during Sarcopenia

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Dominique Dardevet

2012-01-01

Full Text Available Skeletal muscle loss is observed in several physiopathological situations. Strategies to prevent, slow down, or increase recovery of muscle have already been tested. Besides exercise, nutrition, and more particularly protein nutrition based on increased amino acid, leucine or the quality of protein intake has generated positive acute postprandial effect on muscle protein anabolism. However, on the long term, these nutritional strategies have often failed in improving muscle mass even if given for long periods of time in both humans and rodent models. Muscle mass loss situations have been often correlated to a resistance of muscle protein anabolism to food intake which may be explained by an increase of the anabolic threshold toward the stimulatory effect of amino acids. In this paper, we will emphasize how this anabolic resistance may affect the intensity and the duration of the muscle anabolic response at the postprandial state and how it may explain the negative results obtained on the long term in the prevention of muscle mass. Sarcopenia, the muscle mass loss observed during aging, has been chosen to illustrate this concept but it may be kept in mind that it could be extended to any other catabolic states or recovery situations.

Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men.

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Verschueren, S; Gielen, E; O'Neill, T W; Pye, S R; Adams, J E; Ward, K A; Wu, F C; Szulc, P; Laurent, M; Claessens, F; Vanderschueren, D; Boonen, S

2013-01-01

The aim of this study was to determine the relationship between reduced muscle mass (sarcopenia) and areal bone mineral density (BMD(a)) in middle-aged and elderly community-dwelling European men. Men with sarcopenia had significantly lower BMD(a) and were more likely to have osteoporosis compared with men without sarcopenia. In men, the relationship between reduced muscle mass (sarcopenia) and BMD(a) is unclear. This study aimed to determine this relationship in middle-aged and elderly community-dwelling men. Men aged 40-79 years from the Manchester (UK) and Leuven (Belgium) cohorts of the European Male Ageing Study were invited to attend for assessment including dual-energy X-ray absorptiometry, from which appendicular lean mass (aLM), fat mass (FM) and whole-body, spine and hip BMD(a) were determined. Relative appendicular skeletal muscle mass (RASM) was calculated as aLM/height². Muscle strength was assessed in subjects from Leuven. Sarcopenia was defined by RASM at Sarcopenia in Older People (RASM at sarcopenia and osteoporosis. Six hundred seventy-nine men with a mean age of 59.6 (SD = 10.7), contributed data to the analysis; 11.9 % were sarcopenic by the conventional definition. After adjustment for age and centre, aLM, RASM and FM were positively associated with BMD(a). Men with RASM at sarcopenia were more likely to have osteoporosis compared with those with normal RASM (odds ratio = 3.0; 95 % CI = 1.6-5.8). Sarcopenia is associated with low BMD(a) and osteoporosis in middle-aged and elderly men. Further studies are necessary to assess whether maintaining muscle mass contributes to prevent osteoporosis.

Sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP) versus dynapenia as a risk factor for mortality in the elderly.

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Alexandre, T da Silva; Duarte, Y A de Oliveira; Santos, J L Ferreira; Wong, R; Lebrão, M L

2014-01-01

Sarcopenia and dynapenia have been associated with poorer physical performance, disability and death. The aim of this study was to compare the association between sarcopenia and dynapenia with mortality. We studied 1,149 Brazilians aged 60 years or older residing in São Paulo. Sarcopenia was defined according to the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which includes three components: low muscle mass (LMM) assessed by skeletal muscle mass index ≤ 8.90kg/m2 (men) and ≤ 6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength sarcopenia required presence of LMM plus LMS or LPP. Dynapenia was defined as handgrip strength sarcopenia were 65.9/1,000 person/years and 20.1/1,000 person/years and for dynapenia were 44.3/1,000 person/years and 14.9/1,000 person/years. The adjusted model showed that sarcopenia (HR=1.52, 95%CI: 1.06 - 2.19) and dynapenia (HR=2.04, 95%CI: 1.24 - 3.37) are independent risk factors for death. The EWGSOP definition of sarcopenia and dynapenia can help to determine risk for mortality and can be used as a screening instrument in public health.

The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

NARCIS (Netherlands)

Reijnierse, E.M.; Trappenburg, M.C.; Leter, M.J.; Blauw, G. J.; van Bokhorst-de van der Schueren, M.A.E.; Meskers, C.G.M.; Maier, A.B.

2015-01-01

Objectives: Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the

Sarcopenia and Age-Related Endocrine Function

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Kunihiro Sakuma

2012-01-01

Full Text Available Sarcopenia, the age-related loss of skeletal muscle, is characterized by a deterioration of muscle quantity and quality leading to a gradual slowing of movement, a decline in strength and power, and an increased risk of fall-related injuries. Since sarcopenia is largely attributed to various molecular mediators affecting fiber size, mitochondrial homeostasis, and apoptosis, numerous targets exist for drug discovery. In this paper, we summarize the current understanding of the endocrine contribution to sarcopenia and provide an update on hormonal intervention to try to improve endocrine defects. Myostatin inhibition seems to be the most interesting strategy for attenuating sarcopenia other than resistance training with amino acid supplementation. Testosterone supplementation in large amounts and at low frequency improves muscle defects with aging but has several side effects. Although IGF-I is a potent regulator of muscle mass, its therapeutic use has not had a positive effect probably due to local IGF-I resistance. Treatment with ghrelin may ameliorate the muscle atrophy elicited by age-dependent decreases in growth hormone. Ghrelin is an interesting candidate because it is orally active, avoiding the need for injections. A more comprehensive knowledge of vitamin-D-related mechanisms is needed to utilize this nutrient to prevent sarcopenia.

Impact of sarcopenia in the management of urological cancer patients.

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Fukushima, Hiroshi; Koga, Fumitaka

2017-05-01

Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, develops as a consequence of the progression of cancer cachexia. Recent studies suggest that sarcopenia may be used as a biomarker in the management of patients with several cancers. Areas covered: In this article, the authors review 1) the methods to simply and optimally evaluate and define sarcopenia using computed tomography images in daily clinical practice and 2) the impact of sarcopenia in the management of urological cancers, specifically focusing on the usefulness in predicting treatment-related complications and prognosis. The authors also discuss the prognostic importance of changes in skeletal muscle mass in the course of treatment and the potential roles of nutritional support and exercise to prevent progression of sarcopenia. Expert commentary: Sarcopenia is associated with treatment-related complications and unfavorable prognosis in urological cancer patients. Nutritional support and exercise might be helpful in improving sarcopenia. The impact of these interventions on clinical outcomes would be elucidated by ongoing or future clinical studies.

Increased Mortality in Elderly Patients with Sarcopenia and Acetabular Fractures.

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Deren, Matthew E; Babu, Jacob; Cohen, Eric M; Machan, Jason; Born, Christopher T; Hayda, Roman

2017-02-01

Sarcopenia is a condition of clinically relevant loss of muscle mass and function. Acetabular fractures in elderly patients are common and difficult to treat. This study aimed to determine if sarcopenia is common in elderly patients with acetabular fractures and correlates with lower-energy mechanisms of injury, higher rates of complications, and higher mortality than patients with normal muscle mass. The Rhode Island Hospital Trauma Database was queried for patients who were ≥60 years of age from 2005 to 2014 using the International Classification of Diseases, Ninth Revision, code for closed acetabular fracture, 808.0. Charts were retrospectively reviewed for demographic data, operative intervention, mechanism of injury, mortality, comorbidities, and other factors. Computed tomography (CT) was used to determine the muscle cross-sectional area and to calculate the skeletal muscle index. The database revealed 192 patients coded for acetabular fracture; of these, 181 were correctly diagnosed. Ninety-nine patients had recorded body mass index (BMI) and adequate CT scans to measure the skeletal muscle index. Forty-two patients (42.4%) had sarcopenia, and 57 patients (57.6%) did not have sarcopenia. There were no significant differences in demographic characteristics between the groups with the exception of BMI and sex. BMI was higher in patients who did not have sarcopenia (31.7 kg/m) than it was in patients with sarcopenia (23.6 kg/m) (p sarcopenia at 76.2% (32 of 42 patients) than in patients without sarcopenia at 50.9% (29 of 57 patients). Fractures in patients without sarcopenia were associated with a higher-energy mechanism of injury in 78.9% of cases compared with 52.4% of cases of patients with sarcopenia (p = 0.005). Sarcopenia was significantly associated (p = 0.0419) with increased 1-year mortality (28.6%) compared with the absence of sarcopenia (12.3%). This association was even stronger if in-hospital mortality was excluded (p = 0.00074). Finally

Screening for sarcopenia in obesity

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Sammarco, R.; Marra, M.; Montagnese, C.; De Rosa, E.; Onufrio, M.; Amato, V.; Santarpia, L.; De Caprio, C.; Contaldo, F.; Pasanisi, F.

2013-04-01

Sarcopenia is a progressive and generalized loss of skeletal muscle mass (SM) and function which can also be found in obese adults. The aim of the study was to evaluate the prevalence of sarcopenia in 1 245 obese women (18 - 67 years, weight 114.7±24.5 kg; BMI 44.1±9.2 fat mass 49.0±6.2%) from Southern Italy. Body composition was evaluated by bioimpedance analysis (BIA) and SM calculated by using Janssen's equation; therefore the sex-specific cut-off points of percentage skeletal muscle index were used. The whole population was divided in two age groups: A (18-40 years; n. 808; weight 115.4±23.5 kg; BMI 43.8±8.8 kg/m2) and B (41-67 years; n. 438; weight 113.4±26.3 kg; BMI 44.8±9.9 kg/m2). In all the sample there was 2.7% moderate and 0.6% severe sarcopenia; in group A, 1.9% moderate and 0.6% severe sarcopenia whilst in group B 4.3% moderate and 0.7% severe sarcopenia. The results of our study suggest that, based on a screening examination by BIA, moderate/severe sarcopenia can be detected in an unselected middle-aged obese population. Further studies are required to clarify the diagnosis with functional tests.

Screening for sarcopenia in obesity

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Sammarco, R; Marra, M; Montagnese, C; Rosa, E De; Onufrio, M; Amato, V; Santarpia, L; Caprio, C De; Contaldo, F; Pasanisi, F

2013-01-01

Sarcopenia is a progressive and generalized loss of skeletal muscle mass (SM) and function which can also be found in obese adults. The aim of the study was to evaluate the prevalence of sarcopenia in 1 245 obese women (18 – 67 years, weight 114.7±24.5 kg; BMI 44.1±9.2; fat mass 49.0±6.2%) from Southern Italy. Body composition was evaluated by bioimpedance analysis (BIA) and SM calculated by using Janssen's equation; therefore the sex-specific cut-off points of percentage skeletal muscle index were used. The whole population was divided in two age groups: A (18-40 years; n. 808; weight 115.4±23.5 kg; BMI 43.8±8.8 kg/m 2 ) and B (41-67 years; n. 438; weight 113.4±26.3 kg; BMI 44.8±9.9 kg/m 2 ). In all the sample there was 2.7% moderate and 0.6% severe sarcopenia; in group A, 1.9% moderate and 0.6% severe sarcopenia whilst in group B 4.3% moderate and 0.7% severe sarcopenia. The results of our study suggest that, based on a screening examination by BIA, moderate/severe sarcopenia can be detected in an unselected middle-aged obese population. Further studies are required to clarify the diagnosis with functional tests.

Novel Intriguing Strategies Attenuating to Sarcopenia

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Kunihiro Sakuma

2012-01-01

Full Text Available Sarcopenia, the age-related loss of skeletal muscle mass, is characterized by a deterioration of muscle quantity and quality leading to a gradual slowing of movement, a decline in strength and power, increased risk of fall-related injury, and, often, frailty. Since sarcopenia is largely attributed to various molecular mediators affecting fiber size, mitochondrial homeostasis, and apoptosis, the mechanisms responsible for these deleterious changes present numerous therapeutic targets for drug discovery. Resistance training combined with amino acid-containing supplements is often utilized to prevent age-related muscle wasting and weakness. In this review, we summarize more recent therapeutic strategies (myostatin or proteasome inhibition, supplementation with eicosapentaenoic acid (EPA or ursolic acid, etc. for counteracting sarcopenia. Myostatin inhibitor is the most advanced research with a Phase I/II trial in muscular dystrophy but does not try the possibility for attenuating sarcopenia. EPA and ursolic acid seem to be effective as therapeutic agents, because they attenuate the degenerative symptoms of muscular dystrophy and cachexic muscle. The activation of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α in skeletal muscle by exercise and/or unknown supplementation would be an intriguing approach to attenuating sarcopenia. In contrast, muscle loss with age may not be influenced positively by treatment with a proteasome inhibitor or antioxidant.

Sarcopenia and frailty in chronic respiratory disease

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Bone, Anna E; Hepgul, Nilay; Kon, Samantha

2017-01-01

Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field. We contrast assessments of sarcopenia, which consider muscle mass and function, with assessments of frailty, which often additionally consider social, cognitive and psychological domains. Frailty is emerging as an important syndrome in respiratory disease, being strongly associated with poor outcome. We also unpick the relationship between sarcopenia, frailty and skeletal muscle dysfunction in chronic respiratory disease and reveal these as interlinked but distinct clinical phenotypes. Suggested areas for future work include the application of sarcopenia and frailty models to restrictive diseases and population-based samples, prospective prognostic assessments of sarcopenia and frailty in relation to common multidimensional indices, plus the investigation of exercise, nutritional and pharmacological strategies to prevent or treat sarcopenia and frailty in chronic respiratory disease. PMID:27923981

[Sarcopenia in elderly : benefice of physical exercices].

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Laszlo, André

2016-11-09

From the age of fifty onwards a progressive loss of muscle mass may be observed, it often leads to real sarcopenia. Sedentary life style and unbalanced feeding habits represent major risk factors. The decrease in muscle tone leads to a loss of function and an altered quality of life, not to mention socioeconomic factors. The molecular mechanisms of sarcopenia are complex but our understanding of them is increasing. There is no pharmaceutical treatment of sarcopenia of use in current practice. Regular, several times a week, practice of a combination of adapted muscle building physical and endurance exercises, associated with protein intake have shown there use. These exercises must be followed on the long term.

Association of Sarcopenia With Nutritional Parameters, Quality of Life, Hospitalization, and Mortality Rates of Elderly Patients on Hemodialysis.

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Giglio, Juliana; Kamimura, Maria Ayako; Lamarca, Fernando; Rodrigues, Juliana; Santin, Fernanda; Avesani, Carla Maria

2018-05-01

This study aimed to assess whether diminished muscle mass, diminished muscle strength, or both conditions (sarcopenia) are associated with worse nutritional status, poor quality of life (QoL), and hard outcomes, such as hospitalization and mortality, in elderly patients on maintenance hemodialysis (MHD). This is a multicenter observational longitudinal study that included 170 patients on MHD (age 70 ± 7 years, 65% male) from 6 dialysis centers. The European Working Group on Sarcopenia in Older People defines sarcopenia as the presence of both low muscle mass by appendicular skeletal + low muscle function by handgrip strength. This study evaluated the clinical and nutritional status (laboratory, anthropometry, dual-energy X-ray absorptiometry, 7-point subjective global assessment) and QoL (Kidney Disease Quality of Life) at baseline. Hospitalization and mortality were recorded during 36 months. Reduced muscle mass was observed in 64% of the patients, reduced muscle strength in 52%, and sarcopenia in 37%. The group with sarcopenia was older, had a higher proportion of men and showed worse clinical and nutritional conditions when compared with patients without sarcopenia. Although reduced muscle mass was strongly associated with poor nutritional status, low muscle strength was associated with worse QoL domains. In the multivariate Cox analyses adjusted by age, gender, dialysis vintage, and diabetes mellitus, low muscle strength alone and sarcopenia were associated with higher hospitalization, and sarcopenia was a predictor of mortality. In conclusion, in this sample, comprised of elderly patients on MHD, sarcopenia was associated with worse nutritional and clinical conditions and was a predictor of hospitalization and mortality. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Depression Is Associated With Muscle Mass And Strength In Patients With End Stage Renal Disease

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Young Rim Song

2012-06-01

Full Text Available Depression is the most common psychiatric complication in patients with end-stage renal disease (ESRD. Sarcopenia, defined as loss of muscle mass and strength, is expected to be associated with depression, because both are closely linked to physical inactivity and functional impairment. We investigated the association of sarcopenia with depression in patients with ESRD. A total of 115 patients undergoing hemodialysis (HD were included in this study. Muscle mass was assessed by lean tissue index (LTI using portable whole body bioimpedance spectroscopy, and muscle strength was measured with handgrip strength (HGS. Depression was defined as Beck Depression Inventory-II (BDI-II score ≥16. About 60% of prevalent HD patients had depression. Compared to subjects without depression, depressed patients had a higher prevalence of sarcopenia (45.5 vs. 8.2%, p<0.001 and significantly increased serum IL-6 and hs-CRP level. However, (prealbumin and body mass index (BMI failed to correlate with BDI-II. HGS and LTI had a consistent negative effect on BDI-II even after adjusting other parameters including inflammation. In multivariate analysis, lower , increased IL-6 and β2-microglobulin,and sarcopenia were significant predictors for depression; sarcopenia was most powerful [odds ratio 9.01, 95% CI 3.60-12.22, p=0.001]. In conclusion, the prevalence of sarcopenia and depression was considerably high and and the presence of sarcopenia was an important predictor for depression.

Prevalence of Sarcopenia in Community-Dwelling Chilean Elders According to an Adapted Version of the European Working Group on Sarcopenia in Older People (EWGSOP) Criteria.

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Lera, L; Albala, C; Sánchez, H; Angel, B; Hormazabal, M J; Márquez, C; Arroyo, P

2017-01-01

Sarcopenia is the progressive loss of mass and skeletal muscle strength and has serious consequences on older people's health. The Chilean older population has a high life-expectancy, but the prevalence of functional dependence is also high. To determine the prevalence of sarcopenia in Chilean older adults and its relationship with age, gender, and body mass index (BMI). Cross-sectional study. Community. 1,006 non-disabled, community-dwelling subjects aged 60 years or older living in Santiago. Anthropometric measurements, handgrip strength, physical performance tests, and dual-energy-x-ray-absorptiometry (DXA) scan were performed. Sarcopenia was defined using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP). Muscle mass was measured with DXA scan; skeletal muscle mass index (SMI) and hand dynamometry were defined with cut-off points obtained for the Chilean population. For a 3m walking speed we used the cut-off point of the EWGSOP definition. Nutritional status and obesity were defined according to World Health Organization standards. Association between sarcopenia and age, gender, BMI and lean/fat mass ratio was estimated by logistic regression models. The prevalence of sarcopenia was 19.1% (95%CI: 16.8%-21.8%), similar in men and women. There was an increasing trend of sarcopenia by age group and a decreasing trend with nutritional status. After logistic regression, sarcopenia was positively associated with age (OR=1.10; 95%CI:1.06-1.15) and falls (OR=1.83; 95%CI:1.07-3.15) and negatively associated with overweight (OR=0.31; 95%CI:0.16-0.59), obesity (OR=0.02; 95%CI:0.004-0.11), lean mass/fat mass ratio (OR=0.69; 95%CI:0.48-0.9997), knee height (OR=0.78; 95%CI:0.68-0.89) and calf circumference (OR=0.87; 95%CI:0.77-0.97). The total prevalence of sarcopenia was 19.1% increasing with age reaching 39.6% in people of 80 or more years of age. A negative association of sarcopenia with overweight, obesity and lean/fat mass ratio was

Aging of the endocrine system and its potential impact on sarcopenia.

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Vitale, Giovanni; Cesari, Matteo; Mari, Daniela

2016-11-01

Sarcopenia, occurring as a primary consequence of aging, is a progressive generalized decline of skeletal muscle mass, strength and function. The pathophysiology of sarcopenia is complex and multifactorial. One major cause of muscle mass and strength loss with aging appears to be the alteration in hormonal networks involved in the inflammatory processes, muscle regeneration and protein synthesis. This review describes the recent findings concerning the role of the aging on the endocrine system in the development of sarcopenia. We also report the benefits and safety of hormone replacement therapy in elderly subjects and discuss future perspectives in the therapy and prevention of skeletal muscle aging. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Psoas muscle cross-sectional area as a measure of whole body lean muscle mass in maintenance hemodialysis patients

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Morrell, Glen R.; Ikizler, Talat A.; Chen, Xiaorui; Heilbrun, Marta E.; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

2016-01-01

Objective We investigate whether psoas or paraspinous muscle area measured on a single L4–5 image is a useful measure of whole lean body mass compared to dedicated mid-thigh magnetic resonance imaging (MRI). Design Observational study. Setting Outpatient dialysis units and a research clinic. Subjects 105 adult participants on maintenance hemodialysis. No control group was used. Exposure variables Psoas muscle area, paraspinous muscle area, and mid-thigh muscle area (MTMA) were measured by MRI. Main outcome measure Lean body mass was measured by dual-energy absorptiometry (DEXA) scan. Results In separate multivariable linear regression models, psoas, paraspinous, and mid-thigh muscle area were associated with increase in lean body mass. In separate multivariate logistic regression models, c-statistics for diagnosis of sarcopenia (defined as lean body mass) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for mid-thigh muscle area. With sarcopenia defined as lean body mass, the corresponding c-statistics were 0.71, 0.92, and 0.94. Conclusions We conclude that psoas muscle area provides a good measure of whole body muscle mass, better than paraspinous muscle area but slightly inferior to mid thigh measurement. Hence, in body composition studies a single axial MR image at the L4–L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. PMID:26994780

Prevalence and associated factors of sarcopenia in elderly subjects with amnestic mild cognitive impairment or Alzheimer disease.

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Sugimoto, Taiki; Ono, Rei; Murata, Shunsuke; Saji, Naoki; Matsui, Yasumoto; Niida, Shumpei; Toba, Kenji; Sakurai, Takashi

2016-01-01

To date, very little is known about the nature of sarcopenia in subjects with cognitive impairment. The aims of this study were firstly to clarify the prevalence of sarcopenia at various stages of cognitive impairment, and secondly to examine factors related to sarcopenia in men and women with cognitive impairment. The subjects were 418 outpatients (normal cognition; NC: 35, amnestic mild cognitive impairment; aMCI: 40, Alzheimer disease; AD: 343) who attended the Memory Clinic at the National Center for Geriatrics and Gerontology of Japan during the period from October 2010 to July 2014. Cognitive status, vitality, depressive mood, body mass index, hand grip strength, timed up and go test, skeletal muscle mass and serum levels of 25-hydroxyvitamin D, albumin and creatinine were assessed. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. We performed the univariate and multivariate logistic regression analyses to explore factors associated with sarcopenia. The overall prevalence of sarcopenia was 21.1% (NC = 8.6%, aMCI = 12.5%, AD = 23.3%). In both sexes, factors associated with sarcopenia were age (P sarcopenia (P sarcopenia. Prevention of sarcopenia in patients with cognitive impairment should be approached from physical and psychologic points of view.

Prevalence of sarcopenia in elderly maintenance hemodialysis patients: the impact of different diagnostic criteria.

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Lamarca, F; Carrero, J J; Rodrigues, J C D; Bigogno, F G; Fetter, R L; Avesani, C M

2014-07-01

The prevalence of sarcopenia on elderly maintenance hemodialysis (MHD) has been scarcely investigated. To investigate the prevalence of decreased muscle mass and strength alone or combined (true sarcopenia) in elderly patients on MHD according to different methods and cutoff limits. Additionally, we evaluated the agreement between dual energy x-ray absorptiometry (DXA) and surrogate methods for the assessment of muscle mass. Observational and cross-sectional study. Non-institutionalized 102 elderly (age > 60 years) patients on MHD. Sarcopenia was considered when the patient fit one criteria for low muscle mass assessed by DXA, bioelectrical impedance (BIA), sum of skinfold thicknesses (SKF), calf circumference and mid-arm muscle circumference (MAMC) and one for low muscle strength evaluated by handgrip dynamometer. Decreased muscle strength was found in 85% of the patients. The prevalence of decreased muscle mass varied from 4 to 73.5% and of sarcopenia (decreased muscle mass and strength combined) from 4 to 63%, depending on the method and cutoff limit applied. A small percentage of patients (2 to 15%) were classified as sarcopenic by more than one diagnostic criteria. The agreement between DXA and the surrogate methods to assess muscle mass showed better kappa coefficients with BIA (r=0.36; Psarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

Vitamin D Signaling in Myogenesis: Potential for Treatment of Sarcopenia

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Akira Wagatsuma

2014-01-01

Full Text Available Muscle mass and strength progressively decrease with age, which results in a condition known as sarcopenia. Sarcopenia would lead to physical disability, poor quality of life, and death. Therefore, much is expected of an effective intervention for sarcopenia. Epidemiologic, clinical, and laboratory evidence suggest an effect of vitamin D on muscle function. However, the precise molecular and cellular mechanisms remain to be elucidated. Recent studies suggest that vitamin D receptor (VDR might be expressed in muscle fibers and vitamin D signaling via VDR plays a role in the regulation of myoblast proliferation and differentiation. Understanding how vitamin D signaling contributes to myogenesis will provide a valuable insight into an effective nutritional strategy to moderate sarcopenia. Here we will summarize the current knowledge about the effect of vitamin D on skeletal muscle and myogenic cells and discuss the potential for treatment of sarcopenia.

Association between pre‐sarcopenia, sarcopenia, and bone mineral density in patients with chronic hepatitis C

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Bering, Tatiana; Diniz, Kiara G.D.; Coelho, Marta Paula P.; Vieira, Diego A.; Soares, Maria Marta S.; Kakehasi, Adriana M.; Correia, Maria Isabel T.D.; Teixeira, Rosângela; Queiroz, Dulciene M.M.; Rocha, Gifone A.

2018-01-01

Abstract Background Preserved skeletal muscle is essential for the maintenance of healthy bone. Loss of bone mineral density (BMD) and muscle strength, considered a predictor of BMD, have been demonstrated in patients with cirrhosis, but they are poorly studied in chronic hepatitis C (CHC) without cirrhosis. Thus, we aimed to evaluate the prevalence of low BMD and its association with body composition, muscle strength, and nutritional status in CHC. Methods One hundred and four subjects [mean age, 50.5 ± 11.3 years; 75.0% males; 67.3% non‐cirrhotic; and 32.7% with compensated cirrhosis] with CHC, prospectively, underwent scanning of the lean tissue, appendicular skeletal muscle mass (ASM), fat mass, lumbar spine, hip, femoral neck, and whole‐body BMD by dual‐energy X‐ray absorptiometry. Muscle strength was assessed by dynamometry. Sarcopenia was defined by the presence of both low, ASM/height2 (ASMI) and low muscle strength according to the European Working Group on Sarcopenia in Older People criteria. The cut‐off points for low ASMI and low muscle strength, for women and men, were  50 years, the T‐score of osteopenia is between −1.0 and −2.49 standard deviation (SD) below the young average value and of osteoporosis is ≥−2.5 SD below the young normal mean for men, and the Z‐score of low bone mass is ≤−2.0 SD below the expected range in men aged < 50 years and women in the menacme. Nutritional status evaluation was based on the Controlling Nutritional Status score. Results Low BMD, low muscle strength, pre‐sarcopenia, sarcopenia, and sarcopenic obesity were observed in 34.6% (36/104), 27.9% (29/104), 14.4% (15/104), 8.7% (9/104), and 3.8% (4/104) of the patients, respectively. ASMI was an independent predictor of BMD (P < 0.001). Sarcopenia was independently associated with bone mineral content (P = 0.02) and malnutrition (P = 0.01). In 88.9% of the sarcopenic patients and in all with sarcopenic obesity, BMI was normal

Role of the nervous system in sarcopenia and muscle atrophy with aging - strength training as a countermeasure

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Aagaard, Per; Suetta, Charlotte; Caserotti, Paolo

2010-01-01

and size (sarcopenia), resulting in impaired mechanical muscle performance that in turn leads to a reduced functional capacity during everyday tasks. Concurrently, maximum muscle strength, power, and rate of force development are decreased with aging, even in highly trained master athletes. The impairment...... to elicit effective countermeasures in elderly individuals even at a very old age (>80 years) by evoking muscle hypertrophy along with substantial changes in neuromuscular function, respectively. Notably, the training-induced changes in muscle mass and nervous system function leads to an improved functional...

Prevalence and associated factors of sarcopenia among elderly in Brazil: findings from the SABE study.

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Alexandre, T da Silva; Duarte, Y A de Oliveira; Santos, J L Ferreira; Wong, R; Lebrão, M L

2014-03-01

The aim of the present study was to examine the prevalence and factors associated with sarcopenia in older residents in São Paulo, Brazil. Cross-sectional study. São Paulo, Brazil. 1,149 older individuals from the second wave of the Saúde, Bem-Estar e Envelhecimento (SABE) study from 2006. The definition of sarcopenia was based on the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which include three components: low muscle mass, assessed by a skeletal muscle mass index of ≤8.90 kg/m2 for men and ≤6.37 kg/m2 for women; low muscle strength, assessed by handgrip strength sarcopenia required presence of low muscle mass plus low muscle strength or low physical performance. Socio-demographic and behavioral characteristics, medical conditions and nutritional status were considered as independent variables to determine the associated factors using a logistic regression model. The prevalence of sarcopenia was 16.1% in women and 14.4% in men. Advanced age with a dose response effect, cognitive impairment, lower income, smoking, undernutrition and risk for undernutrition (psarcopenia. The EWGSOP algorithm is useful to define sarcopenia. The prevalence of sarcopenia in the Brazilian elderly population is high and several associated factors show that this syndrome is affected by multiple domains. No differences were observed by gender in any age groups.

Protein and exercise in the prevention of sarcopenia and aging.

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Naseeb, Manal A; Volpe, Stella L

2017-04-01

Aging is associated with a progressive decline in skeletal muscle mass and strength. The decline, known as sarcopenia, could lead to physical disability, poor quality of life, and death. In addition, the older population usually experiences age-related muscle changes that affect muscle mass, muscular strength, and functional abilities. The purpose of this review is to describe the role of protein and exercise in slowing the progression of sarcopenia. It will also discuss whether age-related changes can be attenuated by dietary protein and exercise in the older population. This review will also cover one of the possible mechanisms of how dietary protein and exercise are involved in sarcopenia prevention, as well as the available measurement tools. Based on the findings of this review, the adequate amount of protein required for older men and women needs to be revised and likely be higher. Moreover, studies are required to explore some inconclusive findings concerning sarcopenia in the older population. Further research is required to investigate the following: (1) the safety and effectiveness concerning the consumption of 1.4 g of protein/kg of body weight (or more) in this vulnerable population; (2) the effectiveness of amino acid supplementation in reducing progression of sarcopenia over time through longitudinal studies; (3) the preferred source and timing of protein for the older population to maintain muscular strength and attenuate sarcopenia; (4) exercise interventions, especially those of longer duration, in the attenuation of sarcopenia; (5) other types of exercise and their effects on age-related muscle changes; (6) the mechanism of how protein and exercise prevent muscle loss with aging; and (7) determine the best method to diagnose sarcopenia. Copyright © 2017 Elsevier Inc. All rights reserved.

Association of insufficient physical activity with sarcopenia and sarcopenic obesity in individuals aged 50 years or more

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Vanessa Ribeiro dos SANTOS

Full Text Available ABSTRACT Objective: To analyze the association of insufficient physical activity in different domains with sarcopenia or sarcopenic obesity in patients aged ³50 years. Methods: The sample consisted of 770 males and females. Sarcopenia was diagnosed when the individual had: (1 low muscle mass and muscle strength; or (2 low walking speed and low muscle mass; sarcopenic obesity was diagnosed when individuals were at risk of obesity and sarcopenia. Muscle mass was given by a predictive equation, and then the muscle mass index (in kg/m² was given by muscle mass divided by height squared. Muscle strength, in kg, was given by measuring handgrip strength with a digital dynamometer. The 4m walk test evaluated walking sped. Low muscle mass, muscle strength, and walking speed were defined as the respective values below the 25th percentile, and risk of obesity was defined as body mass index ³25kg/m2. Results: Habitual physical activity was investigated by a questionnaire. Insufficient leisure-time physical activity was associated with sarcopenia (OR=2.55; 95%CI=1.10-5.88. In addition, insufficient leisure-time physical activity (OR=4.75; 95%CI=1.64-13.72, leisure-time and commuting physical activities (OR=2.49; 95%CI=1.02-6.11, and habitual physical activity (OR=3.55; 95%CI=1.0-11.79 were associated with sarcopenic obesity. Conclusion: Insufficient physical activity is associated with sarcopenia or sarcopenic obesity in the study individuals aged ³50years.

[Sarcopenia and functionality in elderly inpatient].

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Chávez-Moreno, Diana Victoria; Infante-Sierra, Héctor; Serralde-Zúñiga, Aurora E

2015-04-01

Sarcopenia is a geriatric syndrome associated with adverse events. The aim of the present study was to assess the sarcopenia prevalence and its association with the functionality in elderly inpatient. A cross sectional study, during 6 months were included elderly inpatients to determine the presence of sarcopenia using the Baumgartner method. The functionality to perform basic activities of daily living (ABVD) was determined by the Katz index. Student's t test or U de Mann-Whitney was used to assess the differences between two groups and one-factor ANOVA or Kruskal Wallis for multiple comparisons; X2 and Fisher's exact test were used to compare the categorical variables and the Pearson correlation was calculated to determine the correlations between variables. 102 patients were included, 41 women and 61 man; subjects had a mean age of 71±8.6 years, body mass index 27.8±5.2 kg/m2, grip strength 14.9±8.3 kg, appendicular skeletal muscle mass (MMEA) 17.6±4.3 kg and skeletal muscle mass index (IMME) 7.1±1.2 kg/m2. The global prevalence of sarcopenia was 27.5%, was major in men (RR 1.33; CI 95% 1.06-1.67 psarcopenia was associated to a major dependence in both genders (pSarcopenia is a frequent condition in the elderly inpatients associated with the functionality's deterioration,identifying it help to perform a primary or secondary prevention and opportunity treatment.

The Combination of Physical Exercise with Muscle-Directed Antioxidants to Counteract Sarcopenia: A Biomedical Rationale for Pleiotropic Treatment with Creatine and Coenzyme Q10

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Michele Guescini

2017-01-01

Full Text Available Sarcopenia represents an increasing public health risk due to the rapid aging of the world’s population. It is characterized by both low muscle mass and function and is associated with mobility disorders, increased risk of falls and fractures, loss of independence, disabilities, and increased risk of death. Despite the urgency of the problem, the development of treatments for sarcopenia has lagged. Increased reactive oxygen species (ROS production and decreased antioxidant (AO defences seem to be important factors contributing to muscle impairment. Studies have been conducted to verify whether physical exercise and/or AOs could prevent and/or delay sarcopenia through a normalization of the etiologically relevant ROS imbalance. Despite the strong rationale, the results obtained were contradictory, particularly with regard to the effects of the tested AOs. A possible explanation might be that not all the agents included in the general heading of “AOs” could fulfill the requisites to counteract the complex series of events causing/accelerating sarcopenia: the combination of the muscle-directed antioxidants creatine and coenzyme Q10 with physical exercise as a biomedical rationale for pleiotropic prevention and/or treatment of sarcopenia is discussed.

Anti-myostatin antibody increases muscle mass and strength and improves insulin sensitivity in old mice.

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Camporez, João-Paulo G; Petersen, Max C; Abudukadier, Abulizi; Moreira, Gabriela V; Jurczak, Michael J; Friedman, Glenn; Haqq, Christopher M; Petersen, Kitt Falk; Shulman, Gerald I

2016-02-23

Sarcopenia, or skeletal muscle atrophy, is a debilitating comorbidity of many physiological and pathophysiological processes, including normal aging. There are no approved therapies for sarcopenia, but the antihypertrophic myokine myostatin is a potential therapeutic target. Here, we show that treatment of young and old mice with an anti-myostatin antibody (ATA 842) for 4 wk increased muscle mass and muscle strength in both groups. Furthermore, ATA 842 treatment also increased insulin-stimulated whole body glucose metabolism in old mice, which could be attributed to increased insulin-stimulated skeletal muscle glucose uptake as measured by a hyperinsulinemic-euglycemic clamp. Taken together, these studies provide support for pharmacological inhibition of myostatin as a potential therapeutic approach for age-related sarcopenia and metabolic disease.

Physical activity and incidence of sarcopenia: the population-based AGES—Reykjavik Study

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Mijnarends, Donja M.; Koster, Annemarie; Schols, Jos M. G. A.; Meijers, Judith M. M.; Halfens, Ruud J. G.; Gudnason, Vilmundur; Eiriksdottir, Gudny; Siggeirsdottir, Kristin; Sigurdsson, Sigurdur; Jónsson, Pálmi V.; Meirelles, Osorio; Harris, Tamara

2016-01-01

Background: the prevalence of sarcopenia increases with age. Physical activity might slow the rate of muscle loss and therewith the incidence of sarcopenia. Objective: to examine the association of physical activity with incident sarcopenia over a 5-year period. Design: data from the population-based Age, Gene/Environment, Susceptibility–Reykjavik Study were used. Setting: people residing in the Reykjavik area at the start of the study. Subjects: the study included people aged 66–93 years (n = 2309). Methods: the amount of moderate–vigorous physical activity (MVPA) was assessed by a self-reported questionnaire. Sarcopenia was identified using the European Working Group on Sarcopenia in Older People algorithm, including muscle mass (computed tomography imaging), grip strength (computerised dynamometer) and gait speed (6 m). Results: mean age of the participants was 74.9 ± 4.7 years. The prevalence of sarcopenia was 7.3% at baseline and 16.8% at follow-up. The incidence proportion of sarcopenia over 5 years was 14.8% in the least-active individuals and 9.0% in the most-active individuals. Compared with the least-active participants, those reporting a moderate–high amount of MVPA had a significantly lower likelihood of incident sarcopenia (OR = 0.64, 95% CI 0.45–0.91). Participants with a high amount of MVPA had higher baseline levels of muscle mass, strength and walking speed, but baseline MVPA was not associated with the rate of muscle loss. Conclusion: a higher amount of MVPA seems to contribute to counteracting the development of sarcopenia. To delay the onset of sarcopenia and its potential adverse outcomes, attention should be paid to increasing physical activity levels in older adults. PMID:27189729

Bio-impedance analysis for appendicular skeletal muscle mass assessment in (pre-) frail elderly people

NARCIS (Netherlands)

Baar, van H.; Hulshof, P.J.M.; Tieland, C.A.B.; Groot, de C.P.G.M.

2015-01-01

Background & aims Screening populations for skeletal muscle mass (SMM) is important for early detection of sarcopenia. Our aim was to develop an age specific bio-impedance (BI) prediction equation for the assessment of appendicular skeletal muscle mass (ASMM) in (pre-) frail elderly people aged

Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly.

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Pagotto, Valéria; Silveira, Erika Aparecida

2014-01-01

The purpose of this study cross-sectional study comprising 132 community dwelling elderly (≥ 60 years) was to identify sarcopenia prevalence in the Brazilian elderly, utilizing different diagnostic criteria and analyze agreement between criteria. Sarcopenia was assessed by nine muscle mass diagnostic criteria, by two muscle strength criteria and also by the combination of criteria. Prevalence was analyzed for each method, along with differences by gender and age group through calculation of the prevalence ratio (PR) and confidence interval (CI) 95%. The Kappa coefficient was used to analyze the level of agreement between all criteria. Sarcopenia prevalence varied between 60.6% and 8.3% with the application of muscle mass criteria, and between 54.2% and 48.8% with the application of strength criteria. The combination muscle mass+strength resulted in a decrease of prevalence in all criteria, varying between 36.6% and 6.1%. There was an increase in prevalence according to age groups for all methods. Prevalence was higher for men according to three muscle mass criteria, and higher in women for strength criteria and by two combined mass+strength criteria. The best level of agreement was obtained for two methods that utilized dual energy X-ray absorptiometry (DXA). The prevalence of sarcopenia differs by gender and age and definition criteria. The low agreement levels obtained between methods and the different prevalence values encountered indicate the necessities of an operational definition for the estimation of sarcopenia in different population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences

Science.gov (United States)

2012-01-01

Sarcopenia, the age associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy on November 18, 2009 to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multi-factorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. While cachexia may be a component of sarcopenia, the two conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1.0 m·s−1. Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry (DXA) with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s−1 and an objectively measured low muscle mass (eg: appendicular mass relative to ht2 that is ≤ 7.23 kg/ m2 in men ≤ 5.67 kg/ m2 in men). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization and death. PMID:21527165

Presbyphagia and Sarcopenic Dysphagia: Association between Aging, Sarcopenia, and Deglutition Disorders.

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Wakabayashi, H

2014-01-01

Presbyphagia refers to age-related changes in the swallowing mechanism in the elderly associated with a frailty in swallowing. Presbyphagia is different from dysphagia. Sarcopenic dysphagia is difficulty swallowing due to sarcopenia of generalized skeletal muscles and swallowing muscles. Age-related loss of swallowing muscle mass becomes evident in the geniohyoid muscle and tongue. Elderly subjects with both sarcopenia and dysphagia may have not only disease-related dysphagia but also sarcopenic dysphagia. In cases of aspiration pneumonia, deterioration in activity-, disease-, and nutrition-related sarcopenia of generalized skeletal muscles and swallowing muscles may develop into sarcopenic dysphagia. Assessment of sarcopenic dysphagia includes evaluation of both dysphagia and sarcopenia. The 10-item Eating Assessment Tool (EAT-10) and a water test combined with pulse oximetry are useful for dysphagia screening. Assessment of the multi-factorial causes of sarcopenia including nutritional review is important, because rehabilitation of sarcopenic dysphagia differs depending on its etiology. Consensus diagnostic criteria for sarcopenic dysphagia were proposed at the 19th Annual Meeting of the Japanese Society of Dysphagia Rehabilitation. Rehabilitation for sarcopenic dysphagia includes treatment of both dysphagia and sarcopenia. The core components of dysphagia rehabilitation are oral health care, rehabilitative techniques, and food modification. The causes of adult malnutrition may also contribute to the etiology of secondary sarcopenia and sarcopenic dysphagia. Therefore, nutrition management is indispensable for sarcopenic dysphagia rehabilitation. In cases of sarcopenia with numerous complicating causes, treatment should include pharmaceutical therapies for age-related sarcopenia and comorbid chronic diseases, resistance training, early ambulation, nutrition management, protein and amino acid supplementation, and non-smoking.

Loss of mass and performance in skeletal muscle tissue: a continuum model

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Giantesio Giulia

2018-02-01

Full Text Available We present a continuum hyperelastic model which describes the mechanical response of a skeletal muscle tissue when its strength and mass are reduced by aging. Such a reduction is typical of a geriatric syndrome called sarcopenia. The passive behavior of the material is described by a hyperelastic, polyconvex, transversely isotropic strain energy function, and the activation of the muscle is modeled by the so called active strain approach. The loss of ability of activating of an elder muscle is then obtained by lowering of some percentage the active part of the stress, while the loss of mass is modeled through a multiplicative decomposition of the deformation gradient. The obtained stress-strain relations are graphically represented and discussed in order to study some of the effects of sarcopenia.

CORRELATIONS BETWEEN MUSCLE MASS, MUSCLE STRENGTH, PHYSICAL PERFORMANCE, AND MUSCLE FATIGUE RESISTANCE IN COMMUNITY-DWELLING ELDERLY SUBJECTS

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Elizabeth

2016-03-01

Full Text Available Objective: To determine the correlations between muscle mass, muscle strength, physical performance, and muscle fatigue resistance in community-dwelling elderly people in order to elucidate factors which contribute to elderly’s performance of daily activities. Methods: A cross-sectional study was conducted on community-dwelling elderly in Bandung from September to December 2014. One hundred and thirty elderly, 60 years old or above, were evaluated using bioelectrical impedance analysis to measure muscle mass; grip strength to measure muscle strength and muscle fatigue resistance; habitual gait speed to measure physical performance; and Global Physical Activity Questionnaire (GPAQ to assess physical activity. Results: There were significant positive correlations between muscle mass (r=0,27, p=0,0019, muscle strength (r=0,26, p=0,0024, and physical performance (r=0,32, p=0,0002 with muscle fatigue resistance. Physical performance has the highest correlation based on multiple regression test (p=0,0025. In association with muscle mass, the physical activity showed a significant positive correlation (r=0,42, p=0,0000. Sarcopenia was identified in 19 (14.61% of 130 subjects. Conclusions: It is suggested that muscle mass, muscle strength, and physical performance influence muscle fatigue resistance.

Exercise and Sarcopenia.

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Phu, Steven; Boersma, Derek; Duque, Gustavo

2015-01-01

Sarcopenia is a major component of the frailty syndrome and is also a strong predictor of disability, morbidity, and mortality in older persons. Without any available pharmacological intervention to sarcopenia, non-pharmacological interventions are the only option to prevent these poor outcomes in sarcopenic patients. Among those interventions, physical activity with or without protein supplementation has demonstrated to be effective in improving muscle mass and function and in preventing disability and frailty in older persons. Additionally, to the beneficial effect of physical activity on metabolic and cardiovascular diseases, a regular exercise program (3 times/wk) that includes resistance and endurance exercise training would have a major positive effect on sarcopenic muscle through improving muscle mass, strength, and function. In this review, we looked at the effect of exercise on sarcopenic frail older persons from the biological aspects of the response of the muscle to exercise to some practical aspects of exercise prescription in this high-risk population. We conclude that, although challenging, older persons should be encouraged to participate in this type of programs, which would improve not only their function and independence but also their quality of life. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients.

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Yoshimura, Yoshihiro; Wakabayashi, Hidetaka; Bise, Takahiro; Tanoue, Maiko

2017-09-23

The purpose of this study was to investigate the prevalence of sarcopenia following stroke, musculoskeletal disease, or hospital-associated deconditioning in convalescent rehabilitation ward inpatients. The association between the activities of daily living (ADLs), dysphagia, and sarcopenia was also assessed. A cross-sectional study was performed in consecutive patients admitted to convalescent rehabilitation wards. Sarcopenia was defined as a loss of skeletal muscle mass and decreased muscle strength. The primary outcome was the Functional Independence Measure (FIM) score. Body mass index, Mini Nutritional Assessment-Short Form score, Food Intake Level Scale (FILS) score, Charlson Comorbidity Index, premorbid modified Rankin scale, time from onset, reason for admission, bioelectrical impedance analysis for skeletal muscle mass and fat mass, and handgrip strength were also assessed. Univariate and multivariate analyses were used to determine whether ADLs and dysphagia were associated with sarcopenia. The study included 637 patients (mean age: 74 years; 271 men and 366 women). Sarcopenia was diagnosed in 343 (53.0%) patients (141 men and 202 women). Sarcopenia was identified in 53.6% (125/233) of stroke patients (59.8%, 50.0%, and 34.6% of patients with brain infarctions, brain hemorrhages, and subarachnoid hemorrhages, respectively). Sarcopenia was found in 51.3% (154/300) of patients with musculoskeletal diseases (59.5%, 53.6%, and 36.5% of patients with hip fractures, vertebral compression fractures, and total knee arthroplasty, respectively). Of patients with hospital-associated deconditioning, 61.5% (64/104) had sarcopenia (95.1% and 39.7% of patients with pneumonia and other acute diseases, respectively). Multivariate analysis showed that FIM motor domain and FILS scores were independently associated with skeletal muscle mass loss and decreased muscle strength. The prevalence of sarcopenia in convalescent rehabilitation ward inpatients was 53.0%. ADLs and

One size may not fit all: anti-aging therapies and sarcopenia

OpenAIRE

Burks, Tyesha N.; Cohn, Ronald D.

2011-01-01

Sarcopenia refers to age-related loss of muscle mass and function. Several age-related changes occur in skeletal muscle including a decrease in myofiber size and number and a diminished ability of satellite cells to activate and proliferate upon injury leading to impaired muscle remodeling. Although the molecular mechanisms underlying sarcopenia are unknown, it is tempting to hypothesize that interplay between biological and environmental factors cooperate in a positive feedback cycle contrib...

Potential early biomarkers of sarcopenia among independent older adults.

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Coto Montes, Ana; Boga, José Antonio; Bermejo Millo, Carlos; Rubio González, Adrián; Potes Ochoa, Yaiza; Vega Naredo, Ignacio; Martínez Reig, Marta; Romero Rizos, Luis; Sánchez Jurado, Pedro Manuel; Solano, Juan Jose; Abizanda, Pedro; Caballero, Beatriz

2017-10-01

There are no tools or biomarkers for a quantitative analysis of sarcopenia. Cross-sectional study of the diagnosis of sarcopenia in 200 independent adults aged 70 years or over. Sarcopenia was defined as loss of muscle mass together with low strength and/or loss of physical performance. We considered different clinical parameters and assayed potential blood biomarkers (cell energetic metabolism, muscle performance, inflammation, infection and oxidative stress). The prevalence of sarcopenia was 35.3% in women and 13.1% in men, and it was significantly associated with advanced age, a low functional performance in the lower extremities, deficient weekly consumption of kilocalories, risk of malnutrition, and drug use for the digestive system. A close relationship was found between sarcopenia, pre-frailty and depressed mood. With these confounding variables, we observed that products of lipid peroxidation were closely associated with sarcopenia in independent older adults (frail participants and those with severe dependence had been excluded from the sample). The best multivariate model proposed was able to predict 67.6% of the variance in sarcopenia, with a power of discrimination of 93.5%. Additional analyses considering lipid levels, fat mass, dyslipidemia, use of lipid-lowering drugs and hypertension confirmed this close association between lipid peroxidation and sarcopenia. Given the difficulty in the diagnosis of sarcopenia in clinical practice, we suggest the use of blood circulating products of lipid peroxidation as potential biomarkers for an early diagnosis of sarcopenia in independent older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review.

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Mitchell, W Kyle; Williams, John; Atherton, Philip; Larvin, Mike; Lund, John; Narici, Marco

2012-01-01

Changing demographics make it ever more important to understand the modifiable risk factors for disability and loss of independence with advancing age. For more than two decades there has been increasing interest in the role of sarcopenia, the age-related loss of muscle or lean mass, in curtailing active and healthy aging. There is now evidence to suggest that lack of strength, or dynapenia, is a more constant factor in compromised wellbeing in old age and it is apparent that the decline in muscle mass and the decline in strength can take quite different trajectories. This demands recognition of the concept of muscle quality; that is the force generating per capacity per unit cross-sectional area (CSA). An understanding of the impact of aging on skeletal muscle will require attention to both the changes in muscle size and the changes in muscle quality. The aim of this review is to present current knowledge of the decline in human muscle mass and strength with advancing age and the associated risk to health and survival and to review the underlying changes in muscle characteristics and the etiology of sarcopenia. Cross-sectional studies comparing young (18-45 years) and old (>65 years) samples show dramatic variation based on the technique used and population studied. The median of values of rate of loss reported across studies is 0.47% per year in men and 0.37% per year in women. Longitudinal studies show that in people aged 75 years, muscle mass is lost at a rate of 0.64-0.70% per year in women and 0.80-00.98% per year in men. Strength is lost more rapidly. Longitudinal studies show that at age 75 years, strength is lost at a rate of 3-4% per year in men and 2.5-3% per year in women. Studies that assessed changes in mass and strength in the same sample report a loss of strength 2-5 times faster than loss of mass. Loss of strength is a more consistent risk for disability and death than is loss of muscle mass.

Sarcopenia, dynapenia and the impact of advancing age on human skeletal muscle size and strength; a quantitative review.

Directory of Open Access Journals (Sweden)

William Kyle Mitchell

2012-07-01

Full Text Available Changing demographics make it ever more important to understand the modifiable risk factors for disability and loss of independence with advancing age. For more than two decades there has been increasing interest in the role of sarcopenia, the age related loss of muscle or lean mass, in curtailing active and healthy aging. There is now evidence to suggest that lack of strength, or dynapenia, is a more constant factor in compromised wellbeing in old age and it is apparent that the decline in muscle mass and the decline in strength can take quite different trajectories. This demands recognition of the concept of muscle quality; that is the force generating per capacity per unit cross-sectional area (CSA. An understanding of the impact of aging on skeletal muscle will require attention to both the changes in muscle size and the changes in muscle quality.The aim of this review is to present current knowledge of the decline in human muscle mass and strength with advancing age and the associated risk to health and survival and to review the underlying changes in muscle characteristics and the aetiology of sarcopenia. Cross-sectional studies comparing young (18-45yrs and old (>65yrs samples show dramatic variation based on the technique used and population studied. The median of values of rate of loss reported across studies is 0.47% per year in men and 0.37% per year in women. Longitudinal studies show that in people aged 75yrs, muscle mass is lost at a rate of 0.64-0.70% per year in women and 0.80-0.98% per year in men. Strength is lost more rapidly. Longitudinal studies show that at age 75yrs, strength is lost at a rate of 3-4% per year in men and 2.5-3% per year in women. Studies that assessed changes in mass and strength in the same sample report a loss of strength 2 – 5 times faster than loss of mass. Loss of strength is a more consistent risk for disability and death than is loss of muscle mass.

Secondary hyperparathyroidism and its relationship with sarcopenia in elderly women.

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de Souza Genaro, Patrícia; de Medeiros Pinheiro, Marcelo; Szejnfeld, Vera Lúcia; Martini, Lígia Araújo

2015-01-01

Low dietary intake of calcium and poor vitamin D status during aging can result in mild secondary hyperparathyroidism, which may be associated with low muscle mass and reduced strength in the elderly. The aim of this study was to investigate whether low vitamin D, high parathormone (PTH), or both, are associated with sarcopenia. A total of 105 women, 35 with sarcopenia and 70 without sarcopenia, were enrolled in the present study. Body composition measurements were performed by DXA and sarcopenia was defined as skeletal muscle mass indexsarcopenia was higher in hyperparathyroidism (25(OH)D65 pg/dL) than in the absence of hyperparathyroidism (41.2 vs 16.2%, respectively; p=0.046). The odds ratio for sarcopenia in hyperparathyroidism cases was 6.81 (95%CI 1.29-35.9) compared with participants who had low PTH and a high 25(OH)D concentration. The present study showed that vitamin D insufficiency associated with secondary hyperparathyroidism increased the risk of sarcopenia, suggesting that the suppression of hyperparathyroidism by ensuring adequate calcium and vitamin D intake should be considered in interventional studies to confirm potential benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Endocrine determinants of incident sarcopenia in middle-aged and elderly European men

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Gielen, Evelien; O'Neill, Terence W; Pye, Stephen R; Adams, Judith E; Wu, Frederick C; Laurent, Michaël R; Claessens, Frank; Ward, Kate A; Boonen, Steven; Bouillon, Roger; Vanderschueren, Dirk; Verschueren, Sabine

2015-01-01

Background In men, the long-term consequences of low serum levels of sex steroids, vitamin D metabolites, and insulin-like growth factor 1 (IGF-1) on the evolution of muscle mass, muscle strength, or physical performance are unclear. Moreover, there are no data about the relationship between these hormones and incident sarcopenia defined as low muscle mass and function. The aim of this study was to determine whether the baseline levels of sex hormones, vitamin D metabolites, and IGF-1 predict changes in muscle mass, muscle strength, physical performance, and incident sarcopenia. Methods In 518 men aged 40–79 years, recruited for participation in the European Male Ageing Study, total, free, and bioavailable testosterone (T), oestradiol (E), sex hormone-binding globulin, IGF-1, 25-hydroxyvitamin D (25OHD), 1,25-dihydroxyvitamin D (1,25(OH)2D), and parathyroid hormone were assessed at baseline. Appendicular lean mass (aLM), gait speed, and grip strength were measured at baseline and after a mean follow-up of 4.3 years. Sarcopenia was defined by the definition of Baumgartner (relative aLM ≤7.26 kg/m2), the International Working Group on Sarcopenia (IWGS), and the European Working Group on Sarcopenia in Older People (EWGSOP). Results aLM significantly decreased from age 50 years, while gait speed and grip strength significantly decreased from age 70 years. The incidence of sarcopenia by the definitions of Baumgartner, IWGS, and EWGSOP was 8.1%, 3.0%, and 1.6%, respectively. After adjustment for age, centre, body mass index, smoking, and number of comorbidities at baseline, baseline levels of T and vitamin D metabolites were not associated with change in aLM, gait speed, and/or grip strength, while a high baseline level of total E2 was associated with a greater decrease in aLM. In men aged ≥70 years, low IGF-1 was associated with a greater decrease in gait speed. Baseline endocrine variables were not independently associated with an increased risk of incident

Hormonal and lifestyle determinants of appendicular skeletal muscle mass in men: the MINOS study.

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Szulc, Pawel; Duboeuf, François; Marchand, François; Delmas, Pierre D

2004-08-01

Aging-related sarcopenia is characterized by a loss of muscle mass and strength and increased fatigability. However, studies of its determinants in elderly men are scarce. We investigated risk factors for sarcopenia in a large cohort of men. We analyzed 845 men aged 45-85 y who belonged to the MINOS cohort. Lifestyle factors (physical activity, tobacco smoking, alcohol intake, caffeine intake) were evaluated by using a standardized questionnaire. Appendicular skeletal muscle mass (ASM) was estimated by using dual-energy X-ray absorptiometry. The relative appendicular skeletal muscle mass index (RASM) was calculated as ASM/body height(2.3). Apparent free testosterone concentration (AFTC) and free testosterone index (FTI) were calculated on the basis of concentrations of total testosterone and sex hormone-binding globulin. RASM decreased with age (r = -0.29, P values for AFTC, FTI, or 25-hydroxycholecalciferol [25(OH)D] were >2 SDs below the mean for young men had significantly lower RASM than did men with higher values. Men with sarcopenia, defined as the lowest quartile of RASM in the studied cohort (normal RASM, weighed significantly less, smoked more, and spent significantly less time on leisure-time activities. Sarcopenic men also had lower values for testosterone, AFTC, FTI, and 25(OH)D. In elderly men, low physical activity, tobacco smoking, thinness, low testosterone (AFTC and FTI), and decreased 25(OH)D concentrations are risk factors for sarcopenia.

Jump test performance and sarcopenia status in men and women, 55 to 75 years of age.

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Singh, Harshvardhan; Kim, Daeyeol; Kim, Eonho; Bemben, Michael G; Anderson, Mark; Seo, Dong-Il; Bemben, Debra A

2014-01-01

Jumping mechanography uses maximal countermovement jumps to test obtain such as jump power (JPow). Recently, it has been shown to be a safe method for assessing muscle function in older adults; however, little is known about the relationships between JPow, muscle strength, and sarcopenia status. The purpose of this study was to examine jump performance, muscle strength, and sarcopenia status in older adults. This was a cross-sectional study that included men (n = 27) and women (n = 33) (55-75 years) recruited from the general community. Participants completed health status and physical activity questionnaires. Body composition, including appendicular skeletal muscle mass (ASM), bone free lean body mass, and relative skeletal muscle mass index, were assessed by total body dual-energy x-ray absorptiometry scans. The criteria for sarcopenia were relative skeletal muscle mass index values less than 7.26 kg/m2 for men and less than 5.45 kg/m2 for women. Three vertical jumps on a jump mat were performed to assess JPow, jump velocity (JVel), and jump height (JHt). Muscle strength was measured by 1RM testing for leg press (LP) and right and left hip abduction isotonic resistance exercises. Sarcopenia was found in 20% (12/60) of the participants. Jump power was significantly lower (P = .001) in the sarcopenia group than in the normal group, 651.1 (41.7) W versus 851.0 (27.4) W, respectively. Jump power and JHt were significantly (P mass. Significant (P muscle strength (LP, right and left hip abduction). The jump test protocol was conducted safely with no injuries or balance issues. Our finding of lower JPow in sarcopenic individuals adds new information to the existing literature on age-related declines in muscle power. Community-dwelling individuals classified as sarcopenic had significantly lower JPow but not muscle strength compared with their counterparts with normal amounts of muscle mass. Jump test variables were positively correlated with lean tissue and lower body

Factors associated with sarcopenia in institutionalized elderly.

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Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa

2017-03-30

The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

Sarcopenia =/= dynapenia.

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Clark, Brian C; Manini, Todd M

2008-08-01

Maximal voluntary force (strength) production declines with age and contributes to physical dependence and mortality. Consequently, a great deal of research has focused on identifying strategies to maintain muscle mass during the aging process and elucidating key molecular pathways of atrophy, with the rationale that the loss of strength is primarily a direct result of the age-associated declines in mass (sarcopenia). However, recent evidence questions this relationship and in this Green Banana article we argue the role of sarcopenia in mediating the age-associated loss of strength (which we will coin as dynapenia) does not deserve the attention it has attracted in both the scientific literature and popular press. Rather, we propose that alternative mechanisms underlie dynapenia (i.e., alterations in contractile properties or neurologic function), and urge that greater attention be paid to these variables in determining their role in dynapenia.

Novel insights on nutrient management of sarcopenia in elderly.

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Rondanelli, Mariangela; Faliva, Milena; Monteferrario, Francesca; Peroni, Gabriella; Repaci, Erica; Allieri, Francesca; Perna, Simone

2015-01-01

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1) the metabolic and nutritional correlates of sarcopenia; (2) the optimum diet therapy for the treatment of these abnormalities. This review included 67 eligible studies. In addition to the well recognized link between adequate intake of proteins/amino acids and sarcopenia, the recent literature underlines that in sarcopenic elderly subjects there is an unbalance in vitamin D synthesis and in omega-6/omega-3 PUFA ratio. Given the detrimental effect of these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of sarcopenia. The optimum diet therapy for the sarcopenia treatment must aim at achieving specific metabolic goals, which must be reached through accession of the elderly to specific personalized dietary program aimed at achieving and/or maintaining muscle mass; increasing their intake of fish (4 times/week) or taking omega-3 PUFA supplements; taking vitamin D supplementation, if there are low serum levels.

Novel Insights on Nutrient Management of Sarcopenia in Elderly

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Rondanelli, Mariangela; Faliva, Milena; Monteferrario, Francesca; Peroni, Gabriella; Repaci, Erica

2015-01-01

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1) the metabolic and nutritional correlates of sarcopenia; (2) the optimum diet therapy for the treatment of these abnormalities. This review included 67 eligible studies. In addition to the well recognized link between adequate intake of proteins/amino acids and sarcopenia, the recent literature underlines that in sarcopenic elderly subjects there is an unbalance in vitamin D synthesis and in omega-6/omega-3 PUFA ratio. Given the detrimental effect of these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of sarcopenia. The optimum diet therapy for the sarcopenia treatment must aim at achieving specific metabolic goals, which must be reached through accession of the elderly to specific personalized dietary program aimed at achieving and/or maintaining muscle mass; increasing their intake of fish (4 times/week) or taking omega-3 PUFA supplements; taking vitamin D supplementation, if there are low serum levels. PMID:25705670

Novel Insights on Nutrient Management of Sarcopenia in Elderly

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Mariangela Rondanelli

2015-01-01

Full Text Available Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1 the metabolic and nutritional correlates of sarcopenia; (2 the optimum diet therapy for the treatment of these abnormalities. This review included 67 eligible studies. In addition to the well recognized link between adequate intake of proteins/amino acids and sarcopenia, the recent literature underlines that in sarcopenic elderly subjects there is an unbalance in vitamin D synthesis and in omega-6/omega-3 PUFA ratio. Given the detrimental effect of these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of sarcopenia. The optimum diet therapy for the sarcopenia treatment must aim at achieving specific metabolic goals, which must be reached through accession of the elderly to specific personalized dietary program aimed at achieving and/or maintaining muscle mass; increasing their intake of fish (4 times/week or taking omega-3 PUFA supplements; taking vitamin D supplementation, if there are low serum levels.

Sarcopenia in diabetic nephropathy: a cross-sectional study.

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Çeliker, Meral; Selçuk, Mustafa Yavuz; Olt, Serdar

2018-06-01

To investigate the relationship between sarcopenia and diabetic nephropathy. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression). In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

Novel Insights on Nutrient Management of Sarcopenia in Elderly

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Rondanelli, Mariangela; Faliva, Milena; Monteferrario, Francesca; Peroni, Gabriella; Repaci, Erica; Allieri, Francesca; Perna, Simone

2015-01-01

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1) the metabolic and nutritional correlates of sarcopenia; (2) the optimum diet therapy fo...

Muscle mass decline, arterial stiffness, white matter hyperintensity, and cognitive impairment: Japan Shimanami Health Promoting Program study.

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Kohara, Katsuhiko; Okada, Yoko; Ochi, Masayuki; Ohara, Maya; Nagai, Tokihisa; Tabara, Yasuharu; Igase, Michiya

2017-08-01

There is a close association between frailty and cognitive impairment. However, the underlying contribution of sarcopenia to the development of cognitive impairment is unclear. We investigated the possible association between muscle mass decline and cognitive impairment in a cross-sectional study of 1518 subjects aged 55 years or above. We also evaluated arterial stiffness and white matter hyperintensities (WMHs) as possible underlying mechanisms for this association. Two sarcopenic indices were measured: thigh muscle cross-sectional area (CSA; calculated by computed tomography) and skeletal muscle mass (bioelectric impedance). Muscle mass decline was defined as either the bottom 10% or 20% of participants for each sex. Cognitive function was assessed using the Touch Panel-type Dementia Assessment Scale, and brachial-ankle pulse wave velocity was measured as an index of arterial stiffness. Both sarcopenic indices were modestly but significantly associated with brachial-ankle pulse wave velocity in male and female subjects. The presence of WMHs was significantly associated with low thigh muscle CSA in men and with low skeletal muscle mass in women. The Touch Panel-type Dementia Assessment Scale score was modestly but significantly and positively associated with thigh muscle CSA in men and skeletal muscle mass in women. Muscle mass decline in the bottom 10% of participants on both sarcopenic indices was significantly and independently related to cognitive impairment in women. Lower sarcopenic indices are significantly related to lower cognitive scores. Arterial stiffness and WMHs could account, at least in part, for this association. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Sarcopenia in older mice is characterized by a decreased anabolic response to a protein meal.

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van Dijk, Miriam; Nagel, Jolanda; Dijk, Francina J; Salles, Jerôme; Verlaan, Sjors; Walrand, Stephane; van Norren, Klaske; Luiking, Yvette

Ageing is associated with sarcopenia, a progressive decline of skeletal muscle mass, muscle quality and muscle function. Reduced sensitivity of older muscles to respond to anabolic stimuli, i.e. anabolic resistance, is part of the underlying mechanisms. Although, muscle parameters have been studied in mice of various ages/strains; the aim was to study if mice display similar deteriorating processes as human ageing. Therefore, 10,16,21 and 25 months-old C57BL6/6J male mice were studied to measure parameters of sarcopenia and factors contributing to its pathophysiology, with the aim of characterizing sarcopenia in old mice. Muscle mass of the hind limb was lower in 25 as compared to 10 month-old mice. A significant decrease in physical daily activity, muscle grip strength and ex vivo muscle maximal force production was observed in 25 compared to 10 month-old mice. The muscle anabolic response to a single protein meal showed increased muscle protein synthesis in young, but not in old mice, indicative to anabolic resistance. However, by increasing the protein content in meals, anabolic resistance could be overcome, similar as in human elderly. Additionally, aged mice showed higher fasted insulin and hepatic malondialdehyde (MDA) levels (=marker oxidative stress). This study shows clear characteristics of sarcopenia that coincide with anabolic resistance, insulin resistance and oxidative stress in 25 month-old C57/BL6 male mice, similar to human ageing. Furthermore, similar decline in muscle mass, strength and function was observed in this aged-mice-model. These observations offer potential for the future to explore in old mice the effects of interventions targeting sarcopenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sarcopenia in cases of chronic and acute illness. A mini-review.

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Dovjak, Peter

2016-02-01

Loss of muscle mass and muscle weakness are often found in cases of acute or chronic illness in elderly patients. Sarcopenia is a risk factor for complications and higher mortality. Based on an exact diagnosis and knowledge of the risk factors for developing sarcopenia, it is now possible to improve the prognosis by providing effective treatment options. This review was carried out based on a PubMed search in the period from 1998 to 2015 using original articles and reviews and posting the terms "sarcopenia", "elderly" and "acute illness". Given the evidence from the current literature, in the case of acute illness it is feasible to identify patients at risk, diagnose sarcopenia and prescribe a multidimensional treatment program to prevent or treat sarcopenia even in the bustling environment of geriatric wards or institutions.

Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

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Hedayati, Kerstin Khalaj; Dittmar, Manuela

2010-01-01

This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

Adiposity to muscle ratio predicts incident physical limitation in a cohort of 3,153 older adults--an alternative measurement of sarcopenia and sarcopenic obesity.

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Auyeung, Tung Wai; Lee, Jenny Shun Wah; Leung, Jason; Kwok, Timothy; Woo, Jean

2013-08-01

Conventionally, sarcopenia is defined by muscle mass and physical performance. We hypothesized that the disability caused by sarcopenia and sarcopenic obesity was related to the amount of adiposity or body weight bearing on a unit of muscle mass, or the adiposity to muscle ratio. We therefore examined whether this ratio could predict physical limitation by secondary analysis of the data in our previous study. We recruited 3,153 community-dwelling adults aged >65 years and their body composition was measured by dual-energy X-ray absorptiometry. Assessment of physical limitation was undertaken 4 years later. The relationship between baseline adiposity to muscle ratio and incident physical limitation was examined by logistic regression. In men, the adiposity to muscle ratios, namely total body fat to lower-limb muscle mass, total body fat to fat-free mass (FFM), and body weight to FFM, were predictive of physical limitation before and after adjustment for the covariates: age, Mini-mental Status Examination score, Geriatric Depression Scale score >8, and the diagnosis of chronic obstructive pulmonary disease, diabetes mellitus, hypertension, heart disease, and stroke (all p values physical limitation 4 years later both before and after adjustment for the same set of covariates (all p values physical limitation in older women across the entire range of the total body fat to lower-limb muscle mass ratio; and in older men when this ratio was equal to or greater than 0.75.

The adipokine leptin increases skeletal muscle mass and significantly alters skeletal muscle miRNA expression profile in aged mice

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Hamrick, Mark W.; Herberg, Samuel; Arounleut, Phonepasong; He, Hong-Zhi; Shiver, Austin; Qi, Rui-Qun; Zhou, Li; Isales, Carlos M.

2010-01-01

Research highlights: → Aging is associated with muscle atrophy and loss of muscle mass, known as the sarcopenia of aging. → We demonstrate that age-related muscle atrophy is associated with marked changes in miRNA expression in muscle. → Treating aged mice with the adipokine leptin significantly increased muscle mass and the expression of miRNAs involved in muscle repair. → Recombinant leptin therapy may therefore be a novel approach for treating age-related muscle atrophy. -- Abstract: Age-associated loss of muscle mass, or sarcopenia, contributes directly to frailty and an increased risk of falls and fractures among the elderly. Aged mice and elderly adults both show decreased muscle mass as well as relatively low levels of the fat-derived hormone leptin. Here we demonstrate that loss of muscle mass and myofiber size with aging in mice is associated with significant changes in the expression of specific miRNAs. Aging altered the expression of 57 miRNAs in mouse skeletal muscle, and many of these miRNAs are now reported to be associated specifically with age-related muscle atrophy. These include miR-221, previously identified in studies of myogenesis and muscle development as playing a role in the proliferation and terminal differentiation of myogenic precursors. We also treated aged mice with recombinant leptin, to determine whether leptin therapy could improve muscle mass and alter the miRNA expression profile of aging skeletal muscle. Leptin treatment significantly increased hindlimb muscle mass and extensor digitorum longus fiber size in aged mice. Furthermore, the expression of 37 miRNAs was altered in muscles of leptin-treated mice. In particular, leptin treatment increased the expression of miR-31 and miR-223, miRNAs known to be elevated during muscle regeneration and repair. These findings suggest that aging in skeletal muscle is associated with marked changes in the expression of specific miRNAs, and that nutrient-related hormones such as leptin

The adipokine leptin increases skeletal muscle mass and significantly alters skeletal muscle miRNA expression profile in aged mice

Energy Technology Data Exchange (ETDEWEB)

Hamrick, Mark W., E-mail: mhamrick@mail.mcg.edu [Department of Cellular Biology and Anatomy, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Department of Orthopaedic Surgery, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Herberg, Samuel; Arounleut, Phonepasong [Department of Cellular Biology and Anatomy, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Department of Orthopaedic Surgery, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); He, Hong-Zhi [Henry Ford Immunology Program, Henry Ford Health System, Detroit, MI (United States); Department of Dermatology, Henry Ford Health System, Detroit, MI (United States); Shiver, Austin [Department of Cellular Biology and Anatomy, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Department of Orthopaedic Surgery, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Qi, Rui-Qun [Henry Ford Immunology Program, Henry Ford Health System, Detroit, MI (United States); Department of Dermatology, Henry Ford Health System, Detroit, MI (United States); Zhou, Li [Henry Ford Immunology Program, Henry Ford Health System, Detroit, MI (United States); Department of Dermatology, Henry Ford Health System, Detroit, MI (United States); Department of Internal Medicine, Henry Ford Health System, Detroit, MI (United States); Isales, Carlos M. [Department of Cellular Biology and Anatomy, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); Department of Orthopaedic Surgery, Institute of Molecular Medicine and Genetics, Medical College of Georgia, Augusta, GA (United States); others, and

2010-09-24

Research highlights: {yields} Aging is associated with muscle atrophy and loss of muscle mass, known as the sarcopenia of aging. {yields} We demonstrate that age-related muscle atrophy is associated with marked changes in miRNA expression in muscle. {yields} Treating aged mice with the adipokine leptin significantly increased muscle mass and the expression of miRNAs involved in muscle repair. {yields} Recombinant leptin therapy may therefore be a novel approach for treating age-related muscle atrophy. -- Abstract: Age-associated loss of muscle mass, or sarcopenia, contributes directly to frailty and an increased risk of falls and fractures among the elderly. Aged mice and elderly adults both show decreased muscle mass as well as relatively low levels of the fat-derived hormone leptin. Here we demonstrate that loss of muscle mass and myofiber size with aging in mice is associated with significant changes in the expression of specific miRNAs. Aging altered the expression of 57 miRNAs in mouse skeletal muscle, and many of these miRNAs are now reported to be associated specifically with age-related muscle atrophy. These include miR-221, previously identified in studies of myogenesis and muscle development as playing a role in the proliferation and terminal differentiation of myogenic precursors. We also treated aged mice with recombinant leptin, to determine whether leptin therapy could improve muscle mass and alter the miRNA expression profile of aging skeletal muscle. Leptin treatment significantly increased hindlimb muscle mass and extensor digitorum longus fiber size in aged mice. Furthermore, the expression of 37 miRNAs was altered in muscles of leptin-treated mice. In particular, leptin treatment increased the expression of miR-31 and miR-223, miRNAs known to be elevated during muscle regeneration and repair. These findings suggest that aging in skeletal muscle is associated with marked changes in the expression of specific miRNAs, and that nutrient

Models of sarcopenia: Short review.

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Palus, S; Springer, J I; Doehner, W; von Haehling, S; Anker, M; Anker, S D; Springer, J

2017-07-01

Approximately 40-50% of the population over 80years of age suffers from sarcopenia making this condition a major geriatric clinical disorder and a key challenge to healthy aging. The hallmark symptom of sarcopenia is the loss of muscle mass and strength without the loss of overall body weight. Sarcopenic patients are likely to have worse clinical outcomes and higher mortality compared to healthy individuals. This review will focus on animal models designed to study sarcopenia including hind-limb unloading, de-nervation, and immobilization by using casts or wire strategies, as well as using aged rodents. Currently there are no registered treatments for sarcopenia. Most sarcopenic individuals show signs of physical frailty, which leads to increases the prevalence of balance disorders, falls, fractures and pain. Therefore, is it essential to develop and use relevant animal models to further the research on sarcopenia therapy? Copyright © 2017 Elsevier B.V. All rights reserved.

Relationships between sarcopenia and household status and locomotive syndrome in a community-dwelling elderly women in Japan.

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Momoki, Chika; Habu, Daiki; Ogura, Juri; Tada, Arisa; Hasei, Ai; Sakurai, Kotone; Watanabe, Hatsumi

2017-01-01

The aim of the present study was to identify factors associated with sarcopenia in community-dwelling elderly women in Japan. A total of 186 women aged over 65 years attending preventive care classes were enrolled in the study. Muscle mass was assessed using bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass and low muscle strength in accord with the consensus report of the Asian Working Group for Sarcopenia. Data regarding household status (living alone, with a spouse, or with children and/or grandchildren), calf circumference and the presence of locomotive syndrome were obtained, as well as dietary variety score, Tokyo Metropolitan Institute of Gerontology Index of Competence and Mini-Nutritional Assessment short form, and 10-item Eating Assessment Tool scores. Sarcopenia was identified in 21.0% of participants. Participants with sarcopenia were older, had a lower body mass index and calf circumference, and were more likely to have locomotive syndrome, and living with children and/or grandchildren. In multivariate analysis, age, body mass index sarcopenia, as were associated living alone (OR 1.69, 95% CI 0.45-6.41), and living with children and/or grandchildren (OR 2.46, 95% CI 0.71-8.54) and dietary variety score ≥9 (OR 4.98, 95% CI 0.97-25.56). Age, body mass index, dietary variety score, locomotive syndrome and household status were associated with sarcopenia. Early interventions are required for older adults identified as having a higher risk of sarcopenia to prevent its adverse health consequences. Geriatr Gerontol Int 2017; 17: 54-60. © 2016 Japan Geriatrics Society.

Sarcopenic obesity or obese sarcopenia: A cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis.

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Kalinkovich, Alexander; Livshits, Gregory

2017-05-01

Sarcopenia, an age-associated decline in skeletal muscle mass coupled with functional deterioration, may be exacerbated by obesity leading to higher disability, frailty, morbidity and mortality rates. In the combination of sarcopenia and obesity, the state called sarcopenic obesity (SOB), some key age- and obesity-mediated factors and pathways may aggravate sarcopenia. This review will analyze the mechanisms underlying the pathogenesis of SOB. In obese adipose tissue (AT), adipocytes undergo hypertrophy, hyperplasia and activation resulted in accumulation of pro-inflammatory macrophages and other immune cells as well as dysregulated production of various adipokines that together with senescent cells and the immune cell-released cytokines and chemokines create a local pro-inflammatory status. In addition, obese AT is characterized by excessive production and disturbed capacity to store lipids, which accumulate ectopically in skeletal muscle. These intramuscular lipids and their derivatives induce mitochondrial dysfunction characterized by impaired β-oxidation capacity and increased reactive oxygen species formation providing lipotoxic environment and insulin resistance as well as enhanced secretion of some pro-inflammatory myokines capable of inducing muscle dysfunction by auto/paracrine manner. In turn, by endocrine manner, these myokines may exacerbate AT inflammation and also support chronic low grade systemic inflammation (inflammaging), overall establishing a detrimental vicious circle maintaining AT and skeletal muscle inflammation, thus triggering and supporting SOB development. Under these circumstances, we believe that AT inflammation dominates over skeletal muscle inflammation. Thus, in essence, it redirects the vector of processes from "sarcopenia→obesity" to "obesity→sarcopenia". We therefore propose that this condition be defined as "obese sarcopenia", to reflect the direction of the pathological pathway. Copyright © 2016 Elsevier B.V. All rights

Clinical impact of sarcopenia on prognosis in pancreatic ductal adenocarcinoma: A retrospective cohort study.

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Ninomiya, Go; Fujii, Tsutomu; Yamada, Suguru; Yabusaki, Norimitsu; Suzuki, Kojiro; Iwata, Naoki; Kanda, Mitsuro; Hayashi, Masamichi; Tanaka, Chie; Nakayama, Goro; Sugimoto, Hiroyuki; Koike, Masahiko; Fujiwara, Michitaka; Kodera, Yasuhiro

2017-03-01

To investigate the impact of the body composition such as skeletal muscle, visceral fat and body mass index (BMI) on patients with resected pancreatic ductal adenocarcinoma (PDAC). A total of 265 patients who underwent curative surgery for PDAC were examined in this study. The total skeletal muscle and fat tissue areas were evaluated in a single image obtained at the third lumber vertebra during a preoperative computed tomography (CT) scan. The patients were assigned to either the sarcopenia or non-sarcopenia group based on their skeletal muscle index (SMI) and classified into high visceral fat area (H-VFA) or low VFA (L-VFA) groups. The association of clinicopathological features and prognosis with the body composition were statistically analyzed. There were 170 patients (64.2%) with sarcopenia. The median survival time (MST) was 23.7 months for sarcopenia patients and 25.8 months for patients without sarcopenia. The MST was 24.4 months for H-VFA patients and 25.8 months for L-VFA patients. However, sarcopenia patients with BMI ≥22 exhibited significantly poorer survival than patients without sarcopenia (MST: 19.2 vs. 35.4 months, P = 0.025). There was a significant difference between patients with and without sarcopenia who did not receive chemotherapy (5-year survival rate: 0% vs. 68.3%, P = 0.003). The multivariate analysis revealed that tumor size, positive dissected peripancreatic tissue margin, and sarcopenia were independent prognostic factors. Sarcopenia is an independent prognostic factor in PDAC patients with a BMI ≥22. Therefore, evaluating skeletal muscle mass may be a simple and useful approach for predicting patient prognosis. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Functional consequences of sarcopenia and dynapenia in the elderly.

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Clark, Brian C; Manini, Todd M

2010-05-01

The economic burden due to the sequela of sarcopenia (muscle wasting in the elderly) are staggering and rank similarly to the costs associated with osteoporotic fractures. In this article, we discuss the societal burden and determinants of the loss of physical function with advancing age, the physiologic mechanisms underlying dynapenia (muscle weakness in the elderly), and provide perspectives on related critical issues to be addressed. Recent epidemiological findings from longitudinal aging studies suggest that dynapenia is highly associated with both mortality and physical disability even when adjusting for sarcopenia indicating that sarcopenia may be secondary to the effects of dynapenia. These findings are consistent with the physiologic underpinnings of muscle strength, as recent evidence demonstrates that alterations in muscle quantity, contractile quality and neural activation all collectively contribute to dynapenia. Although muscle mass is essential for regulation of whole body metabolic balance, overall neuromuscular function seems to be a critical factor for maintaining muscle strength and physical independence in the elderly. The relative contribution of physiologic factors contributing to muscle weakness are not fully understood and further research is needed to better elucidate these mechanisms between muscle groups and across populations.

Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults

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Kim, Jung Hee; Moon, Jae Hoon; Choi, Sung Hee; Lim, Soo; Lim, Jae-Young; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak Chul

2016-01-01

Objective We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project’s recommended criteria for sarcopenia’s association with mortality among older Korean adults. Methods We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs. Results Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69–10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16–28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations. Conclusions New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values. PMID:27832145

Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study.

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Huang, Dong-Dong; Chen, Xiao-Xi; Chen, Xi-Yi; Wang, Su-Lin; Shen, Xian; Chen, Xiao-Lei; Yu, Zhen; Zhuang, Cheng-Le

2016-11-01

One-year mortality is vital for elderly oncologic patients undergoing surgery. Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries, but the association of sarcopenia and 1-year mortality has never been investigated in a prospective study. We conducted a prospective study of elderly patients (≥65 years) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015. Sarcopenia was determined by the measurements of muscle mass, handgrip strength, and gait speed. Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality. A total of 173 patients were included, in which 52 (30.1 %) patients were identified as having sarcopenia. Twenty-four (13.9 %) patients died within 1 year of surgery. Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality. Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia, from 0.835 to 0.868. Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis. Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery. The measurement of muscle function is important for sarcopenia as a preoperative assessment tool.

Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

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Steihaug, Ole Martin; Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

2017-01-01

Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

Directory of Open Access Journals (Sweden)

Ole Martin Steihaug

Full Text Available Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a the feasibility of determining sarcopenia in patients with acute hip fracture, b the prevalence of sarcopenia and c associations of sarcopenia with nutritional status and comorbidities.A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score.Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37% were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR 1.4 per 5 years, 95% confidence interval (CI [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0].Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

Sarcopenia in patients with hip fracture: A multicenter cross-sectional study

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Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

2017-01-01

Background Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. Methods A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Results Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Conclusions Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility. PMID:28902873

Sarcopenia and its individual criteria are associated, in part, with mortality among patients on hemodialysis.

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Kittiskulnam, Piyawan; Chertow, Glenn M; Carrero, Juan J; Delgado, Cynthia; Kaysen, George A; Johansen, Kirsten L

2017-07-01

The relative importance of sarcopenia and its individual components as independent predictors of mortality in the dialysis population has not been determined. We estimated whole-body muscle mass using pre-dialysis bioimpedance spectroscopy measurements in 645 ACTIVE/ADIPOSE-enrolled prevalent hemodialysis patients from San Francisco and Atlanta. Low muscle mass was defined as two standard deviations below sex-specific means for young adults from NHANES and indexed to height 2 , body weight, body surface area, or body mass index. We evaluated the association of sarcopenia (low muscle mass) by four indexing methods, weak hand grip strength, and slow gait speed with mortality. Seventy-eight deaths were observed during a mean follow-up of 1.9 years. Sarcopenia was not significantly associated with mortality after adjusting for covariates. No muscle mass criteria were associated with death, regardless of indexing metrics. In contrast, having weak grip strength or slow walking speed was associated with mortality in the adjusted model. Only gait slowness significantly improved the predictive accuracy for death with an increase in C-statistic from 0.63 to 0.68. However, both gait slowness and hand grip weakness significantly improved the net reclassification index compared to models without performance measures (50.5% for slowness and 33.7% for weakness), whereas models with muscle size did not. Neither sarcopenia nor low muscle mass by itself was a better predictor of mortality than functional limitation alone in patients receiving hemodialysis. Thus, physical performance measures, including slow gait speed and weak hand grip strength, were associated with mortality even after adjustment for muscle size and other confounders. Published by Elsevier Inc.

Sarcopenia associada ao envelhecimento: aspectos etiológicos e opções terapêuticas Sarcopenia and aging: etiological aspects and therapeutic options

Directory of Open Access Journals (Sweden)

Tatiana Alves de Araujo Silva

2006-12-01

Full Text Available A prevalência de incapacidade e dependência funcional é maior em idosos e está intimamente associada à redução da massa muscular, que ocorre, até mesmo, em indivíduos saudáveis. A sarcopenia parece decorrer da interação complexa de distúrbios da inervação, diminuição de hormônios, aumento de mediadores inflamatórios e alterações da ingestão protéico-calórica que ocorrem durante o envelhecimento. A perda de massa e força muscular é responsável pela redução de mobilidade e aumento da incapacidade funcional e dependência. Quando associada à fragilidade, esta perda gera custos econômicos e sociais. Neste artigo, pretende-se avaliar aspectos relacionados à gênese da sarcopenia, bem como analisar possíveis opções terapêuticas e de prevenção.The high prevalence of inability and functional dependence is an important problem in elderly people. It is closely related with aging decrease of lean muscle mass that occurs even in healthy subjects. Skeletal muscle mass deficiency, or sarcopenia, results from complex interactions between innervations disturbances, hormones deficiency, inflammatory cytokines and restriction in caloric-proteic ingestion. Loss of skeletal muscle mass and strength results in disability and functional dependency that are associated to frailty in many elderly people. These conditions represent enormous economic and social budget. In this article, we evaluate pathogenesis of sarcopenia and discuss potential therapies.

Sarcopenia in daily practice: assessment and management.

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Beaudart, Charlotte; McCloskey, Eugène; Bruyère, Olivier; Cesari, Matteo; Rolland, Yves; Rizzoli, René; Araujo de Carvalho, Islène; Amuthavalli Thiyagarajan, Jotheeswaran; Bautmans, Ivan; Bertière, Marie-Claude; Brandi, Maria Luisa; Al-Daghri, Nasser M; Burlet, Nansa; Cavalier, Etienne; Cerreta, Francesca; Cherubini, Antonio; Fielding, Roger; Gielen, Evelien; Landi, Francesco; Petermans, Jean; Reginster, Jean-Yves; Visser, Marjolein; Kanis, John; Cooper, Cyrus

2016-10-05

Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were afterwards organized for the whole group to make amendments and discuss further recommendations. This paper proposes some user-friendly and inexpensive methods that can be used to assess sarcopenia in real-life settings. Healthcare providers, particularly in primary care, should consider an assessment of sarcopenia in individuals at increased risk; suggested tools for assessing risk include the Red Flag Method, the SARC-F questionnaire, the SMI method or different prediction equations. Management of sarcopenia should primarily be patient centered and involve the combination of both resistance and endurance based activity programmes with or without dietary interventions. Development of a number of pharmacological interventions is also in progress. Assessment of sarcopenia in individuals with risk factors, symptoms and/or conditions exposing them to the risk of disability will become particularly important in the near future.

SARCOPENIA: DESIGNING PHASE IIB TRIALS

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CHUMLEA, WM.C.; CESARI, M.; EVANS, W.J.; FERRUCCI, L.; FIELDING, R.A.; PAHOR, M.; STUDENSKI, S.; VELLAS, B.

2012-01-01

Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty and increased health care costs. The development of interventions aimed at preventing and/or treating sarcopenia is complex, requiring the adoption of assumptions and standards that are not well established scientifically or clinically. A number of investigators and clinicians (both from academia and industry) met in Rome (Italy) in 2009 to develop a consensus definition of sarcopenia. Subsequently, in Albuquerque (New Mexico, USA) in 2010, the same group met again to consider the complex issues necessary for designing Phase II clinical trials for sarcopenia. Current clinical trial data indicate that fat-free mass (FFM) parameters are responsive to physical activity/nutritional treatment modalities over short time periods, but pharmacological trials of sarcopenia have yet to show significant efficacy. In order to conduct a clinical trial within a reasonable time frame, groups that model or display accelerated aging and loss of FFM are necessary. Few studies have used acceptable designs for testing treatment effects, sample sizes or primary outcomes that could provide interpretable findings or effects across studies. Dual energy x ray absorptiometry (DXA) is the measure of choice for assessing FFM, but sufficient time is needed for changes to be detected accurately and reliably. A tool set that would allow clinical, basic and epidemiological research on sarcopenia to advance rapidly toward diagnosis and treatment phases should be those reflecting function and strength. PMID:21623466

Sarcopenia and frailty in elderly trauma patients.

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Fairchild, Berry; Webb, Travis P; Xiang, Qun; Tarima, Sergey; Brasel, Karen J

2015-02-01

Sarcopenia describes a loss of muscle mass and resultant decrease in strength, mobility, and function that can be quantified by CT. We hypothesized that sarcopenia and related frailty characteristics are related to discharge disposition after blunt traumatic injury in the elderly. We reviewed charts of 252 elderly blunt trauma patients who underwent abdominal CT prior to hospital admission. Data for thirteen frailty characteristics were abstracted. Sarcopenia was measured by obtaining skeletal muscle cross-sectional area (CSA) from each patient's psoas major muscle using Slice-O-Matic(®) software. Dispositions were grouped as dependent and independent based on discharge location. χ (2), Fisher's exact, and logistic regression were used to determine factors associated with discharge dependence. Mean age 76 years, 49 % male, median ISS 9.0 (IQR = 8.0-17.0). Discharge destination was independent in 61.5 %, dependent in 29 %, and 9.5 % of patients died. Each 1 cm(2) increase in psoas muscle CSA was associated with a 20 % decrease in dependent living (p elderly trauma patients and can be obtained from the admission CT. Lower psoas muscle CSA is related to loss of independence upon discharge in the elderly. The early availability of this variable during the hospitalization of elderly trauma patients may aid in discharge planning and the transition to dependent living.

The Role of Muscle Mass, Muscle Quality, and Body Composition in Risk for the Metabolic Syndrome and Functional Decline in Older Adults: Topical Collection on Nutrition, Obesity, and Diabetes

NARCIS (Netherlands)

R.T. Mankowski (Robert T.); S.D. Anton (Stephen D.); M. Aubertin-Leheudre (Mylene)

2015-01-01

textabstractAbstract Age-related body composition changes include both loss of muscle mass (sarcopenia) and increase in fat mass, which jointly contribute to a decline in metabolic functions. Muscle quality is positively related to functional capacity and a lower risk for the development of the

The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients.

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Reijnierse, Esmee M; Trappenburg, Marijke C; Leter, Morena J; Blauw, Gerard Jan; Sipilä, Sarianna; Sillanpää, Elina; Narici, Marco V; Hogrel, Jean-Yves; Butler-Browne, Gillian; McPhee, Jamie S; Gapeyeva, Helena; Pääsuke, Mati; de van der Schueren, Marian A E; Meskers, Carel G M; Maier, Andrea B

2015-01-01

A consensus on the diagnostic criteria for sarcopenia, a common syndrome in the elderly, has not been reached yet. Prevalence rates vary between studies due to the use of different criteria encompassing different measures, correction factors and cutoff points. This study compared prevalence rates of sarcopenia using nine sets of diagnostic criteria applied in two different elderly populations. The study population encompassed 308 healthy elderly participants (152 males, 156 females; mean age 74 years) and 123 geriatric outpatients (54 males, 69 females; mean age 81 years). Diagnostic criteria included relative muscle mass, absolute muscle mass, muscle strength and physical performance. Prevalence rates of sarcopenia varied between 0 and 15% in healthy elderly participants and between 2 and 34% in geriatric outpatients. This study clearly demonstrates the dependency of sarcopenia prevalence rates on the applied diagnostic criteria. © 2015 S. Karger AG, Basel.

Muscle atrophy as pre-sarcopenia in Japanese patients with chronic liver disease: computed tomography is useful for evaluation

OpenAIRE

Hiraoka, Atsushi; Aibiki, Toshihiko; Okudaira, Tomonari; Toshimori, Akiko; Kawamura, Tomoe; Nakahara, Hiromasa; Suga, Yoshifumi; Azemoto, Nobuaki; Miyata, Hideki; Miyamoto, Yasunao; Ninomiya, Tomoyuki; Hirooka, Masashi; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi

2015-01-01

Background/Aim The definition of muscle atrophy (pre-sarcopenia) and its diagnostic criteria have not been well reported. To elucidate the frequency of pre-sarcopenia in chronic liver disease (CLD), we examined clinical features of Japanese CLD patients using abdominal computed tomography (CT) findings. Methods We enrolled 988 CLD (736 with na?ve hepatocellular carcinoma) and 372 normal control subjects (NCs). The psoas muscle area index [PI, psoas muscle area at the mid-L3 level in CT (cm2)/...

Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain).

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Masanes, F; Culla, A; Navarro-Gonzalez, M; Navarro-Lopez, M; Sacanella, E; Torres, B; Lopez-Soto, A

2012-02-01

The purpose of this study was to evaluate the prevalence of sarcopenia in a cohort of healthy community-dwelling elderly in an urban area in Barcelona (Spain) for native benchmarks and compare them with those published in other geographical areas. We prospectively evaluated a series of 200 healthy elderly in the community with preserved functional capacity and absence of cognitive impairment. We performed a comprehensive geriatric assessment and determined anthropometric data, muscle mass (MM) and the muscle mass index (MMI). Assessment of muscle mass was performed by bioelectrical impedance analysis (BIA). The cut-off point for defining sarcopenia MMI was established as less than 2 SD of the mean of a reference group comprising 220 healthy volunteers (20-42 years) in the same area. Results were compared with studies undertaken in the USA, France and Taiwan. The cut-off points obtained were 8.31 Kg/m(2) for men and 6.68 Kg/m2 for women, being similar to those observed in France and Taiwan but different from the USA. The prevalence of sarcopenia observed was 33% for elderly women and 10% for males. On comparison of the prevalence of sarcopenia in the four populations, we observed some differences, particularly in males. We have defined reference values for sarcopenia, determined by BIA, in our setting. We also observed a remarkable prevalence of sarcopenia in the healthy elderly community, especially in females, showing some differences from those in other geographical regions.

Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people.

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Curcio, Francesco; Basile, Claudia; Liguori, Ilaria; Della-Morte, David; Gargiulo, Gaetano; Galizia, Gianluigi; Testa, Gianluca; Langellotto, Assunta; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

2016-12-01

Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m 2 ; p for trend strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p strength (y = 14.0x + 0.8, r = 0.53; p strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.

Sarcopenia and mortality in older people living in a nursing home in Turkey.

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Yalcin, Ahmet; Aras, Sevgi; Atmis, Volkan; Cengiz, Ozlem Karaarslan; Cinar, Esat; Atli, Teslime; Varli, Murat

2017-07-01

The aim of the present study was to evaluate the relationship between mortality and sarcopenia defined by the criteria of the European Working Group on Sarcopenia in Older People in older nursing home residents in Turkey. This was an observational prospective study. Nursing home residents who were aged older than 65 years and living in the Seyranbagları Nursing Home and Rehabilitation Center (Ankara, Turkey) were recruited for the study. The main outcome measure was the relationship between sarcopenia and mortality. Diagnosis of sarcopenia was carried out according to the European Working Group on Sarcopenia in Older People criteria. Bioelectrical impedance analysis was used for skeletal muscle mass measurement. Muscle strength and muscle performance were evaluated by handgrip testing and gait speed, respectively. Mortality was assessed at the end of 2 years. The Kaplan-Meier method and Cox regression analysis were used to evaluate the relationship between sarcopenia and all-cause mortality. The prevalence of sarcopenia and severe sarcopenia were 29% and 25.4%, respectively. A total of 44% (18) of sarcopenic participants died, whereas 15% (15) of participants without sarcopenia died after 2 years of follow up (P sarcopenia was associated with all-cause mortality among older nursing home residents in Turkey (HR 2.38, 95% CI 1.04-5.46; P = 0.039). However, sarcopenia was not significantly related with mortality after adjustment of MNA score (HR 2.04, 95% CI 0.85-4.9; P = 0.1). Sarcopenia independently increases all-cause mortality in older nursing home residents in Turkey. Nutritional status plays a role in sarcopenia-related mortality. Geriatr Gerontol Int 2017; 17: 1118-1124. © 2016 Japan Geriatrics Society.

LOW MID-UPPER ARM CIRCUMFERENCE AND MORTALITY IN OLDER PERSONS: THE INFLUENCE OF FAT AND MUSCLE MASS

NARCIS (Netherlands)

Delmonico, M.J.; Harris, T.B.; Visser, M.; Park, S.W.; Conroy, M.B.; Velasquez-Mieyer, P.; Boudreau, R.; Manini, T.M.; Nevitt, M.; Newman, A.B.; Goodpaster, B.H.

2009-01-01

Background: Sarcopenia is thought to be accompanied by increased muscle fat infiltration. However, no longitudinal studies have examined concomitant changes in muscle mass, strength, or fat infiltration in older adults. Objective: We present longitudinal data on age-related changes in leg

Psoas Muscle Cross-sectional Area as a Measure of Whole-body Lean Muscle Mass in Maintenance Hemodialysis Patients.

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Morrell, Glen R; Ikizler, Talat A; Chen, Xiaorui; Heilbrun, Marta E; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

2016-07-01

We investigate whether psoas or paraspinous muscle area measured on a single L4-L5 image is a useful measure of whole lean body mass (LBM) compared to dedicated midthigh magnetic resonance imaging (MRI). Observational study. Outpatient dialysis units and a research clinic. One hundred five adult participants on maintenance hemodialysis. No control group was used. Psoas muscle area, paraspinous muscle area, and midthigh muscle area (MTMA) were measured by magnetic resonance imaging. LBM was measured by dual-energy absorptiometry scan. In separate multivariable linear regression models, psoas, paraspinous, and MTMA were associated with increase in LBM. In separate multivariate logistic regression models, C statistics for diagnosis of sarcopenia (defined as <25th percentile of LBM) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for MTMA. With sarcopenia defined as <10th percentile of LBM, the corresponding C statistics were 0.71, 0.92, and 0.94. We conclude that psoas muscle area provides a good measure of whole-body muscle mass, better than paraspinous muscle area but slightly inferior to midthigh measurement. Hence, in body composition studies a single axial MR image at the L4-L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Prevalence and Associated Factors of Sarcopenia in Older Adults with Intellectual Disabilities

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Bastiaanse, Luc P.; Hilgenkamp, Thessa I. M.; Echteld, Michael A.; Evenhuis, Heleen M.

2012-01-01

Sarcopenia is defined as a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength. It has hardly been studied in older people with intellectual disabilities (ID). In this study 884 persons with borderline to profound ID aged 50 years and over, were investigated to determine the prevalence of sarcopenia in…

Sarcopenia in COPD: relationship with COPD severity and prognosis

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Costa, Tatiana Munhoz da Rocha Lemos; Costa, Fabio Marcelo; Moreira, Carolina Aguiar; Rabelo, Leda Maria; Boguszewski, César Luiz; Borba, Victória Zeghbi Cochenski

2015-01-01

Objective: To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. Methods: A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index. Results: We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. Conclusions: In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis. PMID:26578132

Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer

NARCIS (Netherlands)

Boer, B. C.; de Graaff, F.; Brusse-Keizer, M.; Bouman, D. E.; Slump, C. H.; Slee-Valentijn, M.; Klaase, J. M.

The prevalence of colorectal cancer in the elderly is increasing and, therefore, surgical interventions with a risk of potential complications are more frequently performed. This study investigated the role of low skeletal muscle mass (sarcopenia), muscle quality, and the sarcopenic obesity as

Sarcopenia in older mice is characterized by a decreased anabolic response to a protein meal

NARCIS (Netherlands)

Dijk, van Miriam; Nagel, Jolanda; Dijk, Francina J.; Salles, Jerôme; Verlaan, Sjors; Walrand, Stephane; Norren, van Klaske; Luiking, Yvette

2017-01-01

Ageing is associated with sarcopenia, a progressive decline of skeletal muscle mass, muscle quality and muscle function. Reduced sensitivity of older muscles to respond to anabolic stimuli, i.e. anabolic resistance, is part of the underlying mechanisms. Although, muscle parameters have been

Regulation of satellite cell function in sarcopenia

Directory of Open Access Journals (Sweden)

Stephen E Alway

2014-09-01

Full Text Available The mechanisms contributing to sarcopenia include reduced satellite cell (myogenic stem cell function that is impacted by the environment (niche of these cells. Satellite cell function is affected by oxidative stress, which is elevated in aged muscles, and this along with changes in largely unknown systemic factors, likely contribute to the manner in which satellite cells respond to stressors such as exercise, disuse or rehabilitation in sarcopenic muscles. Nutritional intervention provides one therapeutic strategy to improve the satellite cell niche and systemic factors, with the goal of improving satellite cell function in aging muscles. Although many elderly persons consume various nutraceuticals with the hope of improving health, most of these compounds have not been thoroughly tested, and the impacts that they might have on sarcopenia, and satellite cell function are not clear. This review discusses data pertaining to the satellite cell responses and function in aging skeletal muscle, and the impact that three compounds: resveratrol, green tea catechins and β-Hydroxy-β-methylbutyrate have on regulating satellite cell function and therefore contributing to reducing sarcopenia or improving muscle mass after disuse in aging. The data suggest that these nutraceutical compounds improve satellite cell function during rehabilitative loading in animal models of aging after disuse (i.e., muscle regeneration. While these compounds have not been rigorously tested in humans, the data from animal models of aging provide a strong basis for conducting additional focused work to determine if these or other nutraceuticals can offset the muscle losses, or improve regeneration in sarcopenic muscles of older humans via improving satellite cell function.

Regulation of Satellite Cell Function in Sarcopenia

Science.gov (United States)

Alway, Stephen E.; Myers, Matthew J.; Mohamed, Junaith S.

2014-01-01

The mechanisms contributing to sarcopenia include reduced satellite cell (myogenic stem cell) function that is impacted by the environment (niche) of these cells. Satellite cell function is affected by oxidative stress, which is elevated in aged muscles, and this along with changes in largely unknown systemic factors, likely contribute to the manner in which satellite cells respond to stressors such as exercise, disuse, or rehabilitation in sarcopenic muscles. Nutritional intervention provides one therapeutic strategy to improve the satellite cell niche and systemic factors, with the goal of improving satellite cell function in aging muscles. Although many elderly persons consume various nutraceuticals with the hope of improving health, most of these compounds have not been thoroughly tested, and the impacts that they might have on sarcopenia and satellite cell function are not clear. This review discusses data pertaining to the satellite cell responses and function in aging skeletal muscle, and the impact that three compounds: resveratrol, green tea catechins, and β-Hydroxy-β-methylbutyrate have on regulating satellite cell function and therefore contributing to reducing sarcopenia or improving muscle mass after disuse in aging. The data suggest that these nutraceutical compounds improve satellite cell function during rehabilitative loading in animal models of aging after disuse (i.e., muscle regeneration). While these compounds have not been rigorously tested in humans, the data from animal models of aging provide a strong basis for conducting additional focused work to determine if these or other nutraceuticals can offset the muscle losses, or improve regeneration in sarcopenic muscles of older humans via improving satellite cell function. PMID:25295003

Association Between Sarcopenia and Metabolic Syndrome in Cancer Survivors.

Science.gov (United States)

Lee, Su Jung; Kim, Nam Cho

Advanced cancer treatments have improved survival from cancer, but the incidence of cardiovascular disease in survivors has recently increased. Sarcopenia and metabolic syndrome (MetS) are related to cancer survival, and sarcopenia is an emerging risk factor for cardiovascular disease. However, evidence of a relationship between sarcopenia and MetS in cancer survivors is lacking. The aims of this study were to determine the prevalence of sarcopenia and MetS in cancer survivors and to investigate independent predictors of MetS in cancer survivors. From the fourth and fifth Korea National Health and Nutritional Exam Survey (2008-2011), 798 consecutive cancer survivors were analyzed. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight less than 1 SD below the sex-specific healthy population aged 20 to 39 years. Metabolic syndrome was defined using the National Cholesterol Education Program definition. Among 798 cancer survivors, the prevalence rates of sarcopenia and MetS were 23.1% and 30.0%, respectively. Survivors with sarcopenia were more likely to have a higher waist circumference, body mass index, triglyceride level, and blood pressure and to have a lower high-density lipoprotein cholesterol level compared with those without sarcopenia. In multivariable analysis, sarcopenia was an independent predictor of MetS (odds ratio, 2.76; 95% confidence interval, 1.92-3.97). In addition, age and type of cancer were independent predictors of MetS. Sarcopenia was associated with an increased prevalence of MetS in cancer survivors. Interventions to prevent sarcopenia may be necessary to improve cardiovascular outcome in cancer survivors.

Muscle mass as a target to reduce fatigue in patients with advanced cancer.

Science.gov (United States)

Neefjes, Elisabeth C W; van den Hurk, Renske M; Blauwhoff-Buskermolen, Susanne; van der Vorst, Maurice J D L; Becker-Commissaris, Annemarie; de van der Schueren, Marian A E; Buffart, Laurien M; Verheul, Henk M W

2017-08-01

Cancer-related fatigue (CRF) reduces quality of life and the activity level of patients with cancer. Cancer related fatigue can be reduced by exercise interventions that may concurrently increase muscle mass. We hypothesized that low muscle mass is directly related to higher CRF. A total of 233 patients with advanced cancer starting palliative chemotherapy for lung, colorectal, breast, or prostate cancer were studied. The skeletal muscle index (SMI) was calculated as the patient's muscle mass on level L3 or T4 of a computed tomography scan, adjusted for height. Fatigue was assessed with the Functional Assessment of Chronic Illness Therapy-fatigue questionnaire (cut-off for fatigue fatigue score was 36 (interquartile range 26-44). A higher SMI on level L3 was significantly associated with less CRF for men (B 0.447, P 0.004) but not for women (B - 0.401, P 0.090). No association between SMI on level T4 and the Functional Assessment of Chronic Illness Therapy-fatigue score was found (n = 82). The association between SMI and CRF may lead to the suggestion that male patients may be able to reduce fatigue by exercise interventions aiming at an increased muscle mass. In women with advanced cancer, CRF is more influenced by other causes, because it is not significantly related to muscle mass. To further reduce CRF in both men and women with cancer, multifactorial assessments need to be performed in order to develop effective treatment strategies. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Risk of Fracture in Women with Sarcopenia, Low Bone Mass, or Both.

Science.gov (United States)

Harris, Rebekah; Chang, Yuefang; Beavers, Kristen; Laddu-Patel, Deepika; Bea, Jennifer; Johnson, Karen; LeBoff, Meryl; Womack, Catherine; Wallace, Robert; Li, Wenjun; Crandall, Carolyn; Cauley, Jane

2017-12-01

To determine whether women with sarcopenia and low bone mineral density (BMD) are at greater risk of clinical fractures than those with sarcopenia or low BMD alone. Women's Health Initiative (WHI) Observational and Clinical trials. Three U.S. clinical centers (Pittsburgh, PA; Birmingham, AL; Phoenix/Tucson, AZ). Women (mean age 63.3 ± 0.07) with BMD measurements (N = 10,937). Sarcopenia was defined as appendicular lean mass values corrected for height and fat mass. Low BMD was defined as a femoral neck T-score less than -1.0 based on the Third National Health and Nutrition Examination Survey reference database for white women. Cox proportional hazards analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We followed women for incident fractures over a median of 15.9 years. Participants were classified into mutually exclusive groups based on BMD and sarcopenia status: normal BMD and no sarcopenia (n = 3,857, 35%), sarcopenia alone (n = 774, 7%), low BMD alone (n = 4,907, 45%), and low BMD and sarcopenia (n = 1,399, 13%). Women with low BMD, with (HR = 1.72, 95% CI = 1.44-2.06) or without sarcopenia (HR = 1.58, 95% CI = 1.37-1.83), had greater risk of fracture than women with normal BMD; the difference remained statistically significant after adjustment for important covariates. Women with low BMD, with (HR = 2.78, 95% CI = 1.78-4.30 and without (HR = 2.42, 95% CI = 1.63-3.59) sarcopenia had higher risk of hip fractures. Women with sarcopenia alone had similar HRs to women with normal BMD. Compared to women with normal BMD. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

[Sarcopenia: a concept of growing importance in the management of colorectal cancer].

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Barret, Maximilien; Berthaud, Constance; Taïeb, Julien

2014-06-01

Malnutrition in digestive oncology affects quality of life, increases postoperative complication rates, and results in increased chemotherapy toxicity and reduced survival. Loss of skeletal muscle or sarcopenia is not correlated to body mass index, and might play a major role in the complications of malnutrition in oncology. The diagnosis of sarcopenia can be made on routinely available CT scanner images using consensual cutoff numbers. Lean body mass may be useful in normalizing the doses of hydrophilic chemotherapy drugs, such as fluoropyrimidines. To date, neither nutritional intervention nor specific drugs have proven useful in preventing or treating sarcopenia in cancer patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A comparison of pectoralis versus lumbar skeletal muscle indices for defining sarcopenia in diffuse large B-cell lymphoma - two are better than one.

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Go, Se-Il; Park, Mi Jung; Song, Haa-Na; Kim, Hoon-Gu; Kang, Myoung Hee; Kang, Jung Hun; Kim, Hye Ree; Lee, Gyeong-Won

2017-07-18

Sarcopenia is known to be associated with poor clinical outcome in patients with diffuse large B-cell lymphoma (DLBCL). There is no consensus concerning the optimal method to define sarcopenia in DLBCL. We retrospectively reviewed 193 DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Sarcopenia was classified by the region where the pretreatment skeletal muscle index (SMI) was measured. Both the sarcopenia-L3 and sarcopenia-pectoralis muscle (PM) groups had increased incidences of severe treatment-related toxicities and treatment discontinuation compared with the non-sarcopenia-L3 and non-sarcopenia-PM groups, respectively. The sarcopenia-L3 and non-sarcopenia-L3 groups had 5-year overall survival (OS) rates of 40.5% and 67.8% (p sarcopenia-PM and non-sarcopenia-PM groups had 5-year OS rates of 35.9% and 69.0% (p sarcopenia-L3 alone and sarcopenia-PM alone groups were compared, there were no differences in baseline characteristics, treatment toxicity, or survival. In multivariate analysis, when compared with the non-sarcopenia-both group, OS was significantly worse in the sarcopenia-both group (HR, 2.480; 95% CI, 1.284 - 4.792; p = 0.007), but not in patients with either sarcopenia-L3 alone or sarcopenia-PM alone (p = 0.151). L3- and PM-SMIs are equally useful to define sarcopenia, which is related to intolerance to R-CHOP therapy and to worse survival in patients with DLBCL. More prognostic information can be obtained when these two SMIs are combined to define sarcopenia.

Sarcopenia Is Negatively Related to High Gravitational Impacts Achieved From Day-to-day Physical Activity.

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Hartley, April; Gregson, Celia L; Hannam, Kimberly; Deere, Kevin C; Clark, Emma M; Tobias, Jon H

2018-04-17

Sarcopenia has been associated with reduced physical activity (PA). We aimed to determine if sarcopenia, and specific components of muscle size, function, and physical performance, are associated with high impacts achieved during habitual PA, as these are related to bone strength in community-dwelling older women. Participants were older women from the Cohort of Skeletal Health in Bristol and Avon. We defined sarcopenia using the EWGSOP criteria. Lower limb peak muscle power and force were assessed using Jumping Mechanography (JM). High vertical impacts were assessed by tri-axial accelerometry (at least 1.5g above gravity). Cross-sectional associations were analyzed by linear regression, adjusting for age, height and weight (or fat mass for models including appendicular lean mass index), comorbidities, smoking, alcohol, and Index of Multiple Deprivation. Our analyses included 380 participants, with mean age 76.7 (SD 3.0) years; 242 (64%) also completed JM. In age-adjusted analysis, a negative relationship was observed between severity of sarcopenia and high, but not medium or low, impacts (p = .03 for trend). Regarding components of sarcopenia underlying this relationship, multivariable analyses revealed that gait speed (β 1.47 [95% CI 1.14, 1.89], [β-1] reflects the proportionate increase in high impacts per SD increase in exposure) and peak force (1.40 [1.07, 1.84]) were independently associated with high impacts. Older women with sarcopenia experienced fewer bone-strengthening high impacts than those with presarcopenia or without sarcopenia. To increase bone strengthening activity in older women, interventions need to improve both lower limb muscle force and walking speed.

Prevalence and Clinical Correlates of Sarcopenia, Identified According to the EWGSOP Definition and Diagnostic Algorithm, in Hospitalized Older People: The GLISTEN Study.

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Bianchi, Lara; Abete, Pasquale; Bellelli, Giuseppe; Bo, Mario; Cherubini, Antonio; Corica, Francesco; Di Bari, Mauro; Maggio, Marcello; Manca, Giovanna Maria; Rizzo, Maria Rosaria; Rossi, Andrea P; Landi, Francesco; Volpato, Stefano

2017-10-12

Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia. Cross-sectional analysis of 655 participants enrolled in a multicenter observational study of older adults admitted to 12 acute hospital wards in Italy. Sarcopenia was assessed as low skeletal mass index (kg/m2) plus either low handgrip strength or low walking speed (EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Of the 655 patients (age 81.0 ± 6.8 years; women 51.9%) enrolled in the study, 275 (40.2%) were not able to perform the 4-m walking test because of medical problems. The overall prevalence of sarcopenia on hospital admission was 34.7% (95% confidence interval 28-37) and it steeply increased with aging (p sarcopenia on hospital admission were older and were more likely to be male and to have congestive heart failure, cerebrovascular disease, and severe basic activities of daily living disability. The prevalence of sarcopenia was inversely correlated with body mass index. Based on EWGSOP criteria, prevalence of sarcopenia is extremely high among older adults on admission to acute hospital wards. Older age, male gender, congestive heart failure, cerebrovascular disease, severe activities of daily living disability, and body mass index were the clinical variables significantly associated with the presence of sarcopenia. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sarcopenia in Alcoholic Liver Disease: Clinical and Molecular Advances.

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Dasarathy, Jaividhya; McCullough, Arthur J; Dasarathy, Srinivasan

2017-08-01

Despite advances in treatment of alcohol use disorders that focus on increasing abstinence and reducing recidivism, alcoholic liver disease (ALD) is projected to be the major cause of cirrhosis and its complications. Malnutrition is recognized as the most frequent complication in ALD, and despite the high clinical significance, there are no effective therapies to reverse malnutrition in ALD. Malnutrition is a relatively imprecise term, and sarcopenia or skeletal muscle loss, the major component of malnutrition, is primarily responsible for the adverse clinical consequences in patients with liver disease. It is, therefore, critical to define the specific abnormality (sarcopenia) rather than malnutrition in ALD, so that therapies targeting sarcopenia can be developed. Skeletal muscle mass is maintained by a balance between protein synthesis and proteolysis. Both direct effects of ethanol (EtOH) and its metabolites on the skeletal muscle and the consequences of liver disease result in disturbed proteostasis (protein homeostasis) and consequent sarcopenia. Once cirrhosis develops in patients with ALD, abstinence is unlikely to be effective in completely reversing sarcopenia, as other contributors including hyperammonemia, hormonal, and cytokine abnormalities aggravate sarcopenia and maintain a state of anabolic resistance initiated by EtOH. Cirrhosis is also a state of accelerated starvation, with increased gluconeogenesis that requires amino acid diversion from signaling and substrate functions. Novel therapeutic options are being recognized that are likely to supplant the current "deficiency replacement" approach and instead focus on specific molecular perturbations, given the increasing availability of small molecules that can target specific signaling components. Myostatin antagonists, leucine supplementation, and mitochondrial protective agents are currently in various stages of evaluation in preclinical studies to prevent and reverse sarcopenia, in cirrhosis in

Sarcopenia predicts survival outcomes among patients with urothelial carcinoma of the upper urinary tract undergoing radical nephroureterectomy: a retrospective multi-institution study.

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Ishihara, Hiroki; Kondo, Tsunenori; Omae, Kenji; Takagi, Toshio; Iizuka, Junpei; Kobayashi, Hirohito; Hashimoto, Yasunobu; Tanabe, Kazunari

2017-02-01

We aimed to evaluate the effect of sarcopenia, a condition of low muscle mass, on the survival among patients who were undergoing radical nephroureterectomy (RNU) for urothelial carcinoma of the upper urinary tract (UCUT). We retrospectively reviewed consecutive patients with UCUT (cT[any]N0M0) who underwent RNU between 2003 and 2013 at our department and its affiliated institutions. Preoperative computed tomography images were used to calculate each patient's skeletal muscle index, an indicator of whole-body muscle mass. Sarcopenia was defined according to the sex-specific consensus definitions, based on the patient's skeletal muscle and body mass indexes. We analyzed the relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) after RNU to identify factors that predicted patient survival. A total of 137 patients were included, and 90 patients (65.7 %) were diagnosed with sarcopenia. Compared to the non-sarcopenic patients, the sarcopenic patients had a significant inferior 5-year RFS (48.8 vs. 79.6 %, p = 0.0002), CSS (57.1 vs. 92.6 %, p sarcopenia was an independent predictor of shorter RFS, CSS, and OS (all, p Sarcopenia was an independent predictor of survival among patients with UCUT who were undergoing RNU.

The influence of different muscle mass measurements on the diagnosis of cancer cachexia.

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Blauwhoff-Buskermolen, Susanne; Langius, Jacqueline A E; Becker, Annemarie; Verheul, Henk M W; de van der Schueren, Marian A E

2017-08-01

Progressive loss of muscle mass is a major characteristic of cancer cachexia. Consensus definitions for cachexia provide different options to measure muscle mass. This study describes the effect of different methods to determine muscle mass on the diagnosis of cancer cachexia. In addition, the association of cachexia with other features of cachexia, quality of life, and survival was explored. Prior to chemotherapy, cachexia was assessed by weight loss, body mass index, and muscle mass measurements, the latter by mid-upper arm muscle area (MUAMA), computed tomography (CT) scans, and bio-electrical impedance analysis (BIA). In addition, appetite, inflammation, muscle strength, fatigue, quality of life, and survival were measured, and associations with cachexia were explored. Included were 241 patients with advanced cancer of the lung (36%), colon/rectum (31%), prostate (18%), or breast (15%). Mean age was 64 ± 10 years; 54% was male. Prevalence of low muscle mass was as follows: 13% with MUAMA, 59% with CT, and 93% with BIA. In turn, the prevalence of cachexia was 37, 43, and 48%, whereby weight loss >5% was the most prominent component of being defined cachectic. Irrespective of type of muscle measurement, patients with cachexia presented more often with anorexia, inflammation, low muscle strength, and fatigue and had lower quality of life. Patients with cachexia had worse overall survival compared with patients without cachexia: HRs 2.00 (1.42-2.83) with MUAMA, 1.64 (1.15-2.34) with CT, and 1.50 (1.05-2.14) with BIA. Although the prevalence of low muscle mass in patients with cancer depended largely on the type of muscle measurement, this had little influence on the diagnosis of cancer cachexia (as the majority of patients was already defined cachectic based on weight loss). New studies are warranted to further elucidate the additional role of muscle measurements in the diagnosis of cachexia and the association with clinical outcomes. © 2017 The Authors

Sarcopenia is a novel poor prognostic factor in male patients with pathological Stage I non-small cell lung cancer.

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Tsukioka, Takuma; Nishiyama, Noritoshi; Izumi, Nobuhiro; Mizuguchi, Shinjiro; Komatsu, Hiroaki; Okada, Satoshi; Toda, Michihito; Hara, Kantaro; Ito, Ryuichi; Shibata, Toshihiko

2017-04-01

Sarcopenia is the progressive loss of muscle mass and strength, and has a risk of adverse outcomes such as disability, poor quality of life and death. As prognosis depends not only on disease aggressiveness, but also on a patient's physical condition, sarcopenia can predict survival in patients with various cancer types. However, its effects on postoperative prognosis in patients with localized non-small cell lung cancers (NSCLC) have never been reported. We retrospectively investigated 215 male patients with pathological Stage I NSCLC. L3 muscle index is defined as the cross-section area of muscle at the third lumbar vertebra level, normalized for height, and is a clinical measurement of sarcopenia. We then investigated the effect of preoperative sarcopenia on their postoperative prognosis. Our 215 subjects included 30 patients with sarcopenia. Sarcopenia was significantly associated with body mass index, nutritional condition, serum CYFRA 21-1 level and pathological stage, but not with preoperative respiratory function or performance status. Frequency of postoperative complications, length of postoperative hospital stay, thoracic drainage period or causes of death were not correlated with the presence of sarcopenia. The sarcopenia group had a significantly shorter median overall survival (32 months) than the no-sarcopenia group. Sarcopenia might not affect short-term outcomes in patients with early-stage lung cancer. Sarcopenia was a predictor of poor prognosis in male patients with Stage I NSCLC. As sarcopenic patients with NSCLC patients are at risk for significantly worse outcomes, their treatments require careful planning, even for those with Stage I disease. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prevalence of sarcopenia and its association with socioeconomic ...

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Background: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between ...

Sarcopenia: a chronic complication of type 2 diabetes mellitus.

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Trierweiler, Heloísa; Kisielewicz, Gabrielle; Hoffmann Jonasson, Thaísa; Rasmussen Petterle, Ricardo; Aguiar Moreira, Carolina; Zeghbi Cochenski Borba, Victória

2018-01-01

Diabetics are at increased risk for impaired mobility and strength, frequently related to the disease control. Sarcopenia is the reduction of muscle mass associated with the decrease in muscle strength and/or performance, resulting in worse morbidity in chronic diseases. The objectives of this paper was to assess the prevalence of sarcopenia in patients with type 2 diabetes mellitus (T2DM) and determine its association with diabetes characteristics, progression, and complications, as well as changes in bone mineral density. The sample consisted of patients with T2DM followed at the outpatient clinics of the Serviço de Endocrinologia e Metabologia do Hospital de Clínicas da Universidade Federal do Paraná, from March to August 2016. Participants were men and women above 18 years with T2DM diagnosed at least 1 year earlier. Individuals with chronic diseases, users of any drug that modifies body composition, patients with body mass index (BMI) > 35 or < 18 kg/m 2 , and users of illicit drugs or hormonal or nutritional supplementation were excluded. The selected patients answered questionnaires about demographics, eating habits, and disease characteristics, and performed a bone densitometry exam in a dual energy absorptiometry (total body; spine and femur (total and neck)), a handgrip test by manual dynamometer, and an evaluation of the abdominal circumference (AC). The medical records were reviewed seeking diabetes data and laboratory test results. Patients were matched for sex, age, and race with healthy controls [Control Group (CG)]. The diagnosis of sarcopenia was conducted according to the criteria of the Foundation for National Institute of Health. The final sample consisted of 83 patients in the DG and 83 in the CG. The DG had higher BMI, WC, past history of fractures and lower calcium and healthy diet intake (p < 0.005), compared to the CG. The DG presented a higher frequency of abnormal BMD (osteopenia in 45 (53%), and osteoporosis in 14 (19

Sarcopenia is linked to treatment toxicity in patients with metastatic colorectal cancer.

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Barret, Maximilien; Antoun, Sami; Dalban, Cécile; Malka, David; Mansourbakht, Touraj; Zaanan, Aziz; Latko, Ewa; Taieb, Julien

2014-01-01

Chemotherapy toxicity could be linked to decreased skeletal muscle (sarcopenia). We evaluated the effect of sarcopenia on chemotherapy toxicity among metastatic colorectal cancer (mCRC) patients. All consecutive mCRC patients in 3 hospitals were enrolled in this prospective, cross-sectional, multicenter study. Several nutritional indexes and scores were generated. Computed tomography (CT) images were analyzed to evaluate cross-sectional areas of muscle tissue (MT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Toxicities were evaluated in the 2 mo following clinical evaluation. Fifty-one mCRC patients were included in the study. Sarcopenia was observed in 71% of patients (39% of women and 82% of men) whereas only 4% and 18% were considered as underweight using body mass index (BMI) or severely malnourished using the Nutritional Risk Index (NRI), respectively. Grade 3-4 toxicities were observed in 28% of patients. In multivariate analysis including age, sex, BMI, sarcopenia, SAT, and VAT, the only factor associated with Grade 3-4 toxicities was sarcopenia (odds ratio = 13.55; 95% confidence interval [1.08; 169.31], P = 0.043). In mCRC patients undergoing chemotherapy, sarcopenia was much more frequently observed than visible malnutrition. Despite the small number of patients included in our study, we found sarcopenia to be significantly associated with severe chemotherapy toxicity.

The Association between Total Protein and Vegetable Protein Intake and Low Muscle Mass among the Community-Dwelling Elderly Population in Northern Taiwan

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Ru-Yi Huang

2016-06-01

Full Text Available Sarcopenia, highly linked with fall, frailty, and disease burden, is an emerging problem in aging society. Higher protein intake has been suggested to maintain nitrogen balance. Our objective was to investigate whether pre-sarcopenia status was associated with lower protein intake. A total of 327 community-dwelling elderly people were recruited for a cross-sectional study. We adopted the multivariate nutrient density model to identify associations between low muscle mass and dietary protein intake. The general linear regression models were applied to estimate skeletal muscle mass index across the quartiles of total protein and vegetable protein density. Participants with diets in the lowest quartile of total protein density (<13.2% were at a higher risk for low muscle mass (odds ratio (OR 3.03, 95% confidence interval (CI 1.37–6.72 than those with diets in the highest quartile (≥17.2%. Similarly, participants with diets in the lowest quartile of vegetable protein density (<5.8% were at a higher risk for low muscle mass (OR 2.34, 95% CI 1.14–4.83 than those with diets in the highest quartile (≥9.4%. Furthermore, the estimated skeletal muscle mass index increased significantly across the quartiles of total protein density (p = 0.023 and vegetable protein density (p = 0.025. Increasing daily intakes of total protein and vegetable protein densities appears to confer protection against pre-sarcopenia status.

Association between muscle mass and adipo-metabolic profile: a cross-sectional study in older subjects

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Perna S

2015-02-01

Full Text Available Simone Perna,1,* Davide Guido,2,* Mario Grassi,2 Mariangela Rondanelli1 1Department of Public Health, Experimental and Forensic Medicine, School of Medicine, Endocrinology and Nutrition Unit, University of Pavia, Azienda di Servizi alla Persona di Pavia, Pavia, Italy; 2Medical and Genomic Statistics Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy *These authors contributed equally to this work Background: Sarcopenia, the decrease in muscle mass and function, may lead to various negative health outcomes in elderly. The association among sarcopenia with adiposity and metabolic markers has rarely been studied in the elderly population, with controversial results. The aim of this study is to evaluate this relationship in older subjects.Methods: A cross-sectional study was conducted in 290 elderly patients, focusing on the possible association between muscle mass loss, assessed by relative skeletal muscle mass (RSMM, and an adipo-metabolic profile (AMP defined by adiposity and metabolic biochemical markers. Measurements of body composition were assessed by dual energy X-ray absorptiometry. Biochemical parameters, such as albumin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglycerides, C-reactive protein, and homocysteine and its related markers (folate and vitamin B12 were measured. Using canonical correlation analysis and structural equation modeling, an individual score of AMP was created and correlated with RSMM.Results: The AMP–RSMM correlation was equal to +0.642 (95% confidence interval, +0.512 to +0.773; P<0.001. Hence, a negative association between sarcopenia severity and adiposity/metabolic biochemical markers was highlighted.Conclusion: This study contained a novel way to examine the relationship between the variables of interest based on a composite index of adiposity and metabolic conditions. Results shed light on the orientation and magnitude of

Sarcopenia in children with perforated appendicitis.

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López, Joseph J; Cooper, Jennifer N; Albert, Brett; Adler, Brent; King, Denis; Minneci, Peter C

2017-12-01

Decreased skeletal muscle mass, or sarcopenia, has been shown to be associated with worse postoperative recovery and a higher risk of complications in adult surgical patients. We hypothesized that pediatric patients with complicated appendicitis may experience sarcopenic changes over the course of their treatment. The medical records and computed tomography scans of 36 pediatric complex appendicitis patients who had both preoperative and postoperative computerized tomography scans at our hospital were reviewed. Changes in psoas muscle area were examined using linear mixed models with random patient-level intercept and time effects. The median change in body mass index among all patients from admission to discharge was -0.8 kg/m 2 (interquartile range: -1.3 to -0.2). The mean percentage change in psoas muscle area per day over the course of appendicitis-related treatment was -0.81% (95% confidence interval: -1.12 to -0.50) (P  0.10 for all interactions). Our data suggest that pediatric patients with complex appendicitis experience sarcopenic changes during their hospital admission. Given previous reports that sarcopenia is a significant predictor of worse surgical outcomes, more investigation is warranted to assess whether these changes are associated with postsurgical complications and to evaluate potential interventions that may prevent these changes. Copyright © 2017 Elsevier Inc. All rights reserved.

Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

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Shy Cian Khor

2014-01-01

Full Text Available Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

The evaluation in terms of sarcopenia of patients with fibromyalgia syndrome.

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Koca, Irfan; Savas, Esen; Ozturk, Zeynel Abidin; Boyaci, Ahmet; Tutoglu, Ahmet; Alkan, Samet; Yildiz, Hamit; Kimyon, Gezmiş

2016-11-01

Fibromyalgia syndrome (FMS) is an extra-articular rheumatic illness, characterized by widespread body pain and decreased muscle function. Generalized loss of muscle mass and strength is named as sarcopenia. The objective of this study was to evaluate patients with FMS regarding sarcopenia. This was a cross sectional, case-controlled, single-blinded, and single-centered study. The FMS patients were assessed by Fibromyalgia Impact Questionnaire (FIQ), visual analog scale (VAS), Beck Depression Index (BDI), and Pittsburg Sleep Quality Scale (PSQI). All the participants were evaluated for sarcopenia by bioimpedance analysis (BIA), anthropometric measurements, handgrip strength, and the parameters of walking speed. In this study, 82 patients with FMS and 38 healthy control female subjects were included. VAS, BDI, and PSQI scores were statistically higher in the FMS group than the control group (p FIQ in patients was significantly correlated with BIA, waist circumference, HS, WS, and body mass index (r = 0.267, p = 0.018; r = 0.291, p = 0.010; r = - 0.319, p = 0.004; r = - 0.360, p = 0.001; and r  = 0.304, p = 0.007 respectively). Evaluation of female patients with primary FMS by the sarcopenia parameters could contribute a more objective evaluation during the patients' follow-up.

Clinical effectiveness of protein and amino acid supplementation on building muscle mass in elderly people: a meta-analysis.

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Zhe-rong Xu

Full Text Available A major reason for the loss of mobility in elderly people is the gradual loss of lean body mass known as sarcopenia. Sarcopenia is associated with a lower quality of life and higher healthcare costs. The benefit of strategies that include nutritional intervention, timing of intervention, and physical exercise to improve muscle loss unclear as finding from studies investigating this issue have been inconsistent. We have performed a systematic review and meta-analysis to assess the ability of protein or amino acid supplementation to augment lean body mass or strength of leg muscles in elderly patients.Nine studies met the inclusion criteria of being a prospective comparative study or randomized controlled trial (RCT that compared the efficacy of an amino acid or protein supplement intervention with that of a placebo in elderly people (≥ 65 years for the improvement of lean body mass (LBM, leg muscle strength or reduction associated with sarcopenia.The overall difference in mean change from baseline to the end of study in LBM between the treatment and placebo groups was 0.34 kg which was not significant (P = 0.386. The overall differences in mean change from baseline in double leg press and leg extension were 2.14 kg (P = 0.748 and 2.28 kg (P = 0.265, respectively, between the treatment group and the placebo group.These results indicate that amino acid/protein supplements did not increase lean body mass gain and muscle strength significantly more than placebo in a diverse elderly population.

Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79 : the health, aging and body composition study

NARCIS (Netherlands)

Visser, Marjolein; Kritchevsky, Stephen B; Goodpaster, Bret H; Newman, Anne B; Nevitt, Michael; Stamm, Elizabeth; Harris, Tamara B

OBJECTIVES: The loss of muscle mass with aging, or sarcopenia, is hypothesized to be associated with the deterioration of physical function. Our aim was to determine whether low leg muscle mass and greater fat infiltration in the muscle were associated with poor lower extremity performance (LEP).

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

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Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Aoyama, Tomoki; Arai, Hidenori

2015-08-01

The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. A cluster-randomized controlled trial. This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of Sarcopenia and Dynapenia and Their Determinants in Iranian Peritoneal Dialysis Patients.

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As'habi, Atefeh; Najafi, Iraj; Tabibi, Hadi; Hedayati, Mehdi

2018-01-01

Uremic sarcopenia and dynapenia are prevalent in chronic kidney disease patients, including dialysis patients. The present study was designed to determine the prevalence of sarcopenia and dynapenia and their determinants in peritoneal dialysis (PD) patients in Tehran, Iran. All eligible PD patients at the peritoneal dialysis centers of Tehran were included in this cross-sectional study. Skeletal muscle mass and muscle strength were assessed using bioelectrical impedance analysis and hand grip strength, respectively. Physical performance was determined by a 4-m walk gait speed test. The prevalence rates of dynapenia and sarcopenia were 43.0% and 11.5% in the PD patients, respectively. There were significant associations between the prevalence of dynapenia and the age of patients (P = .03), physical activity level (P = .04), and the presence of diabetes mellitus (P = .005). In addition, a significant association was found between the prevalence of sarcopenia and sex (P = .009). This study indicates that uremic sarcopenia and dynapenia are prevalent in PD patients in Tehran, Iran. These conditions may contribute to physical disability, decreased the quality of life, increased morbidity, and a high mortality rate. Therefore, prevention and treatment of uremic sarcopenia and dynapenia are necessary for Iranian PD patients.

Molecular and cellular mechanisms of muscle aging and sarcopenia and effects of electrical stimulation in seniors

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Laura Barberi

2015-08-01

Full Text Available The prolongation of skeletal muscle strength in aging and neuromuscular disease has been the objective of numerous studies employing a variety of approaches. It is generally accepted that cumulative failure to repair damage related to an overall decrease in anabolic processes is a primary cause of functional impairment in muscle. The functional performance of skeletal muscle tissues declines during post- natal life and it is compromised in different diseases, due to an alteration in muscle fiber composition and an overall decrease in muscle integrity as fibrotic invasions replace functional contractile tissue. Characteristics of skeletal muscle aging and diseases include a conspicuous reduction in myofiber plasticity (due to the progressive loss of muscle mass and in particular of the most powerful fast fibers, alteration in muscle-specific transcriptional mechanisms, and muscle atrophy. An early decrease in protein synthetic rates is followed by a later increase in protein degradation, to affect biochemical, physiological, and morphological parameters of muscle fibers during the aging process. Alterations in regenerative pathways also compromise the functionality of muscle tissues. In this review we will give an overview of the work on molecular and cellular mechanisms of aging and sarcopenia and the effects of electrical stimulation in seniors.

Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

Science.gov (United States)

2014-01-01

Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

Accuracy of Body Mass Index Versus Lean Mass Index for Prediction of Sarcopenia in Older Women.

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Benton, M J; Silva-Smith, A L

2018-01-01

We compared accuracy of body mass index (BMI) versus lean mass index (LMI) to predict sarcopenia in 58 community-dwelling women (74.1±0.9 years). Lean mass was measured with multi-frequency bioelectrical impedance analysis, and strength was measured with Arm Curl test, Chair Stand test, and handgrip dynamometry. Sarcopenia was defined as low LMI. When categorized by BMI, normal women had less absolute lean mass (37.6±1.0 vs. 42.6±0.9 kg; Plean mass (14.1±0.2 vs. 16.1±0.2 kg/m2; Plean mass (44.0±0.7 vs. 35.7±0.7 kg; Plean mass (16.2±0.2 vs. 13.8±0.2 kg/m2; Plean mass and strength. For clinical assessment, calculation of LMI rather than BMI is appropriate.

Cardiometabolic implication of sarcopenia: The Korea National Health and Nutrition Examination Study (KNHANES) 2008–2010

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Kyoung Min Kim; Soo Lim; Sung Hee Choi; Jung Hee Kim; Chan Soo Shin; Kyong Soo Park; Hak Chul Jang

2014-01-01

Background: Sarcopenia, the loss of muscle mass, contributes to various adverse health outcomes in the elderly. It may be associated with cardiometabolic risk. The aim of this study was to investigate the relationships between sarcopenia and cardiometabolic risks and to determine an appropriate operational definition for sarcopenia from a cardiometabolic perspective. Material and methods: Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2010 (n = 20,812, ≥20 ...

Sarcopenia, Dynapenia, and the Impact of Advancing Age on Human Skeletal Muscle Size and Strength; a Quantitative Review

OpenAIRE

Mitchell, W. Kyle; Williams, John; Atherton, Philip; Larvin, Mike; Lund, John; Narici, Marco

2012-01-01

Changing demographics make it ever more important to understand the modifiable risk factors for disability and loss of independence with advancing age. For more than two decades there has been increasing interest in the role of sarcopenia, the age-related loss of muscle or lean mass, in curtailing active and healthy aging. There is now evidence to suggest that lack of strength, or dynapenia, is a more constant factor in compromised wellbeing in old age and it is apparent that the decline in m...

[Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study].

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Osuna-Pozo, Carmen María; Serra-Rexach, José Antonio; Viña, José; Gómez-Cabrera, María del Carmen; Salvá, Antoni; Ruiz, Domingo; Masanes, Ferrán; Lopez-Soto, Alfonso; Formiga, Francesc; Cuesta, Federico; Cruz-Jentoft, Alfonso

2014-01-01

There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure

DEFF Research Database (Denmark)

Aagaard, P; Suetta, C; Caserotti, P

2010-01-01

and size (sarcopenia), resulting in impaired mechanical muscle performance that in turn leads to a reduced functional capacity during everyday tasks. Concurrently, maximum muscle strength, power, and rate of force development are decreased with aging, even in highly trained master athletes. The impairment...

A New Equation to Estimate Muscle Mass from Creatinine and Cystatin C.

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Sun-wook Kim

Full Text Available With evaluation for physical performance, measuring muscle mass is an important step in detecting sarcopenia. However, there are no methods to estimate muscle mass from blood sampling.To develop a new equation to estimate total-body muscle mass with serum creatinine and cystatin C level, we designed a cross-sectional study with separate derivation and validation cohorts. Total body muscle mass and fat mass were measured using dual-energy x-ray absorptiometry (DXA in 214 adults aged 25 to 84 years who underwent physical checkups from 2010 to 2013 in a single tertiary hospital. Serum creatinine and cystatin C levels were also examined.Serum creatinine was correlated with muscle mass (P < .001, and serum cystatin C was correlated with body fat mass (P < .001 after adjusting glomerular filtration rate (GFR. After eliminating GFR, an equation to estimate total-body muscle mass was generated and coefficients were calculated in the derivation cohort. There was an agreement between muscle mass calculated by the novel equation and measured by DXA in both the derivation and validation cohort (P < .001, adjusted R2 = 0.829, β = 0.95, P < .001, adjusted R2 = 0.856, β = 1.03, respectively.The new equation based on serum creatinine and cystatin C levels can be used to estimate total-body muscle mass.

Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

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Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

2017-01-01

To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

Frequency of sarcopenia and associated factors among hospitalized elderly patients.

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Martinez, Bruno Prata; Batista, Anne Karine Menezes Santos; Gomes, Isabela Barboza; Olivieri, Flávia Milholo; Camelier, Fernanda Warken Rosa; Camelier, Aquiles Assunção

2015-05-06

Sarcopenia is an important public health problem that affects mainly elders, and has negative consequences, such as disability and even death. Due to the lack of studies evaluating sarcopenia in elderly persons hospitalized in Brazil, the aim of the present study was to describe the frequency of sarcopenia and associated factors among elders in a hospital in the city of Salvador-Brazil. This cross-sectional study included 110 hospitalized elderly patients in a multi-specialty hospital in Salvador-BA, Brazil. Inclusion criteria: were elders aged ≥60 years between the first and fifth day of hospitalization; who were able to walk without external assistance; with medical permission to walk, and who did not take vasoactive and inotropic drugs. The diagnosis of sarcopenia was determined by combining the reduction in skeletal muscle mass with muscle weakness (women, sarcopenia was described in percentages with their respective confidence intervals and logistic regression was performed for multivariate analysis of factors associated with sarcopenia. Among the 110 patients included, the frequency of sarcopenia was 21.8%, with 10.0% being of the severe type. There was a predominance of clinical profile (59.1%), such as heart disease (20.0%), pneumonia (13.6%) and skin infections (9.1%), with a Charlson index of 5.4 ± 1.8. The factors associated with sarcopenia were age (OR = 1.14; 95% CI = 1.06 to 1.23), clinical profile on admission (OR = 5.15; 95% CI = 1.16-22.9) and smoking (OR = 7.8; 95% CI = 1.53-39.9). The frequency of sarcopenia in elderly hospitalized patients was high (1 in 5 elderly) and anthropometric equation can be a viable and inexpensive alternative to screening and programming intervention in this population.

The etiology and exercise implications of sarcopenia in the elderly

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Jie Yu

2015-06-01

Full Text Available An increasing aging population greatly impacts health care services worldwide. A large percentage of healthcare expenditures for seniors arise from the negative outcomes of muscle loss, also known as sarcopenia. Aging-related losses of muscle strength and quality impair balance, walking ability and endurance and cause negative events such as falls, incident disability and frailty. This review systemically explores the significance of sarcopenia in the elderly and addresses several important physiological mechanisms of sarcopenia. The implications of crucial exercise regimens that improve muscle strength and delay the onset of sarcopenia are also discussed.

Sarcopenia is an independent predictor of complications after colorectal cancer surgery.

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Nakanishi, Ryota; Oki, Eiji; Sasaki, Shun; Hirose, Kosuke; Jogo, Tomoko; Edahiro, Keitaro; Korehisa, Shotaro; Taniguchi, Daisuke; Kudo, Kensuke; Kurashige, Junji; Sugiyama, Masahiko; Nakashima, Yuichiro; Ohgaki, Kippei; Saeki, Hiroshi; Maehara, Yoshihiko

2018-02-01

The significance of sarcopenia after colorectal cancer (CRC) resection has only been discussed with relatively small samples or short follow-up periods. This study aimed to clarify the clinical significance of sarcopenia in a large-sample study. We retrospectively analyzed the relationship between sarcopenia and clinical factors, surgical outcomes, and the survival in 494 patients who underwent CRC surgery between 2004 and 2013. Sarcopenia was defined based on the sex-specific skeletal muscle mass index measured by preoperative computed tomography. Sarcopenia was associated with sex (higher rate of male, P Sarcopenia was associated with higher incidence of all postoperative complications (P = 0.02), especially for patients with Clavien-Dindo classification grade ≥2 (CDC; P = 0.0007). Postoperative hospital stays were significantly longer for sarcopenic patients than for non-sarcopenic patients (P = 0.02). In a multivariate analysis, sarcopenia was an independent predictor for postoperative complications (P = 0.01, odds ratio 1.82, 95% confidence interval 1.13-3.00). Among postoperative complications (CDC grade ≥2), sarcopenia was correlated with non-surgical-site infections (P = 0.03). Sarcopenia was not correlated with the overall or recurrence-free survival. Sarcopenia was an independent predictive factor for postoperative complications after CRC surgery.

Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

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Kim, Hee Yeon; Jang, Jeong Won

2015-01-01

Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for end-stage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research. PMID:26167066

Skeletal Muscle Regeneration, Repair and Remodelling in Aging: The Importance of Muscle Stem Cells and Vascularization.

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Joanisse, Sophie; Nederveen, Joshua P; Snijders, Tim; McKay, Bryon R; Parise, Gianni

2017-01-01

Sarcopenia is the age-related loss of skeletal muscle mass and strength. Ultimately, sarcopenia results in the loss of independence, which imposes a large financial burden on healthcare systems worldwide. A critical facet of sarcopenia is the diminished ability for aged muscle to regenerate, repair and remodel. Over the years, research has focused on elucidating underlying mechanisms of sarcopenia and the impaired ability of muscle to respond to stimuli with aging. Muscle-specific stem cells, termed satellite cells (SC), play an important role in maintaining muscle health throughout the lifespan. It is well established that SC are essential in skeletal muscle regeneration, and it has been hypothesized that a reduction and/or dysregulation of the SC pool, may contribute to accelerated loss of skeletal muscle mass that is observed with advancing age. The preservation of skeletal muscle tissue and its ability to respond to stimuli may be impacted by reduced SC content and impaired function observed with aging. Aging is also associated with a reduction in capillarization of skeletal muscle. We have recently demonstrated that the distance between type II fibre-associated SC and capillaries is greater in older compared to younger adults. The greater distance between SC and capillaries in older adults may contribute to the dysregulation in SC activation ultimately impairing muscle's ability to remodel and, in extreme circumstances, regenerate. This viewpoint will highlight the importance of optimal SC activation in addition to skeletal muscle capillarization to maximize the regenerative potential of skeletal muscle in older adults. © 2016 S. Karger AG, Basel.

A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors.

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Sanada, K; Miyachi, M; Tanimoto, M; Yamamoto, K; Murakami, H; Okumura, S; Gando, Y; Suzuki, K; Tabata, I; Higuchi, M

2010-09-01

In this study of Japanese men and women, we determine reference values for sarcopenia and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease, independent of waist circumference. A total of 1,488 Japanese men and women aged 18-85 years participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index: AMM/height2, kg m-2) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18-40 years. The reference values for class 1 and class 2 sarcopenia were 7.77 and 6.87 kg m-2 in men and 6.12 and 5.46 kg m-2 in women. In subjects both with class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite whole-blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women both with class 1 and class 2 sarcopenia were significantly higher than in normal subjects, using one-way ANCOVA with adjustment for the covariate of waist circumference. Although sarcopenia is associated with thin body mass, it is associated with more glycation of serum proteins in men and with greater arterial stiffness in women, independent of waist circumference.

Consequences of sarcopenia.

NARCIS (Netherlands)

Visser, M.; Schaap, L.A.

2011-01-01

This article describes the relationship of sarcopenia and dynapenia with three important outcomes in aging research: functional status, falls, and mortality. The data from epidemiologic studies conducted in large samples of older men and women suggest that muscle functioning, as indicated by muscle

Association between sarcopenia and quality of life in quilombola elderly in Brazil

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Silva Neto LS

2016-04-01

Full Text Available Luiz Sinésio Silva Neto,1–3 Margô GO Karnikowski,2 Neila B Osório,3 Leonardo C Pereira,2 Marcilio B Mendes,1 Dayani Galato,2 Liana B Gomide Matheus,4 João Paulo C Matheus2,4 1School of Medicine, Federal University of Tocantins, Palmas, Tocantins, 2Graduate Program in Health Sciences and Technology, Ceilândia College, University of Brasilia, Federal District, 3Graduate Program in Education, Federal University of Tocantins, Palmas, Tocantins, 4School of Physiotherapy, Ceilândia College, University of Brasília, Federal District, Brazil Introduction: Currently, there is no single consensual definition of sarcopenia in the literature. This creates a challenge for the evaluation of its prevalence and its direct or indirect impact on the quality of life of elderly populations of different races and ethnicities. Furthermore, no studies as yet have analyzed these variables in populations of elderly subjects of the "quilombola" ethnic group. Objective: We aimed to verify the association between sarcopenia and quality of life in quilombola elderly using the Baumgartner and the European Working Group on Sarcopenia in Older People (EWGSOP criteria. Methods: This was a cross-sectional study of 70 male and female participants (mean age: 65.58±6.67 years. Quality of life was evaluated using the multidimensional 36-item Short-Form Health Survey (SF-36 of the Medical Outcomes Study. Sarcopenia was diagnosed according to the Baumgartner cutoff for appendicular skeletal muscle mass and the criteria recommended by the EWGSOP. Muscle mass and fat mass percentages were analyzed by dual-energy X-ray absorptiometry, while handgrip strength (HGS was evaluated using a hand-held dynamometer. Physical performance was assessed through a gait speed test. Results: The prevalence of sarcopenia was 15% according to the Baumgartner cutoff and 10% according to EWGSOP criteria. Quilombola elderly classified as physically active or very active were at least six times less

Association between -308 G/A TNF-α polymorphism and appendicular skeletal muscle mass index as a marker of sarcopenia in normal weight obese syndrome.

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Di Renzo, L; Sarlo, F; Petramala, L; Iacopino, L; Monteleone, G; Colica, C; De Lorenzo, A

2013-01-01

Normal weight obese (NWO) syndrome is characterized by normal body mass index (BMI), but high amount of fat mass and reduced lean mass. We evaluated allelic frequency of the G/A -308 TNF-α polymorphism and prevalence of sarcopenia in NWO. We enrolled 120 Italian healthy women, distinguished into 3 groups: normal weight (NW); NWO, and preobese-obese (PreOB/OB) and evaluated anthropometric parameters, body composition by dual X-ray absorptiometry, blood tests, and genotyping of G/A -308 TNF-α polymorphism. We found a positive association between sarcopenic obesity and -308 TNF-α polymorphism. All obese women were sarcopenic and were no carrier of mutation (G/G). Among all G/G, NWO showed significant differences in lean mass and total body lean mass (TBLean) with respect to NW and PreOB/OB (P skeletal muscle mass index values, 4.21% of NW were sarcopenic (50% G/G and 50% G/A); the same percentage was observed in NWO subjects (100% G/G). Moreover, 2.10% of PreOB/OB were sarcopenic and all were G/G. Our study suggests that TNF-α polymorphism contributes to sarcopenic obesity susceptibility, in association with body composition. This is the first study that shows the importance of TNF-α polymorphism to determine TBLean variation in NWO syndrome.

Association of sarcopenia with both latent autoimmune diabetes in adults and type 2 diabetes: a cross-sectional study.

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Bouchi, Ryotaro; Fukuda, Tatsuya; Takeuchi, Takato; Nakano, Yujiro; Murakami, Masanori; Minami, Isao; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro

2017-06-01

To investigate the association of both latent autoimmune diabetes in adults (LADA) and type 2 diabetes (T2DM) with muscle mass and function (sarcopenia). Japanese patients with LADA (N=20), T2DM (N=208), and control subjects (N=41) were included in this cross-sectional study. The definition of LADA was based on age of onset (≥30), positive glutamic acid decarboxylase autoantibodies, and insulin requirement within the first 6months after diagnosis. Sarcopenia was diagnosed by the criteria for Asians, using skeletal muscle index (male sarcopenia was higher in LADA (35.0%) than in either T2DM (13.3%) or control subjects (9.8%). LADA was significantly associated with an increased risk for sarcopenia in a multivariate model in which age and body mass index were incorporated (OR: 9.57, 95% CI: 1.86-49.27). In contrast, T2DM tended to be associated with an increased risk for sarcopenia (OR: 2.99, 95% CI: 0.83-10.80). This study provides evidence that patients with LADA are at a high risk for sarcopenia compared to those with T2DM or to control subjects. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Clinical relevance of sarcopenia in chronic kidney disease

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Moorthi, Ranjani N.; Avin, Keith G.

2018-01-01

Purpose of review In this article, we review sarcopenia in chronic kidney disease (CKD). We aim to present how definitions of sarcopenia from the general population may pertain to those with CKD, its assessment by clinicians and emerging therapies for sarcopenia in CKD. For this review, we limit our description and recommendations to patients with CKD who are not on dialysis. Recent findings Poorer parameters of lean mass, strength and physical function are associated with worsening patient-centered outcomes such as limiting mobility, falls and mortality in CKD; however, the magnitude of these associations are different in those with and without CKD. Sarcopenia in CKD is a balance between skeletal muscle regeneration and catabolism, which are both altered in the uremic environment. Multiple pathways are involved in these derangements, which are briefly reviewed. Differences between commonly used terms cachexia, frailty, protein-energy wasting, dynapenia and sarcopenia are described. Therapeutic options in predialysis CKD are not well studied; therefore, we review exercise options and emerging pharmacological therapies. Summary Sarcopenia, now with its own International Classification of Diseases, 10th Revision (ICD-10) code, is of importance clinically and should be accounted for in research studies in patients with CKD. Multiple therapies for sarcopenia are in development and will hopefully be available for our patients in the future. PMID:28198733

Sarcopenia in Patients with Chronic Liver Disease: Can It Be Altered by Diet and Exercise?

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Kappus, Matthew R; Mendoza, Mardeli Saire; Nguyen, Douglas; Medici, Valentina; McClave, Stephen A

2016-08-01

Sarcopenia, a loss of muscle mass, is being increasingly recognized to have a deleterious effect on outcomes in patients with chronic liver disease. Factors related to diet and the inflammatory nature of chronic liver disease contribute to the occurrence of sarcopenia in these patients. Sarcopenia adversely influences quality of life, performance, morbidity, success of transplantation, and even mortality. Specific deficiencies in macronutrients (protein, polyunsaturated fatty acids) and micronutrients (vitamins C, D, and E, carotenoids, and selenium) have been linked to sarcopenia. Lessons learned from nutritional therapy in geriatric patient populations may provide strategies to manage sarcopenia in patients with liver disease. Combining diet modification and nutrient supplementation with an organized program of exercise may help ameliorate or even reverse the effects of sarcopenia on an already complex disease process.

The Long Winding Road to Transplant: How Sarcopenia and Debility Impact Morbidity and Mortality on the Waitlist.

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Bhanji, Rahima A; Carey, Elizabeth J; Yang, Liu; Watt, Kymberly D

2017-10-01

Frailty and sarcopenia are common complications of cirrhosis. Frailty has been described as an increased susceptibility to stressors secondary to a cumulative decline in physiologic reserve; this decline occurs with aging or is a result of the disease process, across multiple organ systems. Sarcopenia, a key component of frailty, is defined as progressive and generalized loss of skeletal muscle mass and strength. The presence of either of these complications is associated with increased morbidity and mortality, as these are tightly linked to decompensation and increased complication rates. Recognition of these entities is critical. Studies have shown improvement in muscle strength and function lead to reduced mortality, suggesting both frailty and sarcopenia are modifiable risk factors. In this review we outline the prevalence of frailty and sarcopenia in cirrhosis and the impact on clinical outcomes such as decompensation, hospitalization, and mortality. Existing and potential novel therapeutic approaches for frailty and sarcopenia are also reviewed. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Sarcopenia is an independent risk factor of dysphagia in hospitalized older people.

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Maeda, Keisuke; Akagi, Junji

2016-04-01

Sarcopenia can cause varying physical function disorders, including dysphagia. Malnutrition, a potential result of dysphagia, can also cause sarcopenia. However, the association between sarcopenia and dysphagia is not fully understood, despite evidence suggesting correlations between deglutition disorders and degenerative loss of muscle mass. The present study investigated the prevalence of dysphagia among patients with sarcopenia, and the association between the two conditions. We included 224 older adults (mean age 82.5 ± 8.4 years; 37.9% men). Individuals who had a stroke or other diseases that could directly cause dysphagia were excluded. Logistic regression analyses were carried out after adjusting for potential causes of sarcopenia, including malnutrition, a low activity of daily living levels and aging, to investigate the relationship between the skeletal muscle index (SMI), prevalence of sarcopenia diagnosed based on a low SMI and grip strength, and swallowing functions. The Mini-Nutritional Assessment short form was used to assess their nutritional status, and the Barthel Index was used to evaluate their activities of daily living. The prevalences of sarcopenia and dysphagia were 76.8% and 30.0%, respectively. Multivariate analysis showed that Barthel Index, SMI and presence of sarcopenia were significant independent factors for the prevalence of dysphagia, after adjusting for sex, age and nutritional status. Furthermore, subgroup analysis showed that SMI in males, and both hand-grip strength and SMI in females were lower in dysphagic subjects than in non-dysphagic subjects (P ≤ 0.01). Sarcopenia was an independent risk factor for dysphagia among older individuals. However, further studies are required to define causality. © 2015 Japan Geriatrics Society.

Nutrition and physical activity for the prevention and treatment of age-related sarcopenia.

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Bosaeus, Ingvar; Rothenberg, Elisabet

2016-05-01

Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.

Malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fracture.

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Yoo, Jun-Il; Ha, Yong-Chan; Choi, Hana; Kim, Kyu-Hwang; Lee, Young-Kyun; Koo, Kyung-Hoi; Park, Ki-Soo

2018-01-01

To evaluate malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fractures, as defined by the criteria of the Asian Working Group on Sarcopenia (AWGS). A total of 327 elderly patients with hip fractures were enrolled in this retrospective observational study. The main outcome measure was the nutritional status and nutritional risk factors for sarcopenia in elderly patients. Diagnosis of sarcopenia was made according to the guidelines of the AWGS. Whole body densitometry analysis was used to measure skeletal muscle mass, and muscle strength was evaluated by handgrip testing. Multivariable regression analysis was utilized to analyze the nutritional risk factors for sarcopenia in patients with hip fractures. Of 327 patients with hip fractures (78 men and 249 women), the prevalence of sarcopenia was 60.3% and 30.1% in men and women, respectively. The rates of three indicators of malnutrition in men and women (low BMI, hypoalbuminemia, and hypoproteinemia) in sarcopenia patients with hip fractures were 23.4%, 31.9%, and 53.2% and 21.3%, 21.3%, and 37.3%, respectively. The prevalence of markers of chronic inflammation (increased CRP and ESR) in men and women with sarcopenia and hip fractures were 74.9% and 52.2%, and 49.3% and 85.1%, respectively. After adjusting for covariates, low BMI and hypoproteinemia in women were associated with a 2.9- and 2.1-fold greater risk of sarcopenia than non-sarcopenia, respectively. The present study revealed a strong relationship between sarcopenia and malnutrition and chronic inflammatory factors in elderly patients with hip fractures.

DIAGNÓSTICO Y PREVALENCIA DE SARCOPENIA: UN ESTUDIO INTERDISCIPLINARIO Y MULTICÉNTRICO CON ADULTOS MAYORES DE CIUDAD AUTÓNOMA DE BUENOS AIRES (CABA Y ÁREA METROPOLITANA, ARGENTINA

Directory of Open Access Journals (Sweden)

Nemerovsky J

2015-05-01

Full Text Available Introduction: Sarcopenia is the loss of strength and muscle mass during aging, and it is a highly prevalent geriatric syndrome. Objectives: To determine the prevalence of sarcopenia in a group of elderly in the metropolitan area of Buenos Aires (Argentina, using the criteria proposed by the European Working Group on sarcopenia in Older People (EWGSOP. Methods: quantitative, descriptive, correlational, cross-sectional study. The sample was 82 adults, 65 and older, non-probabilistic by volunteers. Body Mass Index (BMI, Mini Nutritional Assessment (MNA, Muscle Mass Index (IMM (bioelectrical impedance equipment InBody 120, muscle strength (Jamar 5030J1 Integral Gerontological Rating (VGI, Depression (Test was evaluated Yesavage and protective factors for pathological aging (FAPREN were evaluated. For data analysis we used SPSS statistics 20. Results: A sample of 82 subjects divided as follows, 67 women (81.7% and 15 men (18.3% were evaluated; the average age was 75.37 ± 6.29 years. According to the criteria proposed by the EWGSOP: 55 volunteers (67.1% they had sarcopenia, 34.1% (n = 28 pre-sarcopenia, 28% (n = 23 sarcopenia and 4.9% (n = 4 severe sarcopenia. 54.5% of sarcopenic of overweight and obesity, significant relationship between IMM and BMI (p = 0.0004. No significant relationship between sarcopenia and cognitive impairment or depression was found. Conclusion: The prevalence of sarcopenia is significant in the studied sample. The travel speed, Rise and Walk Test and Barthel showed little functional impact on sarcopenic volunteers. Sarcopenic showed that obesity is significant in the studied sample.

A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates : A competing risk analysis in a national cohort

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van Vugt, Jeroen Laurens Ad; Alferink, Louise Johanna Maria; Buettner, Stefan; Gaspersz, Marcia Patricia; Bot, Daphne; Murad, Sarwa Darwish; Feshtali, Shirin; van Ooijen, Peter Martinus Adranius; Polak, Wojciech Grzegorz; Porte, Robert Jan; van Hoek, Bart; van den Berg, Aad Pieter; Metselaar, Herold Johnny; IJzermans, Jan Nicolaas Maria

BACKGROUND AND AIMS: Frail patients with low MELD scores may be underprioritised. Low skeletal muscle mass (i.e. sarcopenia) has been identified as risk factor for waiting list mortality and a recent study proposed to incorporate sarcopenia in the MELD score (i.e. MELD-Sarcopenia score). We aimed to

Phase angle as bioelectrical marker to identify elderly patients at risk of sarcopenia.

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Basile, Claudia; Della-Morte, David; Cacciatore, Francesco; Gargiulo, Gaetano; Galizia, Gianluigi; Roselli, Mario; Curcio, Francesco; Bonaduce, Domenico; Abete, Pasquale

2014-10-01

Several markers have been associated with sarcopenia in the elderly, including bioelectrical indices. Phase angle (PhA) is an impedance parameter and it has been suggested as an indicator of cellular death. Thus, the relationship between PhA and muscle mass and strength was investigated in 207 consecutively elderly participants (mean age 76.2±6.7years) admitted for multidimensional geriatric evaluation. Muscle strength by grip strength using a hand-held dynamometer and muscle mass was measured by bioimpedentiometer. PhA was calculated directly with its arctangent (resistance/reactance×180°/π). Linear relationship among muscular mass and strength and with clinical and biochemical parameters, including PhA at uni- and multivariate analysis were performed. Linear regression analysis demonstrated that lower level of PhA is associated with reduction in grip strength (y=3.16+0.08x; r=0.49; pelderly subjects and it may be considered a good bioelectrical marker to identify elderly patients at risk of sarcopenia. Copyright © 2014 Elsevier Inc. All rights reserved.

Quality of Life in Sarcopenia and Frailty

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Rizzoli, René; Reginster, Jean-Yves; Arnal, Jean-François; Bautmans, Ivan; Beaudart, Charlotte; Bischoff-Ferrari, Heike; Biver, Emmanuel; Boonen, Steven; Brandi, Maria-Luisa; Chines, Arkadi; Cooper, Cyrus; Epstein, Sol; Fielding, Roger A.; Goodpaster, Bret; Kanis, John A.; Kaufman, Jean-Marc; Laslop, Andrea; Malafarina, Vincenzo; Mañas, Leocadio Rodriguez; Mitlak, Bruce H.; Oreffo, Richard O.; Petermans, Jean; Reid, Kieran; Rolland, Yves; Sayer, Avan Aihie; Tsouderos, Yannis; Visser, Marjolein; Bruyère, Olivier

2013-01-01

The reduced muscle mass and impaired muscle performance that defines sarcopenia in older individuals is associated with increased risk of physical limitation and a variety of chronic diseases. It may also contribute to clinical frailty. A gradual erosion of quality of life (QoL) has been evidenced in these individuals, although much of this research has been done using generic QoL instruments, particularly the SF-36, which may not be ideal in older populations with significant comorbidities. This review and report of an expert meeting, presents the current definitions of these geriatric syndromes (sarcopenia and frailty). It then briefly summarises QoL concepts and specificities in older populations, examines the relevant domains of QoL and what is known concerning QoL decline with these conditions. It calls for a clearer definition of the construct of disability and argues that a disease-specific QoL instrument for sarcopenia/frailty would be an asset for future research and discusses whether there are available and validated components that could be used to this end and whether the psychometric properties of these instruments are sufficiently tested. It calls also for an approach using utility weighting to provide some cost estimates and suggests that a time trade off study could be appropriate. PMID:23828275

Incidence of sarcopenia and dynapenia according to stage in patients with idiopathic Parkinson's disease.

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Yazar, Tamer; Yazar, Hülya Olgun; Zayimoğlu, Emel; Çankaya, Soner

2018-05-12

In this study, the aim was to identify the incidence of sarcopenia and dynapenia according to disease stage among idiopathic Parkinson's disease (IPD) patients and collect data to illuminate precautions related to reducing the disease load. The study was completed with 166 patients divided by stage according to modified Hoehn and Yahr (HYR) criteria and 249 healthy volunteers aged from 18 to 39 and 68 to 75 years met the inclusion criteria. In our prospective and cross-sectional study, patients with IPD according to "UK Brain Bank" diagnostic criteria had the Unified Parkinson's Disease Rating Scale (UPDRS) and HYR scales applied. The patient and control groups had skeletal muscle mass index (SMMI), muscle power, and physical performance assessed. Diagnosis of sarcopenia used the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. In our study, in parallel with the increase in disease stage among IPD patients, the incidence of sarcopenia (led by severe sarcopenia) and dynapenia was high compared to that among the control group of the same age. In the early stages of chronic progressive diseases like IPD, identification of sarcopenia and dynapenia is important considering the limitations of disease-preventive effects in treatments applied after diagnosis.

Increased plasma proline concentrations are associated with sarcopenia in the elderly.

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Toyoshima, Kenji; Nakamura, Marie; Adachi, Yusuke; Imaizumi, Akira; Hakamada, Tomomi; Abe, Yasuko; Kaneko, Eiji; Takahashi, Soiciro; Shimokado, Kentaro

2017-01-01

Metabolome analyses have shown that plasma amino acid profiles reflect various pathological conditions, such as cancer and diabetes mellitus. It remains unclear, however, whether plasma amino acid profiles change in patients with sarcopenia. This study therefore aimed to investigate whether sarcopenia-specific changes occur in plasma amino acid profiles. A total of 153 community-dwelling and seven institutionalized elderly individuals (56 men, 104 women; mean age, 77.7±7.0 years) were recruited for this cross-sectional analysis. We performed a comprehensive geriatric assessment, which included an evaluation of hand grip strength, gait speed, muscle mass and blood chemistry, including the concentration of 18 amino acids. Twenty-eight of the 160 participants met the criteria for sarcopenia established by the Asian Working Group on Sarcopenia in Older People. Univariate analysis revealed associations between the presence of sarcopenia and a higher plasma concentration of proline and glutamine, lower concentrations of histidine and tryptophan. Multivariable analysis revealed that a higher concentration of proline was the only variable independently associated with sarcopenia. The plasma concentration of proline may be useful for understanding the underlying pathophysiology of sarcopenia.

Sarcopenia: prevalence and associated factors among elderly from a Brazilian capital

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Andreia Pelegrini

2018-05-01

Full Text Available Abstract Introduction: Sarcopenia has been currently considered a public health problem, affecting a large portion of the elderly and making them more susceptible to the risk of falls. Objective: To estimate the prevalence and factors associated with sarcopenia in the elderly from a Brazilian capital. Methods: This is an epidemiological study with cross-sectional design involving data of 439 elderly people from Florianópolis city, Santa Catarina state. The factors potentially associated with sarcopenia (sex, age, weight status were tested using binary logistic regression, estimating the Odds Ratio and the respective confidence intervals. Results: The prevalence of sarcopenia was 33.3% (95% CI: 28.9, 36.9. Older women (75 years or more showed less muscle mass in relation to other age groups (p < 0.05. Elderly men, individuals that are 75 years or more, and those with low weight were the subgroups at higher risk for sarcopenia. Obese individuals were less likely to have the outcome. Conclusion: More than one-third of elderly people were diagnosed with sarcopenia. Men, individuals who are older, and those with low weight had a higher risk of having sarcopenia.

Increased plasma proline concentrations are associated with sarcopenia in the elderly.

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Kenji Toyoshima

Full Text Available Metabolome analyses have shown that plasma amino acid profiles reflect various pathological conditions, such as cancer and diabetes mellitus. It remains unclear, however, whether plasma amino acid profiles change in patients with sarcopenia. This study therefore aimed to investigate whether sarcopenia-specific changes occur in plasma amino acid profiles.A total of 153 community-dwelling and seven institutionalized elderly individuals (56 men, 104 women; mean age, 77.7±7.0 years were recruited for this cross-sectional analysis. We performed a comprehensive geriatric assessment, which included an evaluation of hand grip strength, gait speed, muscle mass and blood chemistry, including the concentration of 18 amino acids.Twenty-eight of the 160 participants met the criteria for sarcopenia established by the Asian Working Group on Sarcopenia in Older People. Univariate analysis revealed associations between the presence of sarcopenia and a higher plasma concentration of proline and glutamine, lower concentrations of histidine and tryptophan. Multivariable analysis revealed that a higher concentration of proline was the only variable independently associated with sarcopenia.The plasma concentration of proline may be useful for understanding the underlying pathophysiology of sarcopenia.

Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

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Park, Youn Su; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Lee, Jae Kyung; Kim, Joo Sung; Koh, Seong-Joon

2017-04-01

Although sarcopenia is associated with an increased risk for mortality after the curative resection of colorectal cancer, its influence on the development of advanced colonic neoplasia remains unclear. This study included 1270 subjects aged 40 years or older evaluated with first-time screening colonoscopy at Seoul National University Boramae Health Care Center from January 2010 to February 2015. Skeletal muscle mass was measured with a body composition analyzer (direct segmental multifrequency bioelectrical impedance analysis method). Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with advanced colorectal neoplasia. Of 1270 subjects, 139 (10.9%) were categorized into the sarcopenia group and 1131 (89.1%) into the non-sarcopenia group. In the non-sarcopenia group, 55 subjects (4.9%) had advanced colorectal neoplasia. However, in the sarcopenia group, 19 subjects (13.7%) had advanced colorectal neoplasia, including 1 subject with invasive colorectal cancer (0.7%). In addition, subjects with sarcopenia had a higher prevalence of advanced adenoma (P sarcopenia. According to the multiple logistic regression analysis adjusted for variable confounders, age (odds ratio 1.062, 95% confidence interval 1.032-1.093; P sarcopenia (odds ratio 2.347, 95% confidence interval 1.311-4.202; P = 0.004) were associated with an advanced colorectal neoplasia. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

Fall and Fracture Risk in Sarcopenia and Dynapenia With and Without Obesity: the Role of Lifestyle Interventions.

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Scott, David; Daly, Robin M; Sanders, Kerrie M; Ebeling, Peter R

2015-08-01

Due to their differing etiologies and consequences, it has been proposed that the term "sarcopenia" should revert to its original definition of age-related muscle mass declines, with a separate term, "dynapenia", describing muscle strength and function declines. There is increasing interest in the interactions of sarcopenia and dynapenia with obesity. Despite an apparent protective effect of obesity on fracture, increased adiposity may compromise bone health, and the presence of sarcopenia and/or dynapenia ("sarcopenic obesity" and "dynapenic obesity") may exacerbate the risk of falls and fracture in obese older adults. Weight loss interventions are likely to be beneficial for older adults with sarcopenic and dynapenic obesity but may result in further reductions in muscle and bone health. The addition of exercise including progressive resistance training and nutritional strategies, including protein and vitamin D supplementation, may optimise body composition and muscle function outcomes thereby reducing falls and fracture risk in this population.

Sarcopenia and sarcopenic obesity: do they predict inferior oncologic outcomes after gastrointestinal cancer surgery?

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Kimberly L. Mei

2016-10-01

Full Text Available Abstract Sarcopenia, or loss of skeletal muscle mass and quality, has been studied as part of aging and adverse health outcomes in elderly patients but has only recently been evaluated as a separate condition in cancer patients and important indicator of adverse outcomes. Currently, its definition and method of assessment are still being debated. Sarcopenia within an increasingly obese population has led to a subgroup with sarcopenic obesity, at even higher risk of adverse outcomes. Yet, sarcopenia often goes undiagnosed in these patients, hidden beneath higher body mass index. Identifying sarcopenic and sarcopenic obese subpopulations would allow for more effective treatment plans and potential avoidance of suboptimal outcomes, as well as the chance to intervene and combat these modifiable risk factors. This review will examine available literature on the definition and methods of evaluating sarcopenia and sarcopenic obesity, summarize the effectiveness of sarcopenia and sarcopenic obesity as predictors of outcomes after gastrointestinal cancer surgery, including colorectal cancer resection, liver resection, and pancreatic resection, and outline strategies to minimize the impact of sarcopenia. It is clear that untreated sarcopenia and sarcopenic obesity can be associated with suboptimal post-operative outcomes, especially infections and disease-free or overall survival.

Targeting Inflammation and Downstream Protein Metabolism in Sarcopenia: A Brief Up-Dated Description of Concurrent Exercise and Leucine-Based Multimodal Intervention

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Zhi Xia

2017-06-01

Full Text Available Sarcopenia is defined as the progressive loss of muscle mass with age, and poses a serious threat to the physiological and psychological health of the elderly population with consequential economic and social burdens. Chronic low-grade inflammation plays a central role in the development of sarcopenia such that it alters cellular protein metabolism to favor proteolysis over synthesis, and thereby accelerates muscular atrophy. The purpose of this review is to highlight how exercise and nutrition intervention strategies can attenuate or treat sarcopenia. Resistance exercise increases not only muscle mass but also muscle strength, while aerobic exercise is able to ameliorate the age-related metabolic disorders. Concurrent exercise training integrates the advantages of both aerobic and resistance exercise, and may exert a significant synergistic effect in the aging organism. Higher protein intakes rich in the amino acid leucine appear to restore skeletal muscle protein metabolism balance by rescuing protein synthesis in older adults. There is good reason to believe that a multimodal treatment, a combination of exercise and increased leucine consumption in the diet, can combat some of the muscle loss associated with aging. Future research is needed to consolidate these findings to humans, and to further clarify to what extent and by which mechanisms protein metabolism might be directly involved in sarcopenia pathogenesis and the multimodal treatment responses.

[Detection and evaluation of the role of sarcopenia in elderly patients with cancer treated with chemotherapy. ONCOSARCO project].

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Molina Garrido, Maria José; Guillén Ponce, Carmen; Fernández Félix, Borja Manuel; Muñoz Sánchez, Maria Del Mar; Soriano Rodríguez, Maria Del Carmen; Olaverri Hernández, Amaya; Santiago Crespo, Jose Antonio

To develop a predictive model of toxicity to chemotherapy in elderly patients with cancer, using the variables associated with sarcopenia, and to identify which of these parameters, sarcopenia or frailty, is the best predictor of toxicity to chemotherapy in the elderly. A prospective observational study with patients ≥70 years treated with chemotherapy in the Cancer Unit for the Elderly, in the Medical Oncology Section of the Hospital Virgen de la Luz de Cuenca. The following tests will be performed by each patient before chemotherapy: muscle strength (handgrip, cylindrical handgrip, pinch gauge, hip flexion, knee extension), muscle mass (skeletal muscle mass index), and physical function (gait speed and 5STS test). The occurrence of severe toxicity will be recorded over a period of 4 months of chemotherapy treatment. It will be evaluated, using logistic regression analysis, whether sarcopenia (defined by the European Working Group on Sarcopenia in Older People) or frailty (defined by the phenotype of frailty) is the best predictor of chemotherapy toxicity. Using a multinomial logistic regression analysis, we will try to create the first model to predict toxicity to chemotherapy in elderly patients with diagnosis of cancer, based on the definition of sarcopenia. It is expected that the final analysis of this project will be useful to detect predictive factors of toxicity to chemotherapy in elderly patients with cancer. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Long Sleep Duration is Associated With Sarcopenia in Korean Adults Based on Data from the 2008-2011 KNHANES.

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Kwon, Yu-Jin; Jang, Suk-Yong; Park, Eun-Cheol; Cho, A-Ra; Shim, Jae-Yong; Linton, John A

2017-09-15

Sarcopenia, or loss of muscle mass, occurs with aging and results in frailty, disability, cardiovascular disease, and insulin resistance. Recently, researchers have asserted that sarcopenia is not an inevitable process, but is a modifiable condition. Adequate sleep duration is also important to maintain good physical and mental health. Therefore, the aim of our study was to examine the association between sleep duration and sarcopenia in Korean adults. Data from 16,148 participants (7,158 men and 8,990 women) were analyzed from the 2008-2011 Korean National Health and Nutrition Examination Survey (KNHANES). We defined sarcopenia as one standard deviation below the sex-specific means of the appendicular skeletal muscle/height-squared values of a young reference group. Participants were categorized into 5 groups according to sleep duration. The odds ratios (OR) and 95% confidence intervals (95% CI) for sarcopenia according to sleep duration were calculated using multiple logistic regression analysis. The prevalence of sarcopenia was 14.3% in the total population (males 18.7%, females 9.7%). Compared to the 7 hours of sleep group, the OR (95% CI) for sarcopenia of the long sleep duration group (9 hours or more) was 1.589 (1.100-2.295) after controlling for confounding factors. From the results of subgroup analysis, high-risk groups for sarcopenia are as follows: 40-64 years old (OR = 1.868), normal body mass index (OR = 1.516), smoking (OR = 2.219), no regular exercise (OR = 1.506) in long sleepers. Long sleep duration (9 hours or longer) is independently associated with sarcopenia in Korean adults. © 2017 American Academy of Sleep Medicine

Low appendicular skeletal muscle mass (ASM) with limited mobility and poor health outcomes in middle-aged African Americans.

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Malmstrom, Theodore K; Miller, Douglas K; Herning, Margaret M; Morley, John E

2013-09-01

Recent efforts to provide a consensus definition propose that sarcopenia be considered a clinical syndrome associated with the loss of both skeletal muscle mass and muscle function that occurs with aging. Validation of sarcopenia definitions that include both low muscle mass and poor muscle function is needed. In the population-based African American Health (AAH) study (N = 998 at baseline/wave 1), muscle mass and mobility were evaluated in a clinical testing center in a subsample of N = 319 persons (ages 52-68) at wave 4 (2004). Muscle mass was measured using dual energy x-ray absorptiometry and mobility by a 6-min walk test and 4-m gait walk test. Height corrected appendicular skeletal mass (ASM; 9.0 ± 1.5 in n = 124 males, 8.3 ± 2.2 in n = 195 females) was computed as total lean muscle mass in arms and legs (kilograms) divided by the square of height (meters). Cross-sectional and longitudinal (6-year) associations of low ASM (bottom 25 % AAH sample; ASM with limited mobility (4-m gait walk ≤1 m/s or 6-min walk ASM with limited mobility was associated with IADL difficulties (p = .008) and frailty (p = .040) but not with ADL difficulties or falls in cross-sectional analyses; and with ADL difficulties (p = .022), IADL difficulties (p = .006), frailty (p = .039), and mortality (p = .003) but not with falls in longitudinal analyses adjusted for age and gender. Low ASM alone was marginally associated with mortality (p = .085) but not with other outcomes in cross-sectional or longitudinal analyses. Low ASM with limited mobility is associated with poor health outcomes among late middle-aged African Americans.

Sarcopenia Is Independently Associated with Cardiovascular Disease in Older Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES) from 2009

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Chin, Sang Ouk; Rhee, Sang Youl; Chon, Suk; Hwang, You-Cheol; Jeong, In-Kyung; Oh, Seungjoon; Ahn, Kyu Jeung; Chung, Ho Yeon; Woo, Jeong-taek; Kim, Sung-Woon; Kim, Jin-Woo; Kim, Young Seol; Ahn, Hong-Yup

2013-01-01

Background The association between sarcopenia and cardiovascular disease (CVD) in elderly people has not been adequately assessed. The aim of this study was to investigate whether CVD is more prevalent in subjects with sarcopenia independent of other well-established cardiovascular risk factors in older Korean adults. Method This study utilized the representative Korean population data from the Korea National Health and Nutrition Examination Survey (KNHANES) which was conducted in 2009. Subjects older than 65 years of age with appendicular skeletal muscle mass (ASM) determined by dual energy X-ray absorptiometry were selected. The prevalence of sarcopenia in the older Korean adults was investigated, and it was determined whether sarcopenia is associated with CVD independent of other well-known risk factors. Results 1,578 subjects aged 65 years and older with the data for ASM were selected, and the overall prevalence of sarcopenia was 30.3% in men and 29.3% in women. Most of the risk factors for CVD such as age, waist circumference, body mass index, fasting plasma glucose and total cholesterol showed significant negative correlations with the ratio between appendicular skeletal muscle mass and body weight. Multiple logistic regression analysis demonstrated that sarcopenia was associated with CVD independent of other well-documented risk factors, renal function and medications (OR, 1.768; 95% CI, 1.075–2.909, P = 0.025). Conclusions Sarcopenia was associated with the presence of CVD independent of other cardiovascular risk factors after adjusting renal function and medications. PMID:23533671

Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES from 2009.

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Sang Ouk Chin

Full Text Available BACKGROUND: The association between sarcopenia and cardiovascular disease (CVD in elderly people has not been adequately assessed. The aim of this study was to investigate whether CVD is more prevalent in subjects with sarcopenia independent of other well-established cardiovascular risk factors in older Korean adults. METHOD: This study utilized the representative Korean population data from the Korea National Health and Nutrition Examination Survey (KNHANES which was conducted in 2009. Subjects older than 65 years of age with appendicular skeletal muscle mass (ASM determined by dual energy X-ray absorptiometry were selected. The prevalence of sarcopenia in the older Korean adults was investigated, and it was determined whether sarcopenia is associated with CVD independent of other well-known risk factors. RESULTS: 1,578 subjects aged 65 years and older with the data for ASM were selected, and the overall prevalence of sarcopenia was 30.3% in men and 29.3% in women. Most of the risk factors for CVD such as age, waist circumference, body mass index, fasting plasma glucose and total cholesterol showed significant negative correlations with the ratio between appendicular skeletal muscle mass and body weight. Multiple logistic regression analysis demonstrated that sarcopenia was associated with CVD independent of other well-documented risk factors, renal function and medications (OR, 1.768; 95% CI, 1.075-2.909, P = 0.025. CONCLUSIONS: Sarcopenia was associated with the presence of CVD independent of other cardiovascular risk factors after adjusting renal function and medications.

Beta-hydroxy-beta-methyl butyrate (HMB): From experimental data to clinical evidence in sarcopenia.

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Cruz-Jentoft, Alfonso J

2017-05-28

β-hydroxy-β-methylbutyrate (HMB) is a metabolite derived from leucine and its ketoacid alpha-ketoisocaproate. Leucine has a role in regulating protein synthesis in muscle cells, and HMB seems to be a key active metabolite in such regulation. HMB has been shown to modulate muscle protein degradation by inhibiting the ubiquitin-proteasome proteolytic pathway, to up-regulate protein synthesis via the mTOR pathway, and to stabilize cell membranes via the rate limiting enzyme to cholesterol synthesis HMG- coenzyme A reductase. It can also decrease cell apoptosis, therefore improving cell survival; and increase proliferation and differentiation of muscle stem cell, via the MAPK/ERK and PI3K/Akt pathways. HMB is widely used as an ergogenic supplement by athletes and bodybuilders, usually combined with exercise training, to increase muscle mass and strength. Some studies have explored the role of HMB in chronic diseases associated with muscle wasting (cancer, acquired immunodeficiency syndrome, chronic obstructive pulmonary disease) This review focuses on the role of HMB in the management of sarcopenia (age or disease-related loss of muscle mass and function) in older persons. A small number of studies have shown increases in lean (muscle) mass and some muscle function and physical performance parameters in older people with or without resistance exercise, and preservation of muscle mass during bed rest. However, heterogeneous methodological approaches preclude solid conclusions, and more studies are needed to confirm the role of HMB as a promising agent to treat sarcopenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Clinical Assessment of Sarcopenia and Changes in Body Composition During Neoadjuvant Chemotherapy for Esophageal Cancer.

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Miyata, Hiroshi; Sugimura, Keijiro; Motoori, Masaaki; Fujiwara, Yoshiyuki; Omori, Takeshi; Yanagimoto, Yoshitomo; Ohue, Masayuki; Yasui, Masayoshi; Miyoshi, Norikatsu; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Yano, Masahiko

2017-06-01

The aim of this study was to assess changes in body composition during neoadjuvant chemotherapy (NAC) and investigate whether chemotherapy-related toxicities affect body composition in patients with esophageal cancer. In ninety-four patients who underwent NAC for esophageal cancer, body composition was assessed before and after NAC. Associations between the incidence of toxicities and change in body composition during NAC were investigated. Forty-four (46.8%) and 50 (53.2%) out of 94 patients were defined as having sarcopenia before and after NAC, respectively. There was no significant difference in the incidence of any toxicity pre-treatment between patients with sarcopenia and those without sarcopenia. No significant reduction in skeletal muscle mass or fat mass was observed in the patients during NAC (p=0.501 and p=0.072). However, patients who experienced grade 4 neutropenia or febrile neutropenia during NAC showed a significantly larger decrease in change of skeletal muscle mass compared to patients who did not experience those toxicities (p=0.013 and 0.036, respectively). The incidence of serious adverse events such as febrile neutropenia and grade 4 neutropenia is associated with a significant reduction of skeletal muscle mass during NAC. We should make an effort to reduce the incidence of adverse events in order to maintain an appropriate body composition during NAC. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons.

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Benjumea, Angela-María; Curcio, Carmen-Lucía; Duque, Gustavo; Gómez, Fernando

2018-02-15

The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. This is a cross-sectional study in Manizales, Andes Mountains, Colombia. A cohort of 534 subjects (mean age = 74, 75% female) Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP) including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women. Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men. While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment. After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability. Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.

Vitamin B12 deficiency might be related to sarcopenia in older adults.

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Bulut, Esra Ates; Soysal, Pinar; Aydin, Ali Ekrem; Dokuzlar, Ozge; Kocyigit, Suleyman Emre; Isik, Ahmet Turan

2017-09-01

Sarcopenia and dynapenia are related to repeated falls, mobility restriction, depression, frailty, increased mortality and morbidity. The aim of this study is to evaluate the relationship between vitamin B12 deficiency and sarcopenia in older adults. 403 patients, who attended to outpatient clinic and underwent comprehensive geriatric assessment, were included study. All cases' skeletal muscle mass (SMM), walking speed and hand grip strength were recorded by bioimpedance, 4meter walking test and hand dynamometer respectively. The diagnosis of sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older People. Sarcopenia was accepted low SMM with low handgrip strength or low physical performance. Dynapenia was defined as handgrip strength sarcopenia and dynapenia was 24.8% and 32.0%, respectively. In the patients with sarcopenia, mean age, osteoporosis and frailty were higher, and MMSE, and instrumental ADL scores were lower than the patients without sarcopenia (psarcopenia and dynapenia were 31.6% and 35.4%, respectively, in patients with vitamin B12 levels Sarcopenia, which results in lots of negative clinical outcomes in older adults, might be related to vitamin B12 deficiency. Therefore, these patients should be periodically examined for vitamin B12 deficiency due to the potential negative clinical outcomes such as sarcopenia in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

Populations and outcome measures used in ongoing research in sarcopenia.

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Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

2017-08-01

Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly.

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Maeda, Keisuke; Akagi, Junji

2015-02-01

The aim of this study was to clarify the association between tongue pressure and factors related to sarcopenia such as aging, activities of daily living, nutritional state, and dysphagia. One-hundred-and-four patients without a history of treatment of stroke and without a diagnosis of neurodegenerative disease (36 men and 68 women), with a mean age of 84.1 ± 5.6 years, hospitalized from May 2013 to June 2013 were included in this study. Maximum voluntary tongue pressure against the palate (MTP) was measured by a device consisting of a disposable oral balloon probe. Nutritional and anthropometric parameters such as serum albumin concentration, Mini-Nutritional Assessment short form (MNA-SF), body mass index, arm muscle area (AMA), and others and presence of sarcopenia and dysphagia were analyzed to evaluate their relationships. Correlation analysis and univariate or multivariate analysis were performed. Simple correlation analysis showed that MTP correlated with Barthel index (BI), MNA-SF, serum albumin concentration, body mass index, and AMA. Univariate and multivariate analysis showed that sarcopenia, BI, MNA-SF, and age were the independent explanatory factors for decreased MTP, and the propensity score for dysphagia, including causes of primary or secondary sarcopenia, and the presence of sarcopenia were significantly associated with the presence of dysphagia. Decreased MTP and dysphagia were related to sarcopenia or the causes of sarcopenia in the studied population. Furthermore, the clinical condition of sarcopenic dysphagia may be partially interpreted as the presence of sarcopenia and causal factors for sarcopenia.

Quality of life and physical components linked to sarcopenia: The SarcoPhAge study.

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Beaudart, C; Reginster, J Y; Petermans, J; Gillain, S; Quabron, A; Locquet, M; Slomian, J; Buckinx, F; Bruyère, O

2015-09-01

The SarcoPhAge project is an ongoing longitudinal study following community-dwelling elderly subjects with the objective to assess some health and functional consequences of sarcopenia. The sarcopenia diagnosis algorithm developed by the European Working Group on Sarcopenia in Older People (EWGSOP) and used in the present study needs further validation through cross-sectional and longitudinal studies. The aim of the present study is to assess, using this algorithm, the prevalence of sarcopenia and the clinical components linked to this geriatric syndrome. Participants were community dwelling subjects aged 65years or older. To diagnose sarcopenia, we applied the definition of the EWGSOP. Muscle mass was measured by dual-energy X-ray absorptiometry, muscle strength by a hydraulic dynamometer and physical performance by the SPPB test. Large amounts of socio-demographic, anamnestic and clinical data were collected in all subjects. 534 subjects were recruited for this study (60.5% of women, mean age of 73.5±6.16years), among whom 73 subjects were diagnosed sarcopenic, which represents a global prevalence of 13.7%. Prevalence was 11.8% in men and 14.9% in women. Sarcopenic subjects were older; had a lower Body Mass Index, lower calf, waist, wrist and arm circumferences; presented more cognitive impairments (Mini-Mental State Examination), more comorbidities; were more often malnourished; and consumed more drugs. After adjustment for age, BMI, cognitive status, nutritional status, number of comorbidities and number of drugs, sarcopenic subjects had a worse physical health-related quality of life (SF-36) for the domain of physical functioning, were at higher risk of falls (Timed Up and Go test), were more frail (Fried), presented more often tiredness for the achievement of activities of daily living (Mobility-test), presented less fat mass and obviously less lean mass. Sarcopenic women were also more dependent for housekeeping and handling finances (Lawton scale) than non

Muscle protein turnover in the elderly and its potential contribution to the development of sarcopenia.

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Murton, Andrew J

2015-11-01

The underlying aetiology of sarcopenia appears multifaceted and not yet fully defined, but ultimately involves the gradual loss of muscle protein content over time. The present evidence suggests that the loss of lean tissue in the elderly is exacerbated by low dietary protein intake. Moreover, acute stable-isotope-based methodologies have demonstrated that the muscle anabolic response to a given amount of protein may decline with age, a phenomenon that has been termed anabolic resistance. Although the mechanism responsible for the inability of muscle to mount a satisfactory anabolic response to protein provision with increasing age is presently unknown, it does not appear due to impaired digestion or absorption of dietary protein. Rather, the issue could reside with any combination of: a diminished delivery of amino acids to peripheral tissues, impaired uptake of amino acids into muscle cells, or an inability of amino acids to elicit intracellular events pivotal for anabolism to occur. Despite the presence of anabolic resistance to dietary protein, present evidence suggests that protein supplementation may be able to overcome these issues, particularly when combined with resistance exercise programmes. As such, protein supplementation may prove to be an effective approach to delay the loss of muscle mass with age and has led to calls for the recommended daily intake of protein to be increased for the elderly population.

Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and Nutrition Examination Surveys (KNHANES 2008-2010.

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Kyungdo Han

Full Text Available BACKGROUND: Blood pressure (BP is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear. OBJECTIVE: To investigate whether sarcopenia is associated with hypertension in older Koreans. PARTICIPANTS: We surveyed 2,099 males and 2,747 females aged 60 years or older. MEASUREMENTS: Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt that was <1 SD below the gender-specific mean for young adults. Obesity was defined as a body mass index (BMI ≥ 25 kg/m(2. Subjects were divided into four groups based on presence or absence of obesity or sarcopenia. Hypertension was defined as a systolic BP (SBP ≥ 140 mmHg, a diastolic BP (DBP ≥ 90 mmHg, or a self-reported current use of antihypertensive medications. RESULTS: The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR for having hypertension was 1.5 (95% confidence interval (CI = 1.23-1.84 in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68-2.57 in the obese non-sarcopenia group and 3.0 (95% CI = 2.48-3.63 in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend <0.001. Controlling further for body weight and waist circumference did not change the association between hypertension and sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus. CONCLUSION: Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects.

Skeletal muscle aging: stem cell function and tissue homeostasis

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Victor, Pedro Sousa

2012-01-01

Muscle aging, in particular, is characterized by the reduction of tissue mass and function, which are particularly prominent in geriatric individuals undergoing sarcopenia. The age-associated muscle wasting is also associated with a decline in regenerative ability and a reduction in resident muscle stem cell (satellite cell) number and function. Although sarcopenia is one of the major contributors to the general loss of physiological function, the mechanisms involved in age-related loss of mu...

Sarcopenia as a Determinant of Blood Pressure in Older Koreans: Findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008–2010

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Kwon, Hyuk-Sang; Ko, Seung-Hyun; Lee, Seung-Hwan; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Kim, Mee Kyoung; Park, Yong-Moon

2014-01-01

Background Blood pressure (BP) is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear. Objective To investigate whether sarcopenia is associated with hypertension in older Koreans. Participants We surveyed 2,099 males and 2,747 females aged 60 years or older. Measurements Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was sarcopenia. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, a diastolic BP (DBP) ≥90 mmHg, or a self-reported current use of antihypertensive medications. Results The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR) for having hypertension was 1.5 (95% confidence interval (CI) = 1.23–1.84) in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68–2.57) in the obese non-sarcopenia group and 3.0 (95% CI = 2.48–3.63) in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus. Conclusion Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects. PMID:24489804

Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TEST-III trial

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Kemmler W

2013-10-01

Full Text Available Wolfgang Kemmler, Simon von StengelInstitute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, GermanyBackground: The primary aim of this study was to determine the effect of 12 months of whole-body electromyostimulation (WB-EMS exercise on appendicular muscle mass and abdominal fat mass in subjects specifically at risk for sarcopenia and abdominal obesity, but unable or unwilling to exercise conventionally.Methods: Forty-six lean, nonsportive (<60 minutes of exercise per week, elderly women (aged 75 ± 4 years with abdominal obesity according to International Diabetes Federation criteria were randomly assigned to either a WB-EMS group (n=23 which performed 18 minutes of intermittent, bipolar WB-EMS (85 Hz three sessions in 14 days or an "active" control group (n=23. Whole-body and regional body composition was assessed by dual energy X-ray absorptiometry to determine appendicular muscle mass, upper leg muscle mass, abdominal fat mass, and upper leg fat mass. Maximum strength of the leg extensors was determined isometrically by force plates.Results: After 12 months, significant intergroup differences were detected for the primary endpoints of appendicular muscle mass (0.5% ± 2.0% for the WB-EMS group versus −0.8% ± 2.0% for the control group, P=0.025 and abdominal fat mass (−1.2% ± 5.9% for the WB-EMS group versus 2.4% ± 5.8% for the control group, P=0.038. Further, upper leg lean muscle mass changed favorably in the WB-EMS group (0.5% ± 2.5% versus −0.9% ± 1.9%, in the control group, P=0.033, while effects for upper leg fat mass were borderline nonsignificant (−0.8% ± 3.5% for the WB-EMS group versus 1.0% ± 2.6% for the control group, P=0.050. With respect to functional parameters, the effects for leg extensor strength were again significant, with more favorable changes in the WB-EMS group (9.1% ± 11.2% versus 1.0% ± 8.1% in the control group, P=0.010.Conclusion: In summary, WB-EMS showed positive effects on the

"Chair Stand Test" as Simple Tool for Sarcopenia Screening in Elderly Women.

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Pinheiro, P A; Carneiro, J A O; Coqueiro, R S; Pereira, R; Fernandes, M H

2016-01-01

To investigate the association between sarcopenia and "chair stand test" performance, and evaluate this test as a screening tool for sarcopenia in community-dwelling elderly women. Cross-sectional Survey. 173 female individuals, aged ≥ 60 years and living in the urban area of the municipality of Lafaiete Coutinho, Bahia's inland, Brazil. The association between sarcopenia (defined by muscle mass, strength and/or performance loss) and performance in the "chair stand test" was tested by binary logistic regression technique. The ROC curve parameters were used to evaluate the diagnostic power of the test in sarcopenia screening. The significance level was set at 5 %. The model showed that the time spent for the "chair stand test" was positively associated (OR = 1.08; 95% CI = 1.01 - 1.16, p = 0.024) to sarcopenia, indicating that, for each 1 second increment in the test performance, the sarcopenia's probability increased by 8% in elderly women. The cut-off point that showed the best balance between sensitivity and specificity was 13 seconds. The performance of "chair stand test" showed predictive ability for sarcopenia, being an effective and simple screening tool for sarcopenia in elderly women. This test could be used for screening sarcopenic elderly women, allowing early interventions.

Role of Exercise and Nutrition in the Prevention of Sarcopenia.

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Makanae, Yuhei; Fujita, Satoshi

2015-01-01

The age-associated loss of skeletal muscle mass and strength (sarcopenia) has been shown to increase the risk of injury due to falls and incidence of metabolic complications including insulin resistance and diabetes, which subsequently becomes a significant factor to disability among the elderly population. Nutrient intake is the most important anabolic stimulus for skeletal muscle. Specifically, the amino acid leucine and meal-induced insulin both independently stimulate muscle protein synthesis. However, age-specific changes in muscle anabolic responses to leucine become apparent when sub-maximal amounts of amino acids are administered in older subjects. Furthermore, insulin resistance of muscle protein metabolism with aging has been demonstrated in healthy non-diabetic older subjects. Resistance exercise is another anabolic stimulus which increases myofibrillar muscle protein synthesis in both young and older individuals. The increased muscle anabolism is apparent within 2-3 h after a single bout of heavy resistance exercise and remains elevated up to 2 d following the exercise. The mTOR signaling pathway in skeletal muscle is associated with an increased rate of muscle protein synthesis during the early recovery phase following a bout of resistance exercise. Finally, recent evidence on the cumulative effect of resistance exercise in combination with nutritional supplement on muscle protein metabolism will be discussed to propose a possible preventative measure against sarcopenia.

Loop diuretics are associated with greater risk of sarcopenia in patients with non-dialysis-dependent chronic kidney disease.

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Ishikawa, Seiko; Naito, Shotaro; Iimori, Soichiro; Takahashi, Daiei; Zeniya, Moko; Sato, Hidehiko; Nomura, Naohiro; Sohara, Eisei; Okado, Tomokazu; Uchida, Shinichi; Rai, Tatemitsu

2018-01-01

Sarcopenia, the age-related loss of muscle mass and function, frequently accompanies chronic kidney disease. The aim of this study was to clarify the prevalence and the risk factors for sarcopenia among patients with non-dialysis-dependent chronic kidney disease (NDD-CKD), focusing on the use of drugs. We conducted a cross-sectional analysis on a cohort of 260 patients with NDD-CKD in a university hospital, recruited between June 2016 and March 2017. We extracted data on patient gender, age, cause of chronic kidney disease, use of drugs, and comorbidities that could potentially affect the prevalence of sarcopenia. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia. Logistic regression analysis was performed to analyze the association of each factor on the prevalence of sarcopenia. 25.0% of our study subjects had sarcopenia. Multivariable analysis revealed that an increased risk of sarcopenia was significantly associated with age, male gender, body mass index, diabetes mellitus, and loop diuretic use (odds ratio, 4.59: 95% confidence interval, 1.81-11.61: P-value 0.001). In our cohort, the prevalence of sarcopenia in patients with NDD-CKD was high, and diuretics use, particularly loop diuretic use, was suggested to be a risk factor of sarcopenia. Although loop diuretics are commonly used in patients with CKD, careful consideration of the risk of sarcopenia may be necessary.

Sarcopenia and post-hospital outcomes in older adults: A longitudinal study.

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Pérez-Zepeda, Mario Ulises; Sgaravatti, Aldo; Dent, Elsa

Sarcopenia poses a significant problem for older adults, yet very little is known about this medical condition in the hospital setting. The aims of this hospital-based study were to determine: (i) the prevalence of sarcopenia; (ii) factors associated with sarcopenia; and (iii) the association of sarcopenia with adverse clinical outcomes post-hospitalisation. This is a longitudinal analysis of consecutive patients aged ≥70 years admitted to a Geriatric Management and Evaluation Unit (GEMU) ward. Sarcopenia was classified using the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm, which included: handgrip strength, gait speed, and muscle mass using Bioelectrical Impedance Analysis (BIA). Outcomes were assessed at 12-months post-hospital discharge, and included both mortality and admission to a hospital Emergency Department (ED). Kaplan-Meier methods were used to estimate survival, with Cox proportion hazard models then applied. All regression analyses controlled for age, sex, and co-morbidity. 172 patients (72% female) with a mean (SD) age of 85.2 (6.4) years were included. Sarcopenia was present in 69 (40.1%) of patients. Patients with sarcopenia were twice as likely to die in the 12-months post-hospitalisation (HR, 95% CI=2.23, 1.15-4.34), but did not have an increased likelihood of ED admission. Sarcopenia showed an independent association with 12-month post-hospital mortality in older adults. With the new recognition of sarcopenia as a medical condition with its own unique ICD-10-CM code, awareness and diagnosis of sarcopenia in clinical settings is paramount. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study.

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Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Barillaro, Christian; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

2013-04-01

There is increasing evidence that anorexia of aging can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between anorexia and sarcopenia in elderly persons aged 80 years or older. Data are from the baseline evaluation of 354 subjects enrolled in the ilSIRENTE study. The ilSIRENTE study is a prospective cohort study performed in the mountain community living in the Sirente geographic area (L'Aquila, Abruzzo) in Central Italy. We defined anorexia as the presence of loss of appetite and/or lower food intake. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. The relationship between anorexia and sarcopenia was estimated by deriving odds ratios from the multiple logistic regression models considering sarcopenia as the dependent variable. Nearly 21 % of the study sample showed symptoms of anorexia. Using the EWGSOP-suggested algorithm, 103 subjects (29.1 %) with sarcopenia were identified. Thirty-four (46.6 %) participants were affected by sarcopenia among subjects with anorexia compared to 69 subjects [24.6 %] without anorexia (p sarcopenia compared with non-anorexic subjects (HR 1.88, 95 % CI 1.01-3.51). Anorexia is common among community-dwelling older subjects in Italy. Our results suggest that among old-old subjects, anorexia is independently associated with sarcopenia.

Sarcopenia and critical illness: a deadly combination in the elderly.

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Hanna, Joseph S

2015-03-01

Sarcopenia is the age-associated loss of lean skeletal muscle mass. It is the result of multiple physiologic derangements, ultimately resulting in an insidious functional decline. Frailty, the clinical manifestation of sarcopenia and physical infirmity, is associated with significant morbidity and mortality in the elderly population. The underlying pathology results in a disruption of the individual's ability to tolerate internal and external stressors such as injury or illness. This infirmity results in a markedly increased risk of falls and subsequent morbidity and mortality from the resulting traumatic injury, as well as an inability to recover from medical insults, resulting in critical illness. The increasing prevalence of sarcopenia and critical illness in the elderly has resulted in a deadly intersection of disease processes. The lethality of this combination appears to be the result of altered muscle metabolism, decreased mitochondrial energetics needed to survive critical illness, and a chronically activated catabolic state likely mediated by tumor necrosis factor-α. Furthermore, these underlying derangements are independently associated with an increased incidence of critical illness, resulting in a progressive downward spiral. Considerable evidence has been gathered supporting the role of aggressive nutrition support and physical therapy in improving outcomes. Critical care practitioners must consider sarcopenia and the resulting frailty phenotype a comorbid condition so that the targeted interventions can be instituted and research efforts focused. © 2015 American Society for Parenteral and Enteral Nutrition.

Relationship between major dietary patterns and sarcopenia among menopausal women.

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Mohseni, Reza; Aliakbar, Sima; Abdollahi, Afsoun; Yekaninejad, Mir Saeed; Maghbooli, Zhila; Mirzaei, Khadijeh

2017-12-01

Dietary habits have been associated with the prevalence of the sarcopenia and limited data are available in this field for menopausal women. This study focused on the relationship between dietary patterns and prevalence of the sarcopenia in menopausal women. This cross-sectional study was done in 250 menopausal women 45 years old or older. Dietary data were collected using a food-frequency questionnaire and physical activity was assessed by International Physical Activity Questionnaire (IPAQ). Height, weight, skeletal muscle mass, hand grip, and gait speed were measured and sarcopenia was defined based on European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. Using factor analysis, two major dietary patterns were found: a Western pattern (high in commercial beverage, sugar and dessert, snacks, solid fat, potato, high fat dairy, legume, organ meat, fast food, and sweets) and a Mediterranean pattern (high in olive, low-fat dairy, vegetable, fish, nut, and vegetable oil). After adjusting for confounding variables, for the highest vs the lowest tertiles, the Odds Ratio (OR) for sarcopenia was 1.06 [95% confidence interval (CI), 0.47-2.37] in the Western pattern and 0.40 [95% confidence interval (CI), 0.17-0.89] in the Mediterranean pattern. Our findings suggest that Mediterranean dietary pattern has a favorable role in the prevention of sarcopenia.

Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women.

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Lee, Eun Young; Lee, Su Jin; Kim, Kyoung Min; Seo, Da Hea; Lee, Seung Won; Choi, Han Sol; Kim, Hyeon Chang; Youm, Yoosik; Kim, Chang Oh; Rhee, Yumie

2017-06-01

Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.

Association between −308 G/A TNF-α Polymorphism and Appendicular Skeletal Muscle Mass Index as a Marker of Sarcopenia in Normal Weight Obese Syndrome

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L. Di Renzo

2013-01-01

Full Text Available Background and Aim. Normal weight obese (NWO syndrome is characterized by normal body mass index (BMI, but high amount of fat mass and reduced lean mass. We evaluated allelic frequency of the G/A −308 TNF-α polymorphism and prevalence of sarcopenia in NWO. Methods. We enrolled 120 Italian healthy women, distinguished into 3 groups: normal weight (NW; NWO, and preobese-obese (PreOB/OB and evaluated anthropometric parameters, body composition by dual X-ray absorptiometry, blood tests, and genotyping of G/A −308 TNF-α polymorphism. Results. We found a positive association between sarcopenic obesity and −308 TNF-α polymorphism. All obese women were sarcopenic and were no carrier of mutation (G/G. Among all G/G, NWO showed significant differences in lean mass and total body lean mass (TBLean with respect to NW and PreOB/OB (P<0.001. Regarding appendicular skeletal muscle mass index values, 4.21% of NW were sarcopenic (50% G/G and 50% G/A; the same percentage was observed in NWO subjects (100% G/G. Moreover, 2.10% of PreOB/OB were sarcopenic and all were G/G. Conclusion. Our study suggests that TNF-α polymorphism contributes to sarcopenic obesity susceptibility, in association with body composition. This is the first study that shows the importance of TNF-α polymorphism to determine TBLean variation in NWO syndrome.

Publication trends in cachexia and sarcopenia in elderly heart failure patients.

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Springer, Jochen; Anker, Stefan D

2016-12-01

The loss of skeletal mass - sarcopenia and cachexia - is considered to be a major contributor to morbidity and mortality in chronic heart failure (CHF). Unfortunately, sarcopenia is generally considered to be a geriatric syndrome, but not necessarily seen as a comorbidity in CHF, even though it has a wide range of adverse health outcomes. While there were 15,574 publication with the title word "heart failure" in PubMed in the 5‑year period from 1 June 2011 to 31 May 2016, only 22 or 71 publications were found with the search combination "sarcopenia" or "cachexia" (title word) and "heart failure" (all fields), respectively. This shows very clearly that loss of muscle quality and function due to heart failure is still an underappreciated problem in the medical field.

Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study.

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Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

2012-10-01

Sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals. We evaluated the relationship between sarcopenia and 2-year risk of falls in a population of persons aged 80 years or older. Data are from the baseline and follow-up evaluations of the Aging and Longevity Study in the Sirente Geographic Area (ilSIRENTE Study) (n=260). According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was diagnosed in presence of low muscle mass (mid-arm muscle circumference) plus either low muscle strength (hand grip) or low physical performance (4-m walking speed). The primary outcome measure was the incident falls during the follow-up period of 2 years. The relationship between sarcopenia and incident falls was estimated by deriving hazard ratios (HRs) from multiple logistic regression models considering the dependent variable of interest at least one fall during the follow-up period. Sixty-six participants (25.4%) were identified as affected by sarcopenia. Eighteen out of 66 (27.3%) participants with sarcopenia and 19 out of 194 (9.8%) without sarcopenia reported incident falls during the two-year follow-up of the study (pgender, cognitive impairment, ADL impairment, sensory impairments, BMI, depression, physical activity, cholesterol, stroke, diabetes, number of medications, and C-reactive protein, participants with sarcopenia had a higher risk of incident falls compared with non sarcopenic subjects (adjusted hazard ratio [HR], 3.23; 95% confidence interval [CI], 1.25-8.29). The present study suggests that sarcopenia - assessed using the EWGSOP algorithm - is highly prevalent among elderly persons without gender differences (25%). Sarcopenic participants were over three times more likely to fall during a follow-up period of 2 years relative to non sarcopenic individuals, regardless of age, gender and other confounding factors. Copyright © 2012 Elsevier Ltd and European Society for Clinical

Differences in body composition and physical functions associated with sarcopenia in Chinese elderly: reference values and prevalence.

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Zeng, Ping; Wu, Sinan; Han, Yiwen; Liu, Jingmin; Zhang, Yi; Zhang, Enyi; Zhang, Yan; Gong, Huan; Pang, Jing; Tang, Zhili; Liu, Hongxing; Zheng, Xiuyuan; Zhang, Tiemei

2015-01-01

This study investigates the age-related differences in skeletal muscle mass (SM), muscle strength and physical performance in mainland Chinese. Based on available data, the reference values (criteria) for the definition of sarcopenia in elderly Chinese were explored. Body composition measurements were obtained using a bioelectrical impedance analyzer (BIA); muscle strength was determined by handgrip strength (HS); and physical function was evaluated by the subjects' 6-m gait speed (GS). In this study, HS and GS declined significantly after 55 years and very dramatically after 75 years. Appendicular SM index of elderly males and females, respectively. Utilizing Asian Working Group for Sarcopenia (AWGS) criteria in our population results in a very low prevalence of low SM and low GS. If Western criteria for sarcopenia were adopted, the prevalence of low GS and low HS would be 2-4 times higher in the studied population, also exhibiting significant gender differences. These findings indicate that it is necessary to establish an outcomes-based and ethnic-specific set of reference values for the diagnosis of sarcopenia in elderly Chinese. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons

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Angela-María Benjumea

2018-02-01

Full Text Available BACKGROUND: The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. AIM: This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. METHODS: This is a cross-sectional study in Manizales, Andes Mountains, Colombia.  534 subjects (mean age = 74, 75% female Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP including an index of skeletal mass, muscle strength, and gait speed. Dynapenia was defined as a handgrip force ≤ 30 kg for men and ≤ 20 kg for women. RESULTS: Dynapenia and sarcopenia were present in 84.6% and 71.2% respectively. Both were more prevalent in older subjects and women than men.  While sarcopenia was associated with body mass index and hypertension, dynapenia was associated with hypothyroidism and visual impairment.  After controlling for all covariates, sarcopenia was associated with low IADL and mobility disability. CONCLUSIONS: Sarcopenia was associated with mobility, ADL and IADL disability. Dynapenia was not associated with disability in this high - risk population. Systematic assessment of sarcopenia should be implemented in falls and fractures clinics to identify sarcopenia and develop interventions to prevent functional decline among elderly individuals.

White blood cell counts, insulin resistance, vitamin D levels and sarcopenia in Korean elderly men.

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Kim, Sang-Hwan; Kwon, Hyun Seok; Hwang, Hee-Jin

2017-05-01

Sarcopenia is a major determinant of frailty, disability and mortality in the elderly. Whether low-grade inflammation, insulin resistance and vitamin D are independently associated with sarcopenia remains unclear. In our study, sarcopenia was defined as an appendicular skeletal muscle mass divided by height squared (ASM/Ht 2 ) that was sarcopenia in Korean elderly men aged more than 65 years was 11.2%. ASM/Ht 2 were positively associated with vitamin D levels, but negatively associated with white blood cell counts and HOMA-IR by multiple regression analysis. After adjustment for covariables, sarcopenia was associated with the highest quartile of WBC counts (OR = 2.93, 95% CI = 1.21-7.14) and the highest quartile of serum vitamin D levels (OR = 0.38, 95% CI = 0.15-0.95). In conclusion, the study findings suggest that higher WBC counts and lower vitamin D levels are independently associated with the presence of sarcopenia in community-dwelling elderly men. They also provide a basis for further studies of the complex immune-endocrine network in sarcopenia.

Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial

NARCIS (Netherlands)

Bauer, J.M.; Verlaan, S.; Bautmans, I.; Brandt, K.; Donini, L.M.; Maggio, M.; McMurdo, M.E.T.; Mets, T.; Seal, C.; Wijers, S.L.; Ceda, G.P.; De Vito, G.; Donders, G.; Drey, M.; Greig, C.; Holmback, U.; Narici, M.; McPhee, J.; Poggiogalle, E.; Power, D.; Scafoglieri, A.; Schultz, R.; Sieber, C.C.; Cederholm, T.

2015-01-01

Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability. Objective: To

Current review of the SarQoL®: a health-related quality of life questionnaire specific to sarcopenia.

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Beaudart, Charlotte; Reginster, Jean-Yves; Geerinck, Anton; Locquet, Médéa; Bruyère, Olivier

2017-08-01

Sarcopenia, defined by a progressive and generalized loss of muscle mass and muscle function, is associated with many harmful clinical consequences. Several studies have reported the impact of sarcopenia on health-related quality of life (HRQoL) using generic quality of life (QoL) questionnaires. The results of these observational studies are quite heterogenous. Indeed, generic tools may not be able to detect subtle effects of sarcopenia on QoL. Recently, a sarcopenia-specific HRQoL questionnaire was developed and validated in a population of sarcopenic subjects to more accurately assess the impact of sarcopenia on QoL. Areas covered: The purpose of this review is to present evidence regarding the impact of sarcopenia on QoL and to introduce a new specific HRQoL questionnaire, the SarQoL®. Expert commentary: The self-administered SarQoL®, initially developed in French, comprises 55 items translated into 22 questions. The questionnaire has been shown to be understandable, valid, consistent, and reliable and can therefore be recommended for clinical and research purposes. The questionnaire is now available in 11 different languages with another 20 translations in progress. The instrument's sensitivity to change still needs to be assessed in future longitudinal studies.

Dihydrotestosterone treatment rescues the decline in protein synthesis as a result of sarcopenia in isolated mouse skeletal muscle fibres.

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Wendowski, Oskar; Redshaw, Zoe; Mutungi, Gabriel

2017-02-01

Sarcopenia, the progressive decline in skeletal muscle mass and function with age, is a debilitating condition. It leads to inactivity, falls, and loss of independence. Despite this, its cause(s) and the underlying mechanism(s) are still poorly understood. In this study, small skeletal muscle fibre bundles isolated from the extensor digitorum longus (a fast-twitch muscle) and the soleus (a slow-twitch muscle) of adult mice of different ages (range 100-900 days old) were used to investigate the effects of ageing and dihydrotestosterone (DHT) treatment on protein synthesis as well as the expression and function of two amino acid transporters; the sodium-coupled neutral amino acid transporter (SNAT) 2, and the sodium-independent L-type amino-acid transporter (LAT) 2. At all ages investigated, protein synthesis was always higher in the slow-twitch than in the fast-twitch muscle fibres and decreased with age in both fibre types. However, the decline was greater in the fast-twitch than in the slow-twitch fibres and was accompanied by a reduction in the expression of SNAT2 and LAT2 at the protein level. Again, the decrease in the expression of the amino acid transporters was greater in the fast-twitch than in the slow-twitch fibres. In contrast, ageing had no effect on SNAT2 and LAT2 expressions at the mRNA level. Treating the muscle fibre bundles with physiological concentrations (~2 nM) of DHT for 1 h completely reversed the effects of ageing on protein synthesis and the expression of SNAT2 and LAT2 protein in both fibre types. From the observations that ageing is accompanied by a reduction in protein synthesis and transporter expression and that these effects are reversed by DHT treatment, we conclude that sarcopenia arises from an age-dependent reduction in protein synthesis caused, in part, by the lack of or by the low bioavailability of the male sex steroid, DHT.

Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease.

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Kim, Jwa-Kyung; Choi, Sun Ryoung; Choi, Myung Jin; Kim, Sung Gyun; Lee, Young Ki; Noh, Jung Woo; Kim, Hyung Jik; Song, Young Rim

2014-02-01

We investigated the prevalence of sarcopenia in elderly patients with end-stage renal disease (ESRD) and its relationship with various markers of nutrition, cognitive function, depressive symptoms, inflammation and β2-microglobulin. A cross-sectional study was conducted with 95 patients having ESRD aged over 50 years. Sarcopenia was defined as a decline in both muscle mass and strength. The mean age was 63.9 ± 10.0 years; 56.8% were men and 52.6% had diabetes. Sarcopenia was highly prevalent in elderly patients with ESRD (37.0% in men and 29.3% in women). Subjective Global Assessment (SGA), inflammatory markers and β2-microglobulin levels were significantly associated with sarcopenia, even after adjustment for age, gender, diabetes, and body mass index. Additionally, patients with depressive symptoms showed a higher risk of sarcopenia relative to those without depressive symptoms (odds ratio, OR = 6.87, 95% confidence interval, CI = 2.06-22.96) and sarcopenia was more likely to be present in patients with mild cognitive dysfunction (OR = 6.35, 95% CI = 1.62-34.96). Sarcopenia is highly prevalent in elderly patients with ESRD and is closely associated with SGA, inflammatory markers, β2-microglobulin, depression and cognitive dysfunction. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Malnutrition-Sarcopenia Syndrome: Is This the Future of Nutrition Screening and Assessment for Older Adults?

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Maurits F. J. Vandewoude

2012-01-01

Full Text Available Malnutrition is common across varying patient populations, particularly older adults, and sarcopenia prevalence increases with advancing age. Both malnutrition and sarcopenia are associated with substantial adverse outcomes affecting both the patient and the healthcare system, including increased morbidity, mortality, rehospitalization rates, and healthcare costs. Healthcare practitioners may assess patients for either malnutrition or sarcopenia; however, many patients clinically present with both conditions, resulting in the syndrome, Malnutrition-Sarcopenia Syndrome, which is the clinical presentation of both malnutrition and accelerated age-associated loss of lean body mass, strength, and/or functionality. Clinicians are urged to screen, assess, and treat these conditions currently so as to adequately address the full spectrum of patients’ nutritional issues. By examining aspects of both conditions, clinicians can more fully assess their patients’ clinical and nutritional status and can tailor targeted therapies to meet their needs and improve outcomes. This proposed syndrome embodies the inherent association of malnutrition and sarcopenia, highlighting their combined impact on clinical outcomes. The objective of this review paper is to characterize Malnutrition-Sarcopenia Syndrome to advance clinical practice, by providing clinicians with the necessary background information to integrate nutritional assessment along with loss of muscle mass and functionality in their everyday clinical practice.

[Analysis of the dietary factors on sarcopenia in elderly in Beijing].

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Xia, Zhiwei; Meng, Liping; Man, Qingqing; Li, Lixiang; Song, Pengkun; Li, Yuqian; Gao, Yixiong; Ja, Shanshan; Zhang, Jian

2016-05-01

To analyze the dietary factors on sarcopenia in elderly in Beijing and provide nutritional recommendations for the sarcopenia. A total of 830 participants aged 60 and above and without serious diseases were selected from two representative communities in Beijing. A cross-sectional research design was used, including inquiry investigation, dietary surveys (food frequency questionnaire) anthropometry, muscle mass and functional assessment. The prevalence of sarcopenia was 20.1% in this area, the men was 17.1%, while the women was 21.6% (P > 0.05). The prevalence of sarcopenia in the five age groups has significant statistically difference (chi2 = 19.03, P = 0.0008) and increased with age rising (Z = -4.18, P sarcopenia would be downward if the time of exercise prolonged and body mass index (BMI) increased (P sarcopenia in the group of meat consumption 70 g/d was 24.5%,19.9% and 15. 3% (chi2 = 6.02, P = 0.0492), respectively (trend test for groups comparison, Z = 2.45, P =0.0141). The prevalence of sarcopenia in the group of egg consumption 60 g/d was 25.8%, 18.7% and 11.3% (chi2 = 6.50, P = 0.0388), respectively ( trend test for groups comparison, Z =2. 55, P = 0.0109). The prevalence of sarcopenia in the group of energy consumption 2109 kcal/d was 25.8%,19.5% and 15. 0% (x2 = 8. 19 , P = 0. 0158), respectively (trend test for groups comparison, Z = 2.87, P = 0.0042). The prevalence of sarcopenia in the group of protein consumption 78.4 g/d was 25.3%, 18.2% and 16.7% (chi2 = 5.97, P = 0. 0505 ) , respectively (Z = 2.28, P = 0.0227). After controlling the influence of age, BMI, exercise and education, meat consumption (beta = -0.1703, P = 0.0119), egg consumption (beta = -0.1545, P = 0.0302) and the high quality protein consumption (beta = -0.1805, P = 0.0302) were negatively related with sarcopenia. Animal food, such as meet and egg, is an important protective factor for sarcopenia. Therefore, it is the first important thing for the elderly to ensure adequate energy

Sarcopenia Impairs Prognosis of Patients with Hepatocellular Carcinoma: The Role of Liver Functional Reserve and Tumor-Related Factors in Loss of Skeletal Muscle Volume.

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Imai, Kenji; Takai, Koji; Watanabe, Satoshi; Hanai, Tatsunori; Suetsugu, Atsushi; Shiraki, Makoto; Shimizu, Masahito

2017-09-22

Sarcopenia impairs survival in patients with hepatocellular carcinoma (HCC). This study aimed to clarify the factors that contribute to decreased skeletal muscle volume in patients with HCC. The third lumbar vertebra skeletal muscle index (L3 SMI) in 351 consecutive patients with HCC was calculated to identify sarcopenia. Sarcopenia was defined as an L3 SMI value ≤ 29.0 cm²/m² for women and ≤ 36.0 cm²/m² for men. The factors affecting L3 SMI were analyzed by multiple linear regression analysis and tree-based models. Of the 351 HCC patients, 33 were diagnosed as having sarcopenia and showed poor prognosis compared with non-sarcopenia patients ( p = 0.007). However, this significant difference disappeared after the adjustments for age, sex, Child-Pugh score, maximum tumor size, tumor number, and the degree of portal vein invasion by propensity score matching analysis. Multiple linear regression analysis showed that age ( p = 0.015) and sex ( p < 0.0001) were significantly correlated with a decrease in L3 SMI. Tree-based models revealed that sex (female) is the most significant factor that affects L3 SMI. In male patients, L3 SMI was decreased by aging, increased Child-Pugh score (≥56 years), and enlarged tumor size (<56 years). Maintaining liver functional reserve and early diagnosis and therapy for HCC are vital to prevent skeletal muscle depletion and improve the prognosis of patients with HCC.

The endocrine system and sarcopenia: potential therapeutic benefits.

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McIntire, Kevin L; Hoffman, Andrew R

2011-12-01

Age related muscle loss, known as sarcopenia, is a major factor in disability, loss of mobility and quality of life in the elderly. There are many proposed mechanisms of age-related muscle loss that include the endocrine system. A variety of hormones regulate growth, development and metabolism throughout the lifespan. Hormone activity may change with age as a result of reduced hormone secretion or decreased tissue responsiveness. This review will focus on the complex interplay between the endocrine system, aging and skeletal muscle and will present possible benefits of therapeutic interventions for sarcopenia.

Sarcopenia Is Risk Factor for Development of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement.

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Nardelli, Silvia; Lattanzi, Barbara; Torrisi, Sabrina; Greco, Francesca; Farcomeni, Alessio; Gioia, Stefania; Merli, Manuela; Riggio, Oliviero

2017-06-01

Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7.6 ± 1.5) who received TIPS from January 2013 through December 2014 at a tertiary center in Rome, Italy. All patients underwent computed tomography analysis at the level of the third lumbar vertebrae to determine the skeletal muscle index; sarcopenia was defined by sex-specific cut-off values. We estimated the incidence of the first episode of HE after TIPS, taking into account the competing risk nature of the data (death or liver transplantation). Twenty-six patients (57%) were found to have sarcopenia. Twenty-one patients (46%) developed overt HE in the 7 ± 9 months after TIPS placement; all of these patients were sarcopenic, according to the skeletal muscle index. Of the 25 patients without HE after TIPS, only 5 had sarcopenia. In multivariate analysis, model for end-stage liver disease score (subdistribution hazard ratio, 1.16; 95% confidence interval, 1.01-1.34; P = .043) and sarcopenia (subdistribution hazard ratio, 31.3; 95% confidence interval, 4.5-218.07; P Sarcopenia should be considered in selecting patients for TIPS therapy. Nutritional status should be evaluated in patients with sarcopenia before TIPS placement, which might reduce the incidence of HE. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Effect of nutritional supplement combined with exercise intervention on sarcopenia in the elderly: A meta-analysis

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Dan Luo

2017-10-01

Full Text Available Objectives: This systematic review was conducted to explore whether nutritional supplement can improve the benefits of exercise intervention on sarcopenia in the elderly. Methods: Databases, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, WANFANG, and VIP, were searched. All related papers with randomized controlled trials (RCT methodology that were included in the databases from inception to 19 July 2016 were selected for the study. The tool “assessing risk of bias” from Cochrane Handbook 5.10 was used to evaluate the quality of included papers. A meta-analysis of eligible studies was performed using Stata12.0. Data that we were unable to convene or merge were subjected to descriptive analysis. Results: Six trials were included in our study, which included 429 elderly patients with sarcopenia. The overall methodological quality of the trials was moderate. Compared with the exercise group, patients who were given nutritional supplements gained a bigger boost in fat-free mass (standard mean difference (SMD = 5.78, 95% CI: 5.17 to 6.40, P = 0.000 and muscle mass (SMD = 2.048, 95% CI: 0.907 to 3.189, P = 0.000, as well as showed enhancement of keen extension strength (SMD = 1.08, 95% CI: 0.71 to 1.45, P = 0.000 and usual walk speed (SMD = 0.570, 95% CI: 0.19 to 0.95, P = 0.003. Conclusion: Nutritional supplementation may magnify the effect of exercise intervention on sarcopenia elderly in terms of muscle mass, muscle strength, and physical performance. Inconsistencies were present among research studies. More robust studies are needed to determine the most suitable type of nutrient and target population and to explore the actual role of combined intervention in managing sarcopenia in the elderly. Keywords: Sarcopenia, Exercise, Nutritional status, Meta-analysis

Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer

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Tamandl, Dietmar; Baltzer, Pascal A.; Ba-Ssalamah, Ahmed; Paireder, Matthias; Asari, Reza; Schoppmann, Sebastian F.

2016-01-01

To assess the impact of sarcopenia and alterations in body composition parameters (BCPs) on survival after surgery for oesophageal and gastro-oesophageal junction cancer (OC). 200 consecutive patients who underwent resection for OC between 2006 and 2013 were selected. Preoperative CTs were used to assess markers of sarcopenia and body composition (total muscle area [TMA], fat-free mass index [FFMi], fat mass index [FMi], subcutaneous, visceral and retrorenal fat [RRF], muscle attenuation). Cox regression was used to assess the primary outcome parameter of overall survival (OS) after surgery. 130 patients (65 %) had sarcopenia based on preoperative CT examinations. Sarcopenic patients showed impaired survival compared to non-sarcopenic individuals (hazard ratio [HR] 1.87, 95 % confidence interval [CI] 1.15-3.03, p = 0.011). Furthermore, low skeletal muscle attenuation (HR 1.91, 95 % CI 1.12-3.28, p = 0.019) and increased FMi (HR 3.47, 95 % CI 1.27-9.50, p = 0.016) were associated with impaired outcome. In the multivariate analysis, including a composite score (CSS) of those three parameters and clinical variables, only CSS, T-stage and surgical resection margin remained significant predictors of OS. Patients who show signs of sarcopenia and alterations in BCPs on preoperative CT images have impaired long-term outcome after surgery for OC. (orig.)

Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer

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Tamandl, Dietmar; Baltzer, Pascal A.; Ba-Ssalamah, Ahmed [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Comprehensive Cancer Center GET-Unit, Vienna (Austria); Paireder, Matthias; Asari, Reza; Schoppmann, Sebastian F. [Medical University of Vienna, Department of Surgery, Upper-GI-Service, Comprehensive Cancer Center GET-Unit, Vienna (Austria)

2016-05-15

To assess the impact of sarcopenia and alterations in body composition parameters (BCPs) on survival after surgery for oesophageal and gastro-oesophageal junction cancer (OC). 200 consecutive patients who underwent resection for OC between 2006 and 2013 were selected. Preoperative CTs were used to assess markers of sarcopenia and body composition (total muscle area [TMA], fat-free mass index [FFMi], fat mass index [FMi], subcutaneous, visceral and retrorenal fat [RRF], muscle attenuation). Cox regression was used to assess the primary outcome parameter of overall survival (OS) after surgery. 130 patients (65 %) had sarcopenia based on preoperative CT examinations. Sarcopenic patients showed impaired survival compared to non-sarcopenic individuals (hazard ratio [HR] 1.87, 95 % confidence interval [CI] 1.15-3.03, p = 0.011). Furthermore, low skeletal muscle attenuation (HR 1.91, 95 % CI 1.12-3.28, p = 0.019) and increased FMi (HR 3.47, 95 % CI 1.27-9.50, p = 0.016) were associated with impaired outcome. In the multivariate analysis, including a composite score (CSS) of those three parameters and clinical variables, only CSS, T-stage and surgical resection margin remained significant predictors of OS. Patients who show signs of sarcopenia and alterations in BCPs on preoperative CT images have impaired long-term outcome after surgery for OC. (orig.)

Sustained NFκB inhibition improves insulin sensitivity but is detrimental to muscle health.

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Zhang, Ning; Valentine, Joseph M; Zhou, You; Li, Mengyao E; Zhang, Yiqiang; Bhattacharya, Arunabh; Walsh, Michael E; Fischer, Katherine E; Austad, Steven N; Osmulski, Pawel; Gaczynska, Maria; Shoelson, Steven E; Van Remmen, Holly; Chen, Hung I; Chen, Yidong; Liang, Hanyu; Musi, Nicolas

2017-08-01

Older adults universally suffer from sarcopenia and approximately 60-70% are diabetic or prediabetic. Nonetheless, the mechanisms underlying these aging-related metabolic disorders are unknown. NFκB has been implicated in the pathogenesis of several aging-related pathologies including sarcopenia and type 2 diabetes and has been proposed as a target against them. NFκB also is thought to mediate muscle wasting seen with disuse, denervation, and some systemic diseases (e.g., cancer, sepsis). We tested the hypothesis that lifelong inhibition of the classical NFκB pathway would protect against aging-related sarcopenia and insulin resistance. Aged mice with muscle-specific overexpression of a super-repressor IκBα mutant (MISR) were protected from insulin resistance. However, MISR mice were not protected from sarcopenia; to the contrary, these mice had decreases in muscle mass and strength compared to wild-type mice. In MISR mice, NFκB suppression also led to an increase in proteasome activity and alterations in several genes and pathways involved in muscle growth and atrophy (e.g., myostatin). We conclude that the mechanism behind aging-induced sarcopenia is NFκB independent and differs from muscle wasting due to pathologic conditions. Our findings also indicate that, while suppressing NFκB improves insulin sensitivity in aged mice, this transcription factor is important for normal muscle mass maintenance and its sustained inhibition is detrimental to muscle function. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

The role of nutrition in the prevention of sarcopenia.

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Volkert, Dorothee

2011-09-01

Nutrition is regarded as one important contributing factors in the complex etiology of sarcopenia. Associations between several nutritional factors and muscle mass, strength, function and physical performance were reported in a growing number of studies in recent years. Accordingly, the avoidance of weight loss is crucial to prevent the concomitant loss of muscle mass. Adequate amounts of high-quality protein are important for optimal stimulation of muscle protein synthesis. Vitamin D, antioxidants and ω 3-polyunsaturated fatty acids may also contribute to the preservation of muscle function. In order to ensure adequate intake in all elderly, nutritional problems like loss of appetite and weight loss should be recognized early by routine screening for malnutrition in the elderly. Underlying causes need to be identified and subsequently corrected. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase energy expenditure, appetite and food intake in elderly people at risk of malnutrition.

A high whey protein-, leucine-, and vitamin D-enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial

NARCIS (Netherlands)

Verreijen, A.M.; Verlaan, S.; Engberink, M.F.; Swinkels, S.; Bosch, J.; Weijs, P.J.M.

2015-01-01

Background: Intentional weight loss in obese older adults is a risk factor for muscle loss and sarcopenia. Objective: The objective was to examine the effect of a high whey protein-, leucine-, and vitamin D-enriched supplement on muscle mass preservation during intentional weight loss in obese older

Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III.

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Preethi Srikanthan

2010-05-01

Full Text Available Sarcopenia often co-exists with obesity, and may have additive effects on insulin resistance. Sarcopenic obese individuals could be at increased risk for type 2 diabetes. We performed a study to determine whether sarcopenia is associated with impairment in insulin sensitivity and glucose homeostasis in obese and non-obese individuals.We performed a cross-sectional analysis of National Health and Nutrition Examination Survey III data utilizing subjects of 20 years or older, non-pregnant (N = 14,528. Sarcopenia was identified from bioelectrical impedance measurement of muscle mass. Obesity was identified from body mass index. Outcomes were homeostasis model assessment of insulin resistance (HOMA IR, glycosylated hemoglobin level (HbA1C, and prevalence of pre-diabetes (6.0≤ HbA1C<6.5 and not on medication and type 2 diabetes. Covariates in multiple regression were age, educational level, ethnicity and sex.Sarcopenia was associated with insulin resistance in non-obese (HOMA IR ratio 1.39, 95% confidence interval (CI 1.26 to 1.52 and obese individuals (HOMA-IR ratio 1.16, 95% CI 1.12 to 1.18. Sarcopenia was associated with dysglycemia in obese individuals (HbA1C ratio 1.021, 95% CI 1.011 to 1.043 but not in non-obese individuals. Associations were stronger in those under 60 years of age. We acknowledge that the cross-sectional study design limits our ability to draw causal inferences.Sarcopenia, independent of obesity, is associated with adverse glucose metabolism, and the association is strongest in individuals under 60 years of age, which suggests that low muscle mass may be an early predictor of diabetes susceptibility. Given the increasing prevalence of obesity, further research is urgently needed to develop interventions to prevent sarcopenic obesity and its metabolic consequences.

Association of Coffee Consumption with Sarcopenia in Korean Elderly Men: Analysis Using the Korea National Health and Nutrition Examination Survey, 2008?2011

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Chung, Hyewon; Moon, Ji Hyun; Kim, Ju Il; Kong, Mi Hee; Huh, Jung Sik; Kim, Hyeon Ju

2017-01-01

Background Sarcopenia is an age-related loss of muscle mass and strength. Coffee has antioxidant and anti-inflammatory properties that have been shown to be inversely related to the mechanism of sarcopenia. While there have been some studies on the effect of coffee on sarcopenia in animals, studies on the topic in humans are rare. Therefore, we investigated this relationship in elderly Korean men. Methods The cross-sectional data were derived from the 2008?2011 Korea National Health and Nutri...

Body Composition, Sarcopenia, and Suicidal Ideation in Elderly Koreans: Hallym Aging Study.

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Kim, Jeong-Hyeon; Kim, Dong-Hyun; Park, Yong Soon

2016-04-01

This study was conducted to assess the relationship between body composition and suicidal ideation among the Korean elderly population (n = 302; ≥ 65 years) who participated in the Hallym Aging Study in 2010. Body composition was measured using dual-energy X-ray absorptiometry, and obesity was measured by the indices of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body fat percentage. Sarcopenia was defined as presence of both low muscle mass and low muscle function. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. We found no differences in body composition measures between subjects with suicidal ideation and those without. In the logistic regression analyses, there were no significant relationships for suicidal ideation according to body composition measures, including BMI, WC, WHR, WHtR, and body fat percentage in both sexes. After adjusting for age, smoking status, alcohol drinking, regular exercise, medical comorbidities, monthly income, education level, and presence of depressive symptoms, the odds ratio (OR) of suicidal ideation was higher in elderly men with sarcopenia compared to those without, whereas no significant relationships were observed in elderly women (OR 8.28, 95% confidence interval [CI] 1.20-61.34 in men; OR 0.79, 95% CI 0.07-8.43 in women). Sarcopenia is closely associated with an increased risk of suicidal ideation in elderly men.

Qualitative alteration of peripheral motor system begins prior to appearance of typical sarcopenia syndrome in middle-aged rats

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Tetsuro eTamaki

2014-10-01

Full Text Available Qualitative changes in the peripheral motor system were examined using Young, Adult, Middle-aged and Old-aged rats in order to assess before and after the appearance of sarcopenia symptoms. Significant loss of muscle mass and strength, and slow-type fiber grouping with a loss of innervated nerve fibers were used as typical markers of sarcopenia. Dynamic twitch and tetanus tension and evoked electromyogram (EEMG were measured via electrical stimulation through the sciatic nerve under anesthesia using our force-distance transducer system before and after sciatectomy. Digital and analogue data sampling was performed and shortening and relaxing velocity of serial twitches was calculated with tension force. Muscle tenderness in passive stretching was also measured as stretch absorption ability, associated with histological quantitation of muscle connective tissues. The results indicated the validity of the present model, in which Old-aged rats clearly showed the typical signs of sarcopenia, specifically in the fast-type plantaris muscles, while the slow-type soleus showed relatively mild syndromes. These observations suggest the following qualitative alterations as the pathophysiological mechanism of sarcopenia: 1 reduction of shortening and relaxing velocity of twitch; 2 decline of muscle tenderness following an increase in the connective tissue component; 3 impaired recruitment of motor units (sudden depression of tetanic force and EEMG in higher stimulation frequencies over 50-60 Hz; and 4 easy fatigability in the neuromuscular junctions. These findings are likely to be closely related to significant losses in fast-type motor units, muscle strength and contraction velocity, which could be a causative factor in falls in the elderly. Importantly, some of these symptoms began in Middle-aged rats that showed no other signs of sarcopenia. Thus, prevention should be started in middle age that could be retained relatively higher movement ability.

Sarcopenia increases risk of long-term mortality in elderly patients undergoing emergency abdominal surgery.

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Rangel, Erika L; Rios-Diaz, Arturo J; Uyeda, Jennifer W; Castillo-Angeles, Manuel; Cooper, Zara; Olufajo, Olubode A; Salim, Ali; Sodickson, Aaron D

2017-12-01

Frailty is associated with poor surgical outcomes in elderly patients but is difficult to measure in the emergency setting. Sarcopenia, or the loss of lean muscle mass, is a surrogate for frailty and can be measured using cross-sectional imaging. We sought to determine the impact of sarcopenia on 1-year mortality after emergency abdominal surgery in elderly patients. Sarcopenia was assessed in patients 70 years or older who underwent emergency abdominal surgery at a single hospital from 2006 to 2011. Average bilateral psoas muscle cross-sectional area at L3, normalized for height (Total Psoas Index [TPI]), was calculated using computed tomography. Sarcopenia was defined as TPI in the lowest sex-specific quartile. Primary outcome was mortality at 1 year. Secondary outcomes were in-hospital mortality and mortality at 30, 90, and 180 days. The association of sarcopenia with mortality was assessed using Cox proportional hazards regression and model performance judged using Harrell's C-statistic. Two hundred ninety-seven of 390 emergency abdominal surgery patients had preoperative imaging and height. The median age was 79 years, and 1-year mortality was 32%. Sarcopenic and nonsarcopenic patients were comparable in age, sex, race, comorbidities, American Society of Anesthesiologists classification, procedure urgency and type, operative severity, and need for discharge to a nursing facility. Sarcopenic patients had lower body mass index, greater need for intensive care, and longer hospital length of stay (p Sarcopenia was independently associated with increased in-hospital mortality (risk ratio, 2.6; 95% confidence interval [CI], 1.6-3.7) and mortality at 30 days (hazard ratio [HR], 3.7; 95% CI, 1.9-7.4), 90 days (HR, 3.3; 95% CI, 1.8-6.0), 180 days (HR, 2.5; 95% CI, 1.4-4.4), and 1 year (HR, 2.4; 95% CI, 1.4-3.9). Sarcopenia is associated with increased risk of mortality over 1 year in elderly patients undergoing emergency abdominal surgery. Sarcopenia defined by TPI is

Early-stage chronic kidney disease, insulin resistance, and osteoporosis as risk factors of sarcopenia in aged population: the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009.

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Kim, J E; Lee, Y-H; Huh, J H; Kang, D R; Rhee, Y; Lim, S-K

2014-09-01

Sarcopenia means the progressive loss of skeletal muscle mass and strength with aging. In this study, we found that insulin resistance, chronic kidney disease stage 3, and osteoporosis at the femur neck were closely associated with sarcopenia in elderly men. These conditions modified to slow down the progression of sarcopenia. Sarcopenia is known to have multiple contributing factors; however, its modifiable risk factors have not yet been determined. The aim of this study was to identify the most influential and modifiable risk factors for sarcopenia in elderly. This was a population-based, cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009. This study included 940 men and 1,324 women aged 65 years and older who completed a body composition analysis using dual-energy X-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle mass divided by height(2) of less than 1 standard deviation below the sex-specific mean for a younger reference group. Using univariate analysis, age, body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), limitations in daily activities, regular exercise, high-risk drinking, family income, osteoporosis, daily energy, and protein intake were associated with sarcopenia in men; age, BMI, limitations in daily activities, regular exercise, occupation, osteoporosis at the total hip, and daily energy intake were associated with sarcopenia in women. In the multivariate logistic regression analysis, HOMA-IR ≥2.5 (odds ratio [OR] for sarcopenia, 2.27; 95 % confidence interval [CI], 1.21-4.25), chronic kidney disease stage 3 (OR, 3.13; 95 % CI, 1.14-8.61), and osteoporosis at the femur neck (OR, 6.83; 95 % CI, 1.08-43.41) were identified as risk factors for sarcopenia in men. Insulin resistance, chronic kidney disease, and osteoporosis at the femur neck should be modified to prevent the acceleration of skeletal muscle

Pre-hospital dietary intake correlates with muscle mass at the time of fracture in older hip fractured patients

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Riccardo eCalvani

2014-11-01

Full Text Available Background. Failure to meet an adequate dietary intake is involved in the pathogenesis of sarcopenia and osteoporosis, which in turn increase the risk for falls and fractures, respectively. Older people with hip fracture are often protein-malnourished at hospitalization. Whether low protein-energy intake is associated with muscle atrophy in hip fractured patients is presently unknown. This information is necessary for the development of novel strategies to manage this especially vulnerable patient population. The aim of this study was therefore to explore the relationship between dietary intake and muscle mass in older hip fractured patients.Methods. Analyses were conducted in hip fractured elderly admitted to an orthopedic and trauma surgery ward (University Hospital. Muscle mass was estimated by bioelectrical impedance analysis within 24 h from admission. Dietary information was collected via 24-h dietary recall and nutrient intakes calculated by a nutrition software.Results. Among 62 hip fractured patients (mean age 84.6±7.6 years, 84% women, the average energy intake was 929.2±170.3 Kcal/day, with higher values reported by men (1.046.8±231.4 Kcal/day relative to women (906.5±148.3 Kcal/day; p=0.01. Absolute and normalized protein intake was 50.0±13.5 g/day and 0.88±0.27 g/kg (body weight/day, respectively, with no gender differences. A positive correlation was determined between total energy intake and muscle mass (r=0.384; p=0.003. Similarly, protein and leucine consumption was positively correlated with muscle mass (r=0.367 and 0.311, respectively; p=0.005 for both.Conclusions. A low intake of calories, protein and leucine is associated with reduced muscle mass in hip fractured elderly. Given the relevance of sarcopenia as a risk factor for adverse outcomes in this patient population, our findings highlight the importance of a comprehensive dietary assessment for the detection of nutritional deficits predisposing to or aggravating

Incidence, Risk Factors, and the Protective Effect of High Body Mass Index against Sarcopenia in Suburb-Dwelling Elderly Chinese Populations.

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Han, P; Zhao, J; Guo, Q; Wang, J; Zhang, W; Shen, S; Wang, X; Dong, R; Ma, Y; Kang, L; Fu, L; Jia, L; Han, X; He, Z; Bao, Y; Wang, L; Niu, K

2016-01-01

Few studies have explored the risk factors of sarcopenia in certain cohorts. The objective of this study was to examine the incidence of sarcopenia and associated factors over a 1-year period in an elderly Chinese suburban population. This study was conducted on 356 Chinese suburb-dwelling participants aged ≥60 years, for whom detailed information regarding sociodemographics, behavioral characteristics, and medical conditions had been documented. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenia incidence was documented after one year of follow-up, and correlated with several possible factors. At baseline, 64 (9.7%) of the initial 657 participants had sarcopenia. The prevalence of sarcopenia was 10.4% after one year. Between baseline and 1-year follow-up, 13 of the participants without sarcopenia at baseline had developed sarcopenia. After multivariate adjustments, it was found that the incidence of sarcopenia increased with age and high body mass index (BMI) is associated with less incidence of sarcopenia. Incidence was also higher among women. We found sarcopenia incidence increased with age, and women were more likely to have sarcopenia. A higher BMI is also associated with a lower incidence of sarcopenia. Maintaining a healthy weight could be beneficial in the prevention of sarcopenia.

Diminished skeletal muscle microRNA expression with aging is associated with attenuated muscle plasticity and inhibition of IGF-1 signaling

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Older individuals have a reduced capacity to induce muscle hypertrophy with resistance exercise (RE), which may contribute to the age-induced loss of muscle mass and function, sarcopenia. We tested the novel hypothesis that dysregulation of microRNAs (miRNAs) may contribute to reduced muscle plastic...

Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

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Wei Hong

Full Text Available Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients.Patients (322 men and 435 women aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263 and women (n = 1057 aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI, fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group.Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group. Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men.Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

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Hong, Wei; Cheng, Qun; Zhu, Xiaoying; Zhu, Hanmin; Li, Huilin; Zhang, Xuemei; Zheng, Songbai; Du, Yanping; Tang, Wenjing; Xue, Sihong; Ye, Zhibin

2015-01-01

Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients. Patients (322 men and 435 women) aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263) and women (n = 1057) aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI), fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group. Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group). Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men. Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis of the prevalence and associated factors

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Oliveira, Dílmerson; Barbosa, Sérgio Ribeiro; Corrêa, José Otávio do Amaral; Colugnati, Fernando Antônio Basile; Mansur, Henrique Novais; Fernandes, Natália Maria da Silva; Bastos, Marcus Gomes

2017-01-01

Introduction Sarcopenia is a chronic condition that is associated with aging and characterized by a reduction of muscle mass, strength, and function. Sarcopenia is prevalent in patients with chronic kidney disease (CKD) and associated with increased morbidity and mortality, as well as cardiovascular complications. Objectives To investigate the prevalence of sarcopenia in patients with CKD not yet on dialysis and its correlation with clinical and laboratory variables and inflammatory markers. Methods A total of 100 patients of both sexes aged over 18 were evaluated. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. Sociodemographic and clinical data, activities of daily living, functional capacity, and physical activity were also evaluated. Inflammation was assessed by the serum levels of high-sensitivity C-reactive protein (hsCRP) and interleukin (IL) 4 and 6. Results The prevalence of sarcopenia was 11.9% and 28.7% using the EWGSOP and FNIH criteria, respectively. Sarcopenia was more prevalent in the more advanced stages of CKD (34.5% in stages 2 and 3A; and 65.5% in stages 3B, 4, and 5) and associated with worse performance in activities of daily living (p = 0.049), lower walking speeds (p sarcopenia had lower functional capacity (p = 0.012) and higher prevalence of physical inactivity (p = 0.041) compared with patients without sarcopenia. After adjustment for confounding variables, sarcopenia was still significantly correlated with walking speed (p = 0.004) and BMI (p = 0.002). HsCRP levels were inversely correlated with appendicular lean mass adjusted for BMI (p = 0.007) and were also positively associated with BMI (p = 0.001). IL4 levels were positively correlated with walking speed (p = 0.007) and lean mass in the lower limbs (p = 0.022). Conclusions Sarcopenia is common in patients with CKD, particularly in the

Serum concentrations of insulin-like growth factor-1, members of the TGF-beta superfamily and follistatin do not reflect different stages of dynapenia and sarcopenia in elderly women.

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Hofmann, Marlene; Halper, Barbara; Oesen, Stefan; Franzke, Bernhard; Stuparits, Petra; Tschan, Harald; Bachl, Norbert; Strasser, Eva-Maria; Quittan, Michael; Ploder, Martin; Wagner, Karl-Heinz; Wessner, Barbara

2015-04-01

There is a high need for blood-based biomarkers detecting age-related changes in muscular performance at an early stage. Therefore, we investigated whether serum levels of growth and differentiation factor-15 (GDF-15), activin A, myostatin, follistatin, and insulin-like growth factor-1 (IGF-1) would reflect age- and physical performance-related differences between young (22-28 years) and elderly (65-92 years) females. Isokinetic peak torque of knee extension (PTE) was measured in young females to obtain reference values for the discrimination of different stages of age-associated muscle weakness. Additionally, elderly women were screened for sarcopenia using the algorithm of the European Working Group on Sarcopenia in Older People (low muscle mass in addition to low PTE and/or low walking speed). IGF-1 levels were higher and GDF-15 levels were lower in young females in comparison to the elderly (p sarcopenia in elderly women. However, due to the associations of IGF-1 and GDF-15 with correlates of muscle mass and function, these parameters remain promising candidates in a potential set of blood-based biomarkers to diagnose sarcopenia and/or dynapenia. Copyright © 2015 Elsevier Inc. All rights reserved.

Similar effects of leucine rich and regular dairy products on muscle mass and functions of older polymyalgia rheumatica patients: a randomized crossover trial.

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Björkman, M P; Pilvi, T K; Kekkonen, R A; Korpela, R; Tilvis, R S

2011-06-01

Leucine-rich milk and whey proteins have been suggested for prevention of age related loss of muscle mass and strength i.e. sarcopenia. The effects of milk protein supplementation and low intensity home based physical exercise on body composition and muscle functions were investigated. A randomized double blind crossover trial. Community dwelling members of Helsinki rheumatoid association. Older people (N=47, mean age 69.5 years) suffering from polymyalgia rheumatica. Patients performed as many stand ups as possible twice a day after which they ingested a regular (Control) or a whey protein enriched dairy product with high leucine content (Test). The 8-week intervention periods were separated by a 4-week wash-out. Body composition was measured by dual x-ray absorptiometry and muscle functions by hand grip strength, force platform countermovement jump performance, chair stand test, and walking speed. The 16-week home-based post-exercise supplementation resulted in a 1.8% increase (p = 0.052) in lower limb muscle mass. Walking speed (+5.3%, p = 0.007) and chair stand test performance (-12.2 %, p products prevent or treat age-associated sarcopenia and whether they are superior to the present commercial milk products.

Nutrient-rich meat proteins in offsetting age-related muscle loss.

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Phillips, Stuart M

2012-11-01

From a health perspective, an underappreciated consequence of the normal aging process is the impacts that the gradual loss of skeletal muscle mass, termed sarcopenia, has on health beyond an effect on locomotion. Sarcopenia, refers to the loss of muscle mass, and associated muscle weakness, which occurs in aging and is thought to proceed at a rate of approximately 1% loss per year. However, periods of inactivity due to illness or recovery from orthopedic procedures such as hip or knee replacement are times of accelerated sarcopenic muscle loss from which it may be more difficult for older persons to recover. Some of the consequences of age-related sarcopenia are easy to appreciate such as weakness and, eventually, reduced mobility; however, other lesser recognized consequences include, due to the metabolic role the skeletal muscle plays, an increased risk for poor glucose control and a predisposition toward weight gain. What we currently know is that two stimuli can counter this age related muscle loss and these are physical activity, specifically resistance exercise (weightlifting), and nutrition. The focus of this paper is on the types of dietary protein that people might reasonably consume to offset sarcopenic muscle loss. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Relationship between Sarcopenia and Systemic Inflammatory Response for Cancer Cachexia in Small Cell Lung Cancer.

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Eun Young Kim

Full Text Available The prognostic significance of sarcopenia, an important component of cancer cachexia, has been demonstrated in oncologic patients. Catabolic drivers have been suggested to be key features of cancer cachexia.To determine the relationship between systemic inflammatory markers and CT-determined muscle mass in patients with SCLC.Cross-sectional muscle areas were evaluated at the level of the third lumbar vertebra (L3 using baseline CT images in 186 SCLC patients. Sarcopenia was defined as a L3 muscle index (L3MI, muscle area at L3/height2 of < 55 cm2/m2 for men and of < 39 cm2/m2 for women. Systemic inflammatory markers investigated included serum white blood cell count (WBC, neutrophil: lymphocyte ratio (NLR, C-reactive protein (CRP, and albumin.Mean L3MI was 47.9 ± 9.7 cm2/m2 for men and 41.6 ± 7.0 cm2/m2 for women. Sarcopenia was present in 128 patients (68.8%, and sarcopenic patients had significant serum lymphocyte counts and albumin levels (p = 0.002 and 0.041, respectively, and higher NLRs and CRP levels (p = 0.011 and 0.026 than non-sarcopenic patients. Multivariable analysis revealed that CRP independently predicted L3MI (β = -0.208; 95% CI, -0.415 to -0.002; p = 0.048, along with gender and BMI (p values < 0.001 and performance status (p = 0.010.The present study confirms a significant linear relationship exists between CT-determined muscle mass and CRP in SCLC patients. This association might provide a better understanding of the mechanism of cancer cachexia.

Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food

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Alemán-Mateo H

2012-07-01

Full Text Available Heliodoro Alemán-Mateo,1 Liliana Macías,1 Julián Esparza-Romero,1 Humberto Astiazaran-García,1 Ana Luz Blancas21Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, AC, Hermosillo, Sonora, México; 2Dirección General de Servicios de Salud a la Persona, Hermosillo, Sonora, MéxicoBackground: Sarcopenia is strongly associated with an inadequate intake of dietary protein. Dietary protein supplementation boosts muscle-protein synthesis and increases muscle mass in the elderly. This study tested whether adding a protein-rich food, ricotta cheese, to the habitual diet increased total appendicular skeletal muscle mass and strength in elderly people.Methods: Participants (n = 40, were sarcopenic elderly men and women over 60 years of age. Two comparison groups were formed at random and followed for 3 months: the intervention group received 210 g/day of ricotta cheese plus the habitual diet, while the control group followed the habitual diet with no additional intervention. Total appendicular skeletal muscle (TASM was assessed by dual-energy X-ray absorptiometry, while strength was measured using a handheld dynamometer at baseline and after the intervention period. The primary outcomes were the percentage of relative change in TASM and strength.Results: The percentage of relative change in TASM was not significant between the groups after the intervention period. Muscle strength improved in the intervention group, but showed only a tendency towards significance (P = 0.06. Secondary analysis showed that the men in the intervention group gained 270 g in TASM compared to those in the control group, and improved their fasting insulin levels (P = 0.05, muscle strength, lean body mass in the arms, and body weight variables.Conclusion: The results of this study indicate that a nutritional intervention using a high-quality protein food, specifically ricotta cheese, in order to increase the amount of protein intake might not

Impairment of IGF-I Expression and Anabolic Signaling Following Ischemia/Reperfusion in Skeletal Muscle of Old Mice

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2011-04-01

has a role in the impaired recovery of skeletal muscle with age. Keywords Tourniquet; sarcopenia ; muscle regeneration; mTOR; FoxO Correspondence...Prescribed by ANSI Std Z39-18 INTRODUCTION Sarcopenia is the progressive decline in skeletal muscle mass and function with advanced aging (See Adamo...clinically-relevant problem. Considering the large proportion of orthopedic surgeries performed on elderly individuals, the extent of damage and subsequent

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia

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Law, Timothy D.; Clark, Leatha A.; Clark, Brian C.

2016-01-01

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive re...

Animal models of cachexia and sarcopenia in chronic illness: Cardiac function, body composition changes and therapeutic results.

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Ishida, Junichi; Saitoh, Masakazu; Doehner, Wolfram; von Haehling, Stephan; Anker, Markus; Anker, Stefan D; Springer, Jochen

2017-07-01

Cachexia is defined as a complex metabolic syndrome associated with underlying illness that is characterized by the loss of body weight consisting of muscle and fat mass wasting. Sarcopenia is defined as the ageing related loss of muscle mass in health and disease that may not have an effect on body weight. As millions of patients are in cachectic or sarcopenic states, both conditions contribute to high numbers to death worldwide. A number of treatments have been proposed for cachexia and sarcopenia, but these are either in the preclinical stage or in clinical trials and hence not available to the general population. Particularly in cachexia there is a massive problem of recruiting patients for trials and also with the follow-up, due to the seriousness of the disease. This underlines the importance of well-characterized animal models. Obviously, most of the widely used cachexia and sarcopenia animal models have limitations in reproducibility of the condition and novel models are warranted in this context. The key findings of developing models in the field of cachexia and sarcopenia are that more types of the conditions have been taken into the researchers' interest. In cardiac cachexia, technical issues, which limit the preciseness and reproducibility in surgical heart failure models, have been overcome by a combination of surgery and the use of transgenic mouse models or salt sensitive rat models. Fatigue is the most pronounced symptom of cachexia and may be caused by reduced cardiac function independent of the underlying disease. Sarcopenia models often suffer from the use of young animals, due to the limited availability and very high costs of using aged animals. This review will focus on rodent models designed to mimic cachexia and sarcopenia including co-morbidities such as cancer, heart failure, as well as other diseases and conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Inflammation and sarcopenia: A systematic review and meta-analysis.

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Bano, Giulia; Trevisan, Caterina; Carraro, Sara; Solmi, Marco; Luchini, Claudio; Stubbs, Brendon; Manzato, Enzo; Sergi, Giuseppe; Veronese, Nicola

2017-02-01

Inflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analyzed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; psarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-α than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I 2 =97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association between −308 G/A TNF-α Polymorphism and Appendicular Skeletal Muscle Mass Index as a Marker of Sarcopenia in Normal Weight Obese Syndrome

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Di Renzo, L.; Sarlo, F.; Petramala, L.; Iacopino, L.; Monteleone, G.; Colica, C.; De Lorenzo, A.

2013-01-01

Background and Aim. Normal weight obese (NWO) syndrome is characterized by normal body mass index (BMI), but high amount of fat mass and reduced lean mass. We evaluated allelic frequency of the G/A ?308 TNF- ? polymorphism and prevalence of sarcopenia in NWO. Methods. We enrolled 120 Italian healthy women, distinguished into 3 groups: normal weight (NW); NWO, and preobese-obese (PreOB/OB) and evaluated anthropometric parameters, body composition by dual X-ray absorptiometry, blood tests, and ...

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection.

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Zhang, Tenghui; Cao, Lei; Cao, Tingzhi; Yang, Jianbo; Gong, Jianfeng; Zhu, Weiming; Li, Ning; Li, Jieshou

2017-05-01

Sarcopenia has been proposed to be a prognostic factor of outcomes for various diseases but has not been applied to Crohn's disease (CD). We aimed to assess the impact of sarcopenia on postoperative outcomes after bowel resection in patients with CD. Abdominal computed tomography images within 30 days before bowel resection in 114 patients with CD between May 2011 and March 2014 were assessed for sarcopenia as well as visceral fat areas and subcutaneous fat areas. The impact of sarcopenia on postoperative outcomes was evaluated using univariate and multivariate analyses. Of 114 patients, 70 (61.4%) had sarcopenia. Patients with sarcopenia had a lower body mass index, lower preoperative levels of serum albumin, and more major complications (15.7% vs 2.3%, P = .027) compared with patients without sarcopenia. Moreover, predictors of major postoperative complications were sarcopenia (odds ratio [OR], 9.24; P = .04) and a decreased skeletal muscle index (1.11; P = .023). Preoperative enteral nutrition (OR, 0.13; P = .004) and preoperative serum albumin level >35 g/L (0.19; P = .017) were protective factors in multivariate analyses. The prevalence of sarcopenia is high in patients with CD requiring bowel resection. It significantly increases the risk of major postoperative complications and has clinical implications with respect to nutrition management before surgery for CD.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

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Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (psarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly

Sarcopenia: Prevalence, and Impact on Operative and Oncologic Outcomes in the Multimodal Management of Locally Advanced Esophageal Cancer.

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Elliott, Jessie A; Doyle, Suzanne L; Murphy, Conor F; King, Sinead; Guinan, Emer M; Beddy, Peter; Ravi, Narayanasamy; Reynolds, John V

2017-11-01

The aim of this article was to study the prevalence and significance of sarcopenia in the multimodal management of locally advanced esophageal cancer (LAEC), and to assess its independent impact on operative and oncologic outcomes. Sarcopenia in cancer may confer negative outcomes, but its prevalence and impact on modern multimodal regimens for LAEC have not been systematically studied. Two hundred fifty-two consecutive patients were studied. Lean body mass (LBM), skeletal muscle index (SMI), and fat mass (FM) were determined pre-treatment, preoperatively, and 1 year postoperatively. Sarcopenia was defined by computed tomography (CT) at L3 as SMI Sarcopenia increased (P = 0.02) from 16% at diagnosis to 31% post-neoadjuvant therapy, with loss of LBM (-3.0 ± 5.4 kg, P sarcopenia was associated with CCI (P = 0.043), and CDC ≥IIIb (P = 0.003). PPCs occurred in 36% nonsarcopenic versus 55% sarcopenic patients (P = 0.01). Sarcopenia did not impact disease-specific (P = 0.14) or overall survival (P = 0.11) after resection. At 1 year, 35% had sarcopenia, significantly associated with pre-treatment BMI (P = 0.013) but not complications (P = 0.20). Sarcopenia increases through multimodal therapy, is associated with an increased risk of major postoperative complications, and is prevalent in survivorship. These data highlight a potentially modifiable marker of risk that should be assessed and targeted in modern multimodal care pathways.

Differential association between sarcopenia and metabolic phenotype in Korean young and older adults with and without obesity.

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Hwang, You-Cheol; Cho, In-Jin; Jeong, In-Kyung; Ahn, Kyu Jeung; Chung, Ho Yeon

2017-01-01

To determine whether sarcopenia was associated with metabolic phenotype in subjects with and without obesity. A total of 6,021 participants (2,592 men, 3,429 women) aged 30 to 93 years were assessed using data from the 2009 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as appendicular skeletal muscle mass divided by weight (%) that is young adults. Metabolically unhealthy was defined as ≥2 components of metabolic syndrome or the presence of hypertension, diabetes, or cardiovascular disease. Obesity was defined as body mass index ≥25.0 kg/m 2 . Sarcopenia was associated with a metabolically unhealthy phenotype in nonobese men independent of age, smoking, regular physical activity, daily energy intake, total body fat, fasting insulin, non-HDL cholesterol, white blood cell count, ferritin level, and 25(OH) vitamin D level (OR per 1 SD increment (95% CI) 1.88 (1.28-2.75), P obesity. Sarcopenia was independently associated with a metabolically unhealthy phenotype in nonobese men, but this association was not evident in nonobese women or subjects with obesity. © 2016 The Obesity Society.

Sarcopenia and Endothelial Function in Patients With Chronic Heart Failure: Results From the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF).

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Dos Santos, Marcelo R; Saitoh, Masakazu; Ebner, Nicole; Valentova, Miroslava; Konishi, Masaaki; Ishida, Junichi; Emami, Amir; Springer, Jochen; Sandek, Anja; Doehner, Wolfram; Anker, Stefan D; von Haehling, Stephan

2017-03-01

Skeletal muscle wasting, also known as sarcopenia, has recently been identified as a serious comorbidity in patients with heart failure (HF). We aimed to assess the impact of sarcopenia on endothelial dysfunction in patients with HF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Cross-sectional study. Ambulatory patients with HF were recruited at Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. We assessed peripheral blood flow (arm and leg) in 228 patients with HF and 32 controls who participated in the Studies Investigating Comorbidities Aggravating HF (SICA-HF). The appendicular skeletal muscle mass of the arms and the legs combined was assessed by dual energy x-ray absorptiometry (DEXA). Sarcopenia was defined as the appendicular muscle mass two standard deviations below the mean of a healthy reference group of adults aged 18 to 40 years, as suggested for the diagnosis of muscle wasting in healthy aging. All patients underwent a 6-minute walk test and spiroergometry testing. Forearm and leg blood flow were measured by venous occlusion plethysmography. Peak blood flow was assessed after a period of ischemia in the limbs to test endothelial function. Sarcopenia was identified in 37 patients (19.5%). Patients with sarcopenia presented with lower baseline forearm blood flow (2.30 ± 1.21 vs. 3.06 ± 1.49 vs. 4.00 ± 1.66 mL min -1 100 mL -1 ; P = .02) than those without sarcopenia or controls. The group of patients with sarcopenia showed similar baseline leg blood flow (2.06 ± 1.62 vs. 2.39 ± 1.39 mL min -1 100 mL -1 ; P = .11) to those without but lower values when compared to controls (2.06 ± 1.62 vs. 2.99 ± 1.28 mL min -1 100 mL -1 ; P = .03). In addition, patients with and without sarcopenia presented with lower peak flow in the forearm when compared to controls (18.37 ± 7.07 vs. 22.19 ± 8.64 vs. 33.63 ± 8.57 mL min -1 100 mL -1 ; P sarcopenia, and coronary artery

Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer

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Wendrich, Anne W; Swartz, Justin E; Bril, Sandra I; Wegner, Inge; de Graeff, Alexander; Smid, Ernst J; de Bree, Remco; Pothen, Ajit J

OBJECTIVES: Low skeletal muscle mass (SMM) or sarcopenia is emerging as an adverse prognostic factor for chemotherapy dose-limiting toxicity (CLDT) and survival in cancer patients. Our aim was to determine the impact of low SMM on CDLT in patients with locally advanced head and neck squamous cell

High prevalence of sarcopenia among binge drinking elderly women: a nationwide population-based study.

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Yoo, Jun-Il; Ha, Yong-Chan; Lee, Young-Kyun; Hana-Choi; Yoo, Moon-Jib; Koo, Kyung-Hoi

2017-05-30

Alcohol consumption is considered a risk factor for sarcopenia, but the association between alcohol consumption and the prevalence of sarcopenia has not been evaluated in detail. This study was to identify the relationship between alcohol drinking patterns and the prevalence of sarcopenia in the elderly Korean population. The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Participants were excluded if they were under the age of 65, or if data was not available regarding skeletal muscle mass or dietary intake. After these exclusions, a total of 4020 participants (men: 1698; women: 2322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS). Binge drinking was defined as consuming ≥5 standard alcoholic drinks (≥4 drinks for women) consecutively on one occasion. This data was subcategorized into two groups based on presence of binge drinking: Social drinking (≤1 time/month) and binge drinking (>1 time/month). Women binge drinkers with weekly or daily consumption had 2.8 times higher prevalence of sarcopenia than social drinkers (Odds Ratio [OR] = 2.84; 95% Confidence Interval [CI] = 1.12-7.29). However, there were no associations between binge drinkers and sarcopenia in men. After adjusting for age, body mass index (BMI), energy intake, moderate physical activity, and energy intake, women binge drinkers with weekly or daily alcohol consumption had 3.9 times higher prevalence of sarcopenia than social drinkers (OR = 3.88; 95% CI = 1.33-11.36). The prevalence of sarcopenia in elderly women was related to binge drinking frequency and amounts of drinking after adjusting for covariates. Elderly Korean women who binge drink once or more per week may be associated with sarcopenia, as seen with the observed 3.9 times higher prevalence compared to social drinkers.

Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.

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Yang, Ming; Hu, Xiaoyi; Wang, Haozhong; Zhang, Lei; Hao, Qiukui; Dong, Birong

2017-04-01

The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards. We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow-up period following the baseline investigation. Two hundred and eighty-eight participants (mean age: 81.1 ± 6.6 years) were included. Forty-nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow-up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants (40.8% vs. 17.1%, respectively, P sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80). Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Forcing the vicious circle: sarcopenia increases toxicity, decreases response to chemotherapy and worsens with chemotherapy.

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Bozzetti, F

2017-09-01

Sarcopenia has recently emerged as a new condition that, independently from malnutrition, may adversely affect the prognosis of cancer patients. Purpose of this narrative review is to define the prevalence of sarcopenia in different primaries, its role in leading to chemotherapy toxicity and decreased compliance with the oncological therapy and the effect of some drugs on the onset of sarcopenia. Finally, the review aims to describe the current approaches to restore the muscle mass through nutrition, exercise and anti-inflammatory agents or multimodal programmes with a special emphasis on the results of randomized controlled trials. The examination of the computed tomography scan at the level of the third lumbar vertebra-a common procedure for staging many tumours-has allowed the oncologist to evaluate the muscle mass and to collect many retrospective data on the prevalence of sarcopenia and its clinical consequences. Sarcopenia is a condition affecting a high percentage of patients with a range depending on type of primary tumour and stage of disease. It is noteworthy that patients may be sarcopenic even if their nutritional status is apparently maintained or they are obese. Sarcopenic patients exhibited higher chemotherapy toxicity and poorer compliance with oncological treatments. Furthermore, several antineoplastic drugs appeared to worsen the sarcopenic status. Therapeutic approaches are several and this review will focus on those validated by randomized controlled trials. They include the use of ω-3-enriched oral nutritional supplements and orexigenic agents, the administration of adequate high-protein regimens delivered enterally or parenterally, and programmes of physical exercise. Better results are expected combining different procedures in a multimodal approach. In conclusion, there are several premises to prevent/treat sarcopenia. The oncologist should coordinate this multimodal approach by selecting priorities and sequences of treatments and then

Skeletal muscle performance and ageing.

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Tieland, Michael; Trouwborst, Inez; Clark, Brian C

2018-02-01

The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

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

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Isanejad, Masoud; Sirola, Joonas; Mursu, Jaakko; Rikkonen, Toni; Kröger, Heikki; Tuppurainen, Marjo; Erkkilä, Arja T

2017-03-16

To examine whether higher adherence to Baltic Sea diet (BSD) and Mediterranean diet (MED) have beneficial association with sarcopenia indices in elderly women. 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. 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. Better diet quality as measured by higher adherence to BSD and MED might reduce the risk of sarcopenia in elderly women.

Sarcopenia and sarcopenic obesity and their association with dyslipidemia in Korean elderly men: the 2008-2010 Korea National Health and Nutrition Examination Survey.

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Baek, S J; Nam, G E; Han, K D; Choi, S W; Jung, S W; Bok, A R; Kim, Y H; Lee, K S; Han, B D; Kim, D H

2014-03-01

Recently, aging has been shown to be associated with sarcopenic obesity (SO), of which decreased muscle mass and increased fat mass are features. Sarcopenia and obesity alone are known to be associated with abnormal lipid metabolism. However, it remains unclear whether SO has greater adverse effects on dyslipidemia than on sarcopenia or obesity alone. We aimed to investigate the association between SO and dyslipidemia in elderly Koreans. This study was based on data collected during the 2008-2010 Korea National Health and Nutrition Examination Survey. We included 1,466 men and 2,017 women aged 65 years and over. Sarcopenia was indicated in participants with height- or weight-adjusted appendicular skeletal muscle that was 1 standard deviation below the sex-specific mean for the young reference group, and obesity was defined as a body mass index ≥ 25 kg/m(2). Dyslipidemia was defined according to the National Cholesterol Education Program-Adult Treatment Panel III. After adjusting for confounding factors, the SO group had a higher risk for dyslipidemia [odds ratio (OR) 2.82 (95 % confidence interval 1.76-4.51)] than the obese group [2.12 (1.11-4.07)] and sarcopenic group [1.46 (1.01-2.11)] (p elderly men, SO was associated with an increased risk for dyslipidemia compared with sarcopenia or obesity alone.

Increased skeletal muscle 11βHSD1 mRNA is associated with lower muscle strength in ageing.

Directory of Open Access Journals (Sweden)

Alixe H M Kilgour

Full Text Available Sarcopenia, the loss of muscle mass and function with age, is associated with increased morbidity and mortality. Current understanding of the underlying mechanisms is limited. Glucocorticoids (GC in excess cause muscle weakness and atrophy. We hypothesized that GC may contribute to sarcopenia through elevated circulating levels or increased glucocorticoid receptor (GR signaling by increased expression of either GR or the GC-amplifying enzyme 11 beta-hydroxysteroid dehydrogenase type 1 (11βHSD1 in muscle.There were 82 participants; group 1 comprised 33 older men (mean age 70.2 years, SD 4.4 and 19 younger men (22.2 years, 1.7 and group 2 comprised 16 older men (79.1 years, 3.4 and 14 older women (80.1 years, 3.7. We measured muscle strength, mid-thigh cross-sectional area, fasting morning plasma cortisol, quadriceps muscle GR and 11βHSD1 mRNA, and urinary glucocorticoid metabolites. Data were analysed using multiple linear regression adjusting for age, gender and body size.Muscle strength and size were not associated with plasma cortisol, total urinary glucocorticoids or the ratio of urinary 5β-tetrahydrocortisol +5α-tetrahydrocortisol to tetrahydrocortisone (an index of systemic 11βHSD activity. Muscle strength was associated with 11βHSD1 mRNA levels (β -0.35, p = 0.04, but GR mRNA levels were not significantly associated with muscle strength or size.Although circulating levels of GC are not associated with muscle strength or size in either gender, increased cortisol generation within muscle by 11βHSD1 may contribute to loss of muscle strength with age, a key component of sarcopenia. Inhibition of 11βHSD1 may have therapeutic potential in sarcopenia.

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy.

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Takagi, Kosei; Yoshida, Ryuichi; Yagi, Takahito; Umeda, Yuzo; Nobuoka, Daisuke; Kuise, Takashi; Fujiwara, Toshiyoshi

2017-05-26

Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections. The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P sarcopenia (odds ratio = 3.43; P Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.

Influence of diet, exercise and serum vitamin D on sarcopenia in post-menopausal women

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Mason, Caitlin; Xiao, Liren; Imayama, Ikuyo; Duggan, Catherine R.; Foster-Schubert, Karen E.; Kong, Angela; Campbell, Kristin L.; Wang, Ching-Yun; Villasenor, Adriana; Neuhouser, Marian L.; Alfano, Catherine M.; Blackburn, George L.; McTiernan, Anne

2012-01-01

Purpose To investigate the effects of 12 months of dietary weight loss and/or aerobic exercise on lean mass and the measurements defining sarcopenia in postmenopausal women, and to examine the potential moderating effect of serum 25-hydroxyvitamin D (25(OH)D) and age. Methods 439 overweight and obese postmenopausal women were randomized to: diet modification (N=118); exercise (N=117), diet+exercise (N=117), or control (N=87). The diet intervention was a group-based program with a 10% weight loss goal. The exercise intervention was 45 mins/day, 5 days/week of moderate-to-vigorous intensity aerobic activity. Total and appendicular lean mass were quantified by dual Xray absorptiometry (DXA) at baseline and 12 months. A skeletal muscle index (SMI=appendicular lean mass (kg)/m2) and the prevalence of sarcopenia (SMIlean mass, and a borderline significant decrease in appendicular lean mass and SMI compared to controls. In contrast, aerobic exercise significantly preserved appendicular lean mass and SMI. Diet + exercise attenuated the loss of appendicular lean mass and SMI compared to diet alone, and did not result in significant loss of total- or appendicular lean mass compared to controls. Neither serum 25(OH)D nor age were significant moderators of the intervention effects. Conclusions Aerobic exercise added to dietary weight loss can attenuate the loss of appendicular lean mass during weight loss, and may be effective for the prevention and treatment of sarcopenia among overweight and obese postmenopausal women. PMID:23190588

Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

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Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

2017-05-01

A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

Implications of ICD-10 for Sarcopenia Clinical Practice and Clinical Trials: Report by the International Conference on Frailty and Sarcopenia Research Task Force.

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Vellas, B; Fielding, R A; Bens, C; Bernabei, R; Cawthon, P M; Cederholm, T; Cruz-Jentoft, A J; Del Signore, S; Donahue, S; Morley, J; Pahor, M; Reginster, J-Y; Rodriguez Mañas, L; Rolland, Y; Roubenoff, R; Sinclair, A; Cesari, M

2018-01-01

Establishment of an ICD-10-CM code for sarcopenia in 2016 was an important step towards reaching international consensus on the need for a nosological framework of age-related skeletal muscle decline. The International Conference on Frailty and Sarcopenia Research Task Force met in April 2017 to discuss the meaning, significance, and barriers to the implementation of the new code as well as strategies to accelerate development of new therapies. Analyses by the Sarcopenia Definitions and Outcomes Consortium are underway to develop quantitative definitions of sarcopenia. A consensus conference is planned to evaluate this analysis. The Task Force also discussed lessons learned from sarcopenia trials that could be applied to future trials, as well as lessons from the osteoporosis field, a clinical condition with many constructs similar to sarcopenia and for which ad hoc treatments have been developed and approved by regulatory agencies.

Biomarkers of sarcopenia in clincal trials recommendations from the international working group on sarcopenia

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Sarcopenia, the age-related skeletal muscle decline, is associated with relevant clinical and socioeconomic negative outcomes in older persons. The study of this phenomenon and the development of preventive/therapeutic strategies represent public health priorities. The present document reports the r...

Ageing in relation to skeletal muscle dysfunction: redox homoeostasis to regulation of gene expression

OpenAIRE

Goljanek-Whysall, Katarzyna; Iwanejko, Lesley A.; Vasilaki, Aphrodite; Pekovic-Vaughan, Vanja; McDonagh, Brian

2016-01-01

Ageing is associated with a progressive loss of skeletal muscle mass, quality and function?sarcopenia, associated with reduced independence and quality of life in older generations. A better understanding of the mechanisms, both genetic and epigenetic, underlying this process would help develop therapeutic interventions to prevent, slow down or reverse muscle wasting associated with ageing. Currently, exercise is the only known effective intervention to delay the progression of sarcopenia. Th...

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia.

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Law, Timothy D; Clark, Leatha A; Clark, Brian C

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive resistance exercise training can have on increasing muscle strength, muscle size and functional capacity in older adults. In this review article we discuss how resistance exercise training can be used in the management and prevention of sarcopenia and dynapenia. We first provide an overview of the evidence for this notion and highlight certain critical factors- namely exercise intensity, volume and progression- that are key to optimizing the resistance exercise prescription. We then highlight how many, if not most, of the commonly prescribed exercise programs for seniors are not the 'best practices', and subsequently present easy-to-read guidelines for a well-rounded resistance exercise training program designed for the management and prevention of sarcopenia and dynapenia, including example training programs for the beginner through the advanced senior resistance exerciser. These guidelines have been written for the academician as well as the student and health care provider across a variety of disciplines, including those in the long term care industry, such as wellness instructors or activity directors.

The additional value of bioelectrical impedance analysis-derived muscle mass as a screening tool in geriatric assessment for fall prevention.

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Van Puyenbroeck, Karolien; Roelandts, Lieven; Van Deun, Thomas; Van Royen, Paul; Verhoeven, Veronique

2012-01-01

The decline in skeletal muscle in old age is a factor in the development of functional limitations. The objective of this study was to assess if there is a correlation between muscle mass based on bioelectrical impedance analysis (BIA) detection and the fall incidence in nursing home residents and to examine the risk factors for falling in nursing home residents. This prospective cohort study was part of a longitudinal study on nutritional issues in 52 nursing homes in Antwerp (Belgium) from October 2007 to April 2008. Two hundred and seventy-six people aged 65 years and older were included. Each subject was assessed with BIA, the timed get-up-and-go test, the Katz score, the Mini Nutritional Assessment - Short Form and the 36-Item Short Form Health Survey. The primary outcome parameter was fall incidence during the study. The prevalence of sarcopenia varied from 24.3 to 81.5% depending on which definition was used. No association was found between BIA-derived muscle mass and fall incidence. Logistic regression analysis showed that gait speed (odds ratio 1.029; p = 0.003) and mental health (odds ratio 0.981; p = 0.015) are significantly associated with fall incidence in nursing homes. A receiver operating characteristic curve showed that none of the BIA-derived muscle parameters are good predictors of the risk of falling. This study shows that there is no association between sarcopenia based on BIA and fall incidence and that BIA-derived muscle mass has no additional value in predicting fall incidents compared to the timed get-up-and-go test. Copyright © 2012 S. Karger AG, Basel.

Fatores dietéticos, antropométricos e socioeconômicos associados à sarcopenia em idosos: estudo transversal de base populacional

OpenAIRE

Martins, Lucélia Campos Aparecido [UNESP

2015-01-01

Introduction: Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength that occurs with aging. It is prevalent in the elderly population and has been postulated as the main factor in the decline in strength with age, representing a health deficient state with a personal high cost. Purpose: The aim of this study was to identy the prevalence of sarcopenia and its association with dietary, anthropometric and socioeconomic factors ...

Advantages of dietary, exercise-related, and therapeutic interventions to prevent and treat sarcopenia in adult patients: an update

Directory of Open Access Journals (Sweden)

DL Waters

2010-09-01

Full Text Available DL Waters1, RN Baumgartner2, PJ Garry3, B Vellas41Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; 2Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA; 3Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA; 4Department of Internal Medicine and Geriatric Medicine, University Hospital Center of Toulouse, Gerontopole, Toulouse, FranceAbstract: Sarcopenia is the loss of skeletal muscle mass and function with aging. Although the term sarcopenia was first coined in 1989, its etiology is still poorly understood. Moreover, a consensus for defining sarcopenia continues to elude us. Sarcopenic changes in the muscle include losses in muscle fiber quantity and quality, alpha-motor neurons, protein synthesis rates, and anabolic and sex hormone production. Other factors include basal metabolic rate, increased protein dietary requirements, and chronic inflammation secondary to age-related changes in cytokines and oxidative stress. These changes lead to decreased overall physical functioning, increased frailty, falls risk, and ultimately the loss of independent living. Because the intertwining relationships of these factors are complex, effective treatment options are still under investigation. The published data on sarcopenia are vast, and this review is not intended to be exhaustive. The aim of this review is to provide an update on the current knowledge of the definition, etiology, consequences, and current clinical trials that may help address this pressing public health problem for our aging populations.Keywords: aging, muscle loss, nutrition, physical activity

Malnutrition and sarcopenia in a large cohort of patients with systemic sclerosis.

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Caimmi, C; Caramaschi, P; Venturini, A; Bertoldo, E; Vantaggiato, E; Viapiana, O; Ferrari, M; Lippi, G; Frulloni, L; Rossini, M

2018-04-01

Systemic sclerosis (SSc) is an autoimmune disease which may lead to malnutrition. Previous studies have defined it with different criteria. No thorough evaluations of sarcopenia in SSc are available. The aim of the present study was to assess the prevalence and the potential association of malnutrition and sarcopenia in a large cohort of SSc cases. A total of 141 SSc consecutive outpatients were enrolled. Body composition was analyzed by densitometry. Malnutrition was defined according to recently published ESPEN criteria, whereas sarcopenia was diagnosed in patients with reduced skeletal muscle index. Malnutrition was diagnosed in 9.2% of patients (95% CI, 4.4-14.0%). Malnourished patients had worse gastrointestinal symptoms according to UCLA SCTC GIT 2.0 questionnaire (p = 0.007), lower physical activity (p = 0.028), longer disease duration (p = 0.019), worse predicted DLCO/VA and FVC (p = 0.009, respectively), worse disease severity according to Medsger severity score (p < 0.001), lower hemoglobin (p = 0.023), and fat-free mass (p < 0.001) and were more often sarcopenic (p < 0.001). In multivariate analysis, only FVC (p = 0.006) and disease severity (p = 0.003), in particular for the lungs (p = 0.013), were confirmed to be worse in malnourished patients. Sarcopenia was diagnosed in 29\\140 patients (20.7%; 95% CI, 14.0-27.4%); 11\\29 were also malnourished. In multivariate analysis, sarcopenic patients had longer disease duration (p = 0.049), worse DLCO/VA (p = 0.002), and lung (p = 0.006) and skin (p = 0.014) involvement. In SSc, malnutrition defined with ESPEN criteria was found to be lower than previously reported. Sarcopenia was found to be somewhat common. Lung involvement was significantly associated with nutritional status and may not be explained only by muscle weakness.

Impact of sarcopenia on the outcomes of elective total arch replacement in the elderly†.

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Ikeno, Yuki; Koide, Yutaka; Abe, Noriyuki; Matsueda, Takashi; Izawa, Naoto; Yamazato, Takahiro; Miyahara, Shunsuke; Nomura, Yoshikatsu; Sato, Shunsuke; Takahashi, Hiroaki; Inoue, Takeshi; Matsumori, Masamichi; Tanaka, Hiroshi; Ishihara, Satoshi; Nakayama, Shinichi; Sugimoto, Koji; Okita, Yutaka

2017-06-01

The purpose of this study was to identify the cut-off value of sarcopenia based on the psoas muscle area index and evaluate early and late outcomes following elective total arch replacement in the elderly. Sarcopenia was assessed by the psoas muscle area index [defined as the psoas muscle area at the L3 level on computed tomography (cm 2 )/body surface area (m 2 )]. The cut-off value for sarcopenia was defined as > 2 standard deviations below the mean psoas muscle area index value obtained from 464 normal control patients. Between October 1999 and July 2015, 266 patients who were ≥ 65 years and had undergone psoas muscle area index measurement underwent elective total arch replacement. These patients were classified into the sarcopenia (Group S, n  = 81) and non-sarcopenia (Group N, n  = 185) groups. The mean age was 76.2 ± 5.6 years in Group S and 75.7 ± 5.7 years in Group N ( P  = 0.553). Hospital mortality was 3.7% (3/81) in Group S and 2.2% (4/185) in Group N ( P  = 0.483). Mean follow-up was 48.3 ± 38.7 months. Five-year survival was significantly worse in Group S (S: 63.2 ± 6.6% vs N: 88.7 ± 2.6%, P  sarcopenia significantly predicted poor survival (hazard ratio 2.59; 95% confidence interval 1.27-5.29; P  = 0.011). Sarcopenia did not predict hospital death following total arch replacement, but it was negatively associated with overall survival. Sarcopenia can be an additional risk factor to estimate the outcomes of thoracic aortic surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Sarcopenia and Hearing Loss in Older Koreans: Findings from the Korea National Health and Nutrition Examination Survey (KNHANES 2010.

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Jieun Lee

Full Text Available Age-related hearing impairment (ARHI is becoming a more significant issue as geriatric population increases. Sarcopenia in older people is known to have a diverse health problem in various circumstances in recent studies. We assessed whether the decrease in muscle mass is related to ARHI. We used the 2010 data of the Korea National Health and Nutrition Examination Survey (KNHANES to examine the associations between sarcopenia and ARHI. A total number of participants was 1,622 including 746 males and 876 females aged 60 years or older. Muscle mass was assessed as an appendicular skeletal muscle mass, and hearing loss was defined as the pure-tone averages (PTA of test frequencies 0.5, 1, 2, 4 kHz at a threshold of 40 dB or higher in worse hearing side of the ear. Among 1,622 participants, 298 men and 256 women had hearing loss. Appendicular muscle mass (ASM, expressed as kg, was categorized in tertiles. In female population, after adjusting for age, smoking, drinking, amount of exercise, total body fat, education level, income level, and tinnitus, the odds ratio (OR for hearing loss was 1.57 (95% confidence interval (CI = 0.92-2.68 in the middle tertile and 1.79 (1.03-3.08 in the lowest tertile, compared with the highest tertile. P for trend in this model was 0.036. Controlling further for hypertension, diabetes mellitus, chronic kidney disease, and three types of noise exposure did not change the association. Larger muscle mass is associated with lower prevalence of hearing loss in elderly Korean females.

Association between visceral obesity and sarcopenia and vitamin D deficiency in older Koreans: the Ansan Geriatric Study.

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Seo, Ji A; Cho, Hyunjoo; Eun, Chai R; Yoo, Hye J; Kim, Sin G; Choi, Kyung M; Baik, Sei H; Choi, Dong S; Park, Moon H; Han, Changsu; Kim, Nan H

2012-04-01

To investigate whether vitamin D levels are independently associated with visceral obesity, sarcopenia, or sarcopenic obesity. Cross-sectional. Population-based sample of elderly adults living in Ansan, Korea. Two hundred sixteen men and 268 women aged 65 and older. Serum 25-hydroxyvitamin D (25(OH)D) levels, visceral fat area (VFA) according to abdominal computed tomography scanning, and body composition (body fat percentage, appendicular skeletal muscle mass (ASM)) using dual-energy X-ray absorptiometry. Visceral obesity was defined as VFA of 100 cm(2) or greater and sarcopenia as ASM/height(2) more than 1 standard deviation (SD) below the sex-specific mean of a young reference group. The adjusted 25(OH)D level for men was negatively associated with systolic blood pressure, VFA, and body fat percentage but positively associated with ASM. In women, waist circumference, triglyceride levels, and VFA were negatively correlated with 25(OH)D levels. In the joint regression model, VFA and ASM were independently associated with 25(OH)D levels (β = -0.078, P = .01 and β = 0.087, P = .02, respectively) per 1SD difference in VFA and ASM in men but not women. When participants were categorized according to four visceral obesity and sarcopenia categories, adjusted mean 25(OH)D level was lower in men with visceral obesity than in men without but was not affected by the presence or absence of sarcopenia. Greater visceral fat and lower muscle mass were associated with lower 25(OH)D levels in elderly Korean men, suggesting that screening for vitamin D deficiency may be appropriate in older Koreans with visceral obesity or sarcopenia. Sarcopenic obesity as defined according to prespecified criteria did not have an additive association with 25(OH)D levels. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Sarcopenia, but not excess weight or increased caloric intake, is associated with coronary subclinical atherosclerosis in the very elderly.

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Campos, Alessandra M; Moura, Filipe A; Santos, Simone N; Freitas, Wladimir M; Sposito, Andrei C

2017-03-01

Excess weight is a widespread condition related to increased risk of coronary heart disease (CHD). Sarcopenia is a catabolic pathway common of the aging process and also associated with CHD. In the elderly, both changes occur concurrently and it remains unclear the relative contribution on CHD risk. We aimed to investigate whether sarcopenia, excess weight, or both are associated with subclinical atherosclerosis and/or endothelial dysfunction in very elderly individuals. We performed a cross-sectional study of cohort enrolled individuals, aged 80 years or older (n = 208), who had never manifested cardiovascular diseases. Blood tests, medical and nutritional evaluations, cardiac computed tomography, flow-mediated dilation (FMD) and physical performance tests were obtained at the study admission. Odds ratio (OR) was calculated by multivariate regression models using coronary calcium score (CCS) categories and FMD as dependent variables. Adjustment for potential confounders was done. Muscle mass, but not fatty mass, was inversely associated with CCS categories [OR:2.54(1.06-6.06); p = 0.018]. The lowering of gait speed was negatively related to CCS>100 [OR:2.36 (1.10-5.06); p = 0.028] and skeletal muscle index was directly associated with FMD [OR:5.44 (1.22-24.24); p = 0.026]. Total caloric intake was positively related to fatty mass [OR:2.71 (1.09-6.72); p = 0.031], but was not related to CCS. This study reveals that sarcopenia - comprised by reduction of muscle mass and its strength - is associated with subclinical atherosclerosis and endothelial dysfunction. Surprisingly, the excess of fatty mass seems not to be related to atherosclerotic burden in very elderly individuals. Copyright © 2017 Elsevier B.V. All rights reserved.