scholarly journals Sarcopenia and homocysteine: is there a possible association in the elderly? A narrative review

2021 ◽  
pp. 1-36
Author(s):  
Rachele De Giuseppe ◽  
Chiara Elena Tomasinelli ◽  
Alessandra Vincenti ◽  
Ilaria Di Napoli ◽  
Massimo Negro ◽  
...  

Abstract Background Sarcopenia (SA) is a progressive skeletal muscle disorder, associated with increased risk of adverse outcomes, including falls, fractures, physical disability and mortality. Several risks factors may contribute to the development of SA in the elderly; among them, nutrition plays a key role in muscle health. The elderly are at risk of inadequate intake in terms of micronutrients affecting muscle-homeostasis, such as B vitamins, related to homocysteine (Hcy) metabolism. Objectives and Methods This narrative review analysed the association between increased Hcy levels and SA, according to the criteria of the International Working Group on Sarcopenia, the European Working Group on Sarcopenia in Older People and the Asian Working Group for Sarcopenia. The authors focused not only on SA per se but also on exploring the association between increased Hcy levels and components of SA, including muscle mass, muscle strength and physical performance. Results Results are inconsistent, except for muscle mass, showing no significant associations with Hcy levels. Conclusions Few and conflicting data emerged in this review on the association between SA and increased Hcy levels due to numerous differences between studies that change the significance of the association of Hcy and SA, as well as with the muscle strength, muscle mass and physical performance. Furthermore, because the ageing process is not uniform in the population due to differences in genetics, lifestyle and general health, chronological age fails to address the observed heterogeneity among the "elderly" of the studies reported in this revision. Therefore, further studies are still needed.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroki Oba ◽  
Yasumoto Matsui ◽  
Hidenori Arai ◽  
Tsuyoshi Watanabe ◽  
Hiroki Iida ◽  
...  

Abstract Background For the diagnosis of Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP) revised the algorisms in 2019, where they added computed tomography (CT) as an assessment tool not only for quantity but also for quality in research purpose. However, the evidence for clinical appreciation of CT has been lacking. Therefore, we investigated the correlation between CT and various motor function tests to assess the utility of CT as a potential diagnostic tool for sarcopenia. Methods In total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index by DXA and BIA, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia. Results Knee muscle strength correlated with CSA (r = 0.60) and the correlation was significantly greater than that with DXA and BIA. For physical performance, standing-up test correlated with CSA (r = − 0.20) and CTV (r = − 0.40) and walking speed with CTV (r = 0.43), which was significantly greater than that with DXA and BIA. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01). Furthermore, CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01). Conclusions CSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.


2019 ◽  
Vol 48 (6) ◽  
pp. 910-916 ◽  
Author(s):  
Miji Kim ◽  
Chang Won Won

Abstract Background in October 2018, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) updated their original definition of sarcopenia to reflect the scientific and clinical evidence that has accumulated over the last decade. Objective to determine the prevalence of sarcopenia in a large group of community-dwelling older adults using the EWGSOP2 definition and algorithm. Design a cross-sectional study. Setting the nationwide Korean Frailty and Aging Cohort Study (KFACS). Subjects a total of 2,099 ambulatory community-dwelling older adults, aged 70–84 years (mean age, 75.9 ± 4.0 years; 49.8% women) who were enrolled in the KFACS. Methods physical function was assessed by handgrip strength, usual gait speed, the five-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. Appendicular skeletal muscle mass (ASM) was measured by dual-energy X-ray absorptiometry. Results according to the criteria of the EWGSOP2, the sarcopenia indicators of combined low muscle strength and low muscle quantity were present in 4.6–14.5% of men and 6.7–14.4% of women. The severe sarcopenia indicators of combined low muscle strength, low muscle quantity and low physical performance were present in 0.3–2.2% of men and 0.2–6.2% of women. Using the clinical algorithm with SARC-F as a screening tool, the prevalence of probable sarcopenia (2.2%), confirmed sarcopenia (1.4%) and severe sarcopenia (0.8%) was low. Conclusions the prevalence of sarcopenia among community-dwelling older individuals varied depending on which components of the revised EWGSOP2 definition were used, such as the tools used to measure muscle strength and the ASM indicators for low muscle mass.


2019 ◽  
Vol 122 (12) ◽  
pp. 1386-1397 ◽  
Author(s):  
Ana Paula Medeiros Menna Barreto ◽  
Maria Inês Barreto Silva ◽  
Karine Scanci da Silva Pontes ◽  
Mariana Silva da Costa ◽  
Kelli Trindade de Carvalho Rosina ◽  
...  

AbstractSarcopenia is a progressive and generalised skeletal muscle disorder associated with adverse outcomes. Ageing causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of the present study was to evaluate the prevalence of sarcopenia using guidelines recommended by the European Working Group on Sarcopenia in Older People (EWGSOP, 2010; EWGSOP2, 2018) and the Foundation of the National Institutes of Health (FNIH) and analyse the relationship between sarcopenia and body adiposity in adult renal transplant recipients (RTR). This was a cross-sectional study of adult RTR (BMI ≥ 18·5 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry (DXA) and anthropometry. Glomerular filtration rate was estimated (eGFR) by CKD-Epidemiology Collaboration equation. The prevalence of sarcopenia in adult RTR (n 185; 57 % men, 50 (se 0·82) years and eGFR 55·80 (se 1·52) ml/min) was 7 % (FNIH), 11 % (EWGSOP2) and 17 % (EWGSOP). Low muscle mass, muscle function and physical performance affected, respectively, up to 28, 46 and 10 % of the participants. According to EWGSOP and EWGSOP2, body adiposity evaluated by anthropometry and DXA (percentage trunk fat) was lower in participants with sarcopenia. Conversely, according to the FNIH criteria, RTR with sarcopenia presented higher waist:height ratio. The present study suggests that adult RTR sarcopenia prevalence varies according to the diagnostic criteria; low muscle mass, low muscle function and low physical performance are common conditions; the association of body adiposity and sarcopenia depends on the criteria used to define this syndrome; and the FNIH criteria detected higher adiposity in individuals with sarcopenia.


Author(s):  
Titin Kristiana ◽  
Novira Widajanti ◽  
Rwahita Satyawati

ABSTRACTBackground: Sarcopenia is a decrease in muscle mass and strength that mostly happens in the elderly. Sarcopenia is a problem that is often found in the elderly who are at risk of disability, hospitalization and death. This data on muscle mass and strength with physical performance is expected to support the theory of sarcopenia and as a reference in promoting and preventing sarcopenia in elderly.Aims: To analyze the association between muscle mass and strength (handgrip strength) with physical performance assessed using Short Physical Performance Battery (SPPB) in an elderly community.Methods: This study was a cross-sectional observational analytic study involving 203 sample of elderly (age >60 years old). The subjects were categorized as the strong and weak muscle mass and muscle strength, also the high, moderate and low physical performance. We used Bioimpedance Analysis (BIA) and hand dynamometer to measure muscle mass and muscle strength (handgrip strength). SPPB was used to assess physical performance.The association between muscle mass and strength with physical performance was displayed in bivariate analysis with chi square.Result: Of all 203 subjects, 57 were males and 146 were females. Chi square test showed association between muscle strength (handgrip strength) with physical performance (SPPB) (p=0.001), with a weak correlation (r=0.26) and no association between muscle mass and physical performance (SPPB) (p=0.517).Conclusion: There is a positive association between muscle strength with physical performance, with a weak correlation and no association between muscle mass and physical performance in the elderly community in Surabaya.


2017 ◽  
Vol 4 (3) ◽  
pp. 9 ◽  
Author(s):  
Brigida Silva Cunha ◽  
Carla Rejane Gonçalves de Souza ◽  
Lorena Ohrana Braz Prudente ◽  
Neila Barbosa Osório ◽  
Luiz Sinésio da Silva Neto

A sarcopenia é uma síndrome geriátrica com prejuízos na massa e força muscular e desempenho físico e está associada a agravos na funcionalidade e qualidade de vida. Nesse sentido, a compreensão das características antropométricas e funcionais em idosos é adjuvante, em especial nas populações vulneráveis como as quilombolas. O objetivo desse estudo é analisar a sarcopenia, força de preensão manual (FPM) e variáveis antropométricas em idosas quilombolas. A amostra foi composta por 39 mulheres com idade média de 63,77±7,58 anos, das comunidades quilombolas de Malhadinha e Córrego Fundo-Tocantins. Para o diagnóstico de sarcopenia foi utilizado o critério proposto pelo European Working Group consensus (EWGSOP). As variáveis de composição corporal analisadas foram peso, estatura, IMC, circunferência da cintura (CC), circunferência do quadril (CQ), relação cintura quadril (RCQ), percentual de gordura (%G) e massa livre de gordura apendicular (MLGA). A mensuração da massa muscular foi realizada pelo exame de absormetria de raios-x de dupla energia (DXA). A FPM foi obtida por meio do dinamômetro modelo Saehan. A velocidade de marcha foi utilizada para status de desempenho físico. A prevalência de sarcopenia foi de 7,69%. Foram encontradas diferenças significativas de peso (p=0,004), IMC (p=0,005), CC (p=0,002), CQ (p=0,045), MLGA (p=0,001), %G (p=0,002) e FPM (p=0,038), revelando valores médios inferiores nas idosas sarcopênicas. Portanto, a condição de sarcopênica revelou prejuízos na funcionalidade. A medida do IMC pode ser um marcador clínico para sarcopenia. A adoção de medidas que minimizem os prejuízos da sarcopenia como a baixa massa magra e FPM são necessárias.         Palavras-chave: Sarcopenia. Idosos. Quilombolas. Força de Preensão Manual. População Vulnerável. ABSTRACT Sarcopenia is a geriatric syndrome with losses in muscle mass and strength and physical performance and is associated with impairments in functionality and quality of life. In this sense, the understanding of the anthropometric and functional characteristics in the elderly is adjuvant, especially in vulnerable populations such as quilombolas. The objective of this study is to analyze sarcopenia, manual grip strength (MPF) and anthropometric variables in quilombolate elderly women. The sample consisted of 39 women with a mean age of 63.77 ± 7.58 years, from the quilombola communities of Malhadinha and Córrego Fundo-Tocantins. For the diagnosis of sarcopenia, the criterion proposed by the European Working Group consensus (EWGSOP) was used. The variables of body composition analyzed were weight, height, BMI, waist circumference (WC), hip circumference (HR), waist hip ratio (WHR), fat percentage (% G) and appendicular fat free mass . Muscle mass measurement was performed by double-energy x-ray absorptiometry (DXA). FPM was obtained using the Saehan model dynamometer. Travel speed was used for physical performance status. The prevalence of sarcopenia was 7.69%. There were significant differences in weight (p = 0.004), BMI (p = 0.005), WC (p = 0.002), CQ (p = 0.045), MLGA (p = 0.001),% G P = 0.038), revealing lower mean values in the sarcopenic elderly. Therefore, the sarcopenic condition revealed functional impairments. Measurement of BMI may be a clinical marker for sarcopenia. The adoption of measures that minimize the losses of sarcopenia such as low lean mass and FPM are necessary.                                         Keywords: Sarcopenia. Elderly. Quilombolas. Handgrip strength. Vulnerable population.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Caoileann Murphy ◽  
Aoibheann McMorrow ◽  
Ellen Flanagan ◽  
Helen Cummins ◽  
Sinead McCarthy ◽  
...  

AbstractSarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime. It is an independent risk factor for numerous adverse health outcomes. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition for the identification of people with sarcopenia (EWGSOP1). In 2018, this definition was updated based on the newest evidence (EWGSOP2), with the focus now on low muscle strength rather than low muscle quantity as the key characteristic of sarcopenia. In addition, EWGSOP2 provides clear cut-off points for measurements of variables that identify sarcopenia. The aim of this study was to determine the prevalence of sarcopenia among community-dwelling older adults in Ireland for the first time and to assess agreement between the EWGSOP1 and EWGSOP2 definitions. In a cross-sectional analysis, 490 community-dwelling adults (age 78.4 ± 8.0 y, body mass index 27.6 ± 5.1 kg/m2) were assessed. Skeletal muscle mass was estimated using bioelectrical impedance analysis, muscle strength was measured via handgrip dynamometry and physical performance via the Short Physical Performance Battery. Sarcopenia was defined according to both the 2010 criteria (EWGSOP1) and the updated 2018 criteria (EWGSOP2). Using the EWGSOP1 criteria, the prevalence of sarcopenia was 7.1% (2.6% sarcopenia, 4.5% severe sarcopenia) and 3.6% were classified as pre-sarcopenic (low muscle mass without a decrement in strength or physical performance). Using the EWGSOP2 criteria, the prevalence of sarcopenia was 5.5% (1.6% sarcopenia, 3.9% severe sarcopenia) and 23.4 % were classified as having low strength but without a decrement in muscle mass. Five of the participants who were classified as sarcopenic (2 sarcopenia, 3 severe sarcopenia) by EWGSOP1 were classified as “normal” using the EWGSOP2 criteria. In conclusion, the prevalence of sarcopenia in community-dwelling older adults in Ireland is in line with the prevalence reported in other European countries using the EWGSOP1 criteria (3.3–11.4 %). To our knowledge this is the first study to compare the prevalence based on the EWGSOP1 and the EWGSOP2 criteria. We report a slightly lower prevalence using the EWGSOP2 definition compared to the EWGSOP1 definition. Importantly however, in contrast to EWGSOP1, the EWGSOP2 definition identified a substantial proportion of older adults with poor strength in the absence of overt sarcopenia (23.4%). These older adults represent a group who would benefit from further clinical investigation and intervention.


Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 547 ◽  
Author(s):  
Julia Traub ◽  
Ina Bergheim ◽  
Martin Eibisberger ◽  
Vanessa Stadlbauer

The European Working group on Sarcopenia in Older People recently updated the diagnostic criteria for sarcopenia. It is yet unclear how these modified criteria influence the rate of diagnosis in high risk populations, such as liver cirrhosis. We therefore assessed if the new diagnostic criteria for sarcopenia impacts on sarcopenia prevalence in liver cirrhosis. Within two years 114 cirrhotic patients were prospectively enrolled in the study. Sarcopenia was determined by muscle strength (handgrip strength), muscle mass (lumbal muscle index) and muscle performance (gait speed). Using the 2019 definition, the rate of pre-sarcopenia was significantly lower (30.7% versus 3.5%) due to the different starting points (2010 muscle mass, 2019 muscle strength) and cut-off values (muscle strength). The change in diagnostic criteria for sarcopenia drastically influences the rate of pre-sarcopenia diagnosis in cirrhotics. To evaluate, which diagnostic criteria should be chosen to diagnose sarcopenia in liver cirrhosis patients, prospective studies are needed.


2021 ◽  
Vol 9 (B) ◽  
pp. 55-59
Author(s):  
Nur Riviati ◽  
Taufik Indrajaya ◽  
Erial Bahar ◽  
Dobi Saputra Burni

BACKGROUND: Geriatric problem characterized by reduced functional ability and impaired adaptation function caused by the decline in various body systems, as well as increased vulnerability to various kinds of stressors, which reduce a person’s functional performance. AIM: This study was aimed to explore the effect of omega-3 supplementation on muscle mass, muscle strength, and physical performance in the elderly community in Palembang, Indonesia. METHODS: This study is an open clinical trial, to assess the potential of omega-3 supplementation on muscle mass, handgrip strength, and physical activity of elderly community. Omega-3 is given as much as 1.2 g once a day for 12 weeks orally. Muscle strength was assessed using Bioelectrical Impedance Analysis. Meanwhile, the muscle strength was assessed with a muscle dynamometer. RESULTS: Omega-3 supplementation has only shown potent efficacy in improving muscle strength in geriatrics patients (before omega-3 supplementation 25.1 + 5.11; after omega-3 supplementation 26.2 + 5.16; p < 0.05). Omega 3 supplementation did not show significant improvement in muscle mass and gait ability in elderly patients. CONCLUSIONS: Omega-3 supplementation improves handgrip strength but does not increase muscle mass and physical performance for geriatrics.


Author(s):  
Filipe Rodrigues ◽  
Christophe Domingos ◽  
Diogo Monteiro ◽  
Pedro Morouço

As aging continues to grow in our society, sarcopenia and associated fall risk is considered a public health problem since falling is the third cause of chronic disability. Falls are negatively related to functionality and independence and positively associated with morbidity and mortality. The cost of treatment of secondary injuries related to falls is high. For example, one in ten fall incidents leads to bone fractures and several other comorbidities. As demonstrated by several experimental studies, adopting a more active lifestyle is critical for reducing the number of fall episodes and their consequences. Therefore, it is essential to debate the proven physical exercise methods to reduce falls and fall-related effects. Since muscle mass, muscle strength, bone density, and cartilage function may play significant roles in daily activities, resistance training may positively and significantly affect the elderly. This narrative review aimed to examine current evidence on existing resistance training using resistance machines and bodyweight or low-cost equipment for the elderly and how they are related to falls and fall-related consequences. We provide theoretical links between aging, sarcopenia, and falls linking to resistance training and offer practical suggestions to exercise professionals seeking to promote regular physical exercise to promote quality of life in this population. Exercise programs focusing on strength may significantly influence muscle mass and muscle strength, minimizing functional decline and risk of falling. Resistance training programs should be customized to each elderly according to age, sex, and other fundamental and individual aspects. This narrative review provides evidence to support recommendations for practical resistance training in the elderly related to intensity and volume. A properly designed resistance training program with adequate instructions and technique is safe for the elderly. It should include an individualized approach based on existing equipment (i.e., body weight, resistance machines). Existing literature shows that exercise performance towards 2–3 sets of 1–2 exercises per major muscle group, performing 5–8 repetitions or achieving intensities of 50–80% of 1RM, 2–3 times per week should be recommended, followed by training principles such as periodization and progression. Bearing this in mind, health and exercise professionals should combine efforts focusing on efficient strategies to reduce falls among the elderly and promote higher experiences of well-being at advanced stages in life.


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