DETERMINING THE PREVALENCE OF SARCOPENIA IN AN INPATIENT GERIATRIC POPULATION USING EWGSOP2 OR FNIH DEFINITIONS

Abstract Sarcopenia has been recognized as a progressive and generalized skeletal muscle disorder leading to loss of strength, muscle mass, and function. It is associated with an increased likelihood of adverse outcomes like falls, fractures, physical disability, and mortality. International consensus groups continue providing new definitions and clinical cut-off points despite over a decade of work in this area. Thus, the purpose of this research was to determine the prevalence of sarcopenia using two of the most current operational definitions (Foundation of NIH Sarcopenia Project (FNIH) and the European Working Group on Sarcopenia in Older Persons 2 (EWGSOP2)). Our cohort of acutely hospitalized older adults was formed from combining data from two randomized controlled trials and one cross-sectional observational study. Testing during hospitalization included measures of: demographics, body composition (DEXA), physical function tests, psychological wellbeing and independence questionnaires, and chart review. These were used to analyze the cohort according to three main groupings of low physical performance, low muscle strength, and low lean mass. We compared multiple tests and cutoffs for each of the three groupings under the FNIH and EWGSOP2 definitions, which varied 3% for low lean mass up to 48% for tests of low physical performance. After examining the efficacy of each cutoff, we evaluated the differences between FNIH and EWGSOP2. In our cohort, the prevalence of sarcopenia was 15.79% by EWGSOP2 and 13.59% by FNIH. The groupings within FNIH and EWGSOP2 were found to be near identical across almost all measures despite the definitions’ discrepancies in cutoff points.

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Sarcopenia and its components in adult renal transplant recipients: prevalence and association with body adiposity

British Journal Of Nutrition ◽

10.1017/s0007114519002459 ◽

2019 ◽

Vol 122 (12) ◽

pp. 1386-1397 ◽

Cited By ~ 3

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 ◽

...

Keyword(s):

Renal Transplant ◽

Muscle Mass ◽

Physical Performance ◽

Muscle Function ◽

Adverse Outcomes ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Cross Sectional ◽

Body Adiposity ◽

European Working

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.

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Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults

Nursing Research and Practice ◽

10.1155/2014/846759 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Harriet Udin Aronow ◽

Jeff Borenstein ◽

Flora Haus ◽

Glenn D. Braunstein ◽

Linda Burnes Bolton

Keyword(s):

Older Adult ◽

Older Patients ◽

Screening Tool ◽

Adverse Outcomes ◽

Patient Harm ◽

Comorbid Conditions ◽

Care Plans ◽

Screening Protocol ◽

Hospitalized Older Adults ◽

Almost All

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events.

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Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001093 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Caoileann Murphy ◽

Aoibheann McMorrow ◽

Ellen Flanagan ◽

Helen Cummins ◽

Sinead McCarthy ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Clinical Investigation ◽

Community Dwelling ◽

Muscle Disease ◽

Cross Sectional ◽

European Working ◽

Community Dwelling Older Adults

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.

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The Roles of Body Composition and Specific Strength in the Relationship Between Race and Physical Performance in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz103 ◽

2019 ◽

Vol 75 (4) ◽

pp. 784-791 ◽

Cited By ~ 1

Author(s):

Nancy Chiles Shaffer ◽

Eleanor M Simonsick ◽

Roland J Thorpe ◽

Stephanie A Studenski

Keyword(s):

Older Adults ◽

Body Composition ◽

High Education ◽

Racial Differences ◽

Physical Performance ◽

Lean Mass ◽

Gait Speed ◽

Cross Sectional ◽

Specific Strength ◽

Appendicular Lean Mass

Abstract Background Socioeconomics may explain black–white differences in physical performance; few studies examine racial differences among socioeconomically similar groups. Performance is also affected by body composition and specific strength, which differ by race. We assessed whether racial differences in physical performance exist among older adults with high education and similar income and whether body composition and specific strength attenuate observed differences. Methods Cross-sectional analysis of 536 men (18% black) and 576 women (28% black) aged more than 60 years from the Baltimore Longitudinal Study of Aging. Body composition was evaluated using dual-energy x-ray absorptiometry. Specific strength was assessed by quadricep peak torque divided by height-normalized thigh cross-sectional area and grip strength divided by body mass index-normalized appendicular lean mass. Physical performance was assessed using usual gait speed and fast 400 m walk time. Sex-stratified linear regression models, adjusted for age, height, education, and recent income, determined whether body composition or specific strength attenuated associations between race and physical performance. Results Blacks were younger, with higher weight and appendicular lean mass. Black women had higher percent fat and specific strength. In both sexes, blacks had poorer physical performance after adjustment for socioeconomic factors. In women, neither body composition nor specific strength altered the association with gait speed. In men, neither body composition nor specific strength attenuated racial differences in either performance measure. Conclusions Poorer physical performance among black compared to white older adults persists among persons with high education and similar income and cannot generally be attributed to differences in body composition or specific strength.

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Prevalence of Sarcopenia Employing Population-Specific Cut-Points: Cross-Sectional Data from the Geelong Osteoporosis Study, Australia

Journal of Clinical Medicine ◽

10.3390/jcm10020343 ◽

2021 ◽

Vol 10 (2) ◽

pp. 343

Author(s):

Sophia X. Sui ◽

Kara L. Holloway-Kew ◽

Natalie K. Hyde ◽

Lana J. Williams ◽

Monica C. Tembo ◽

...

Keyword(s):

Physical Performance ◽

Handgrip Strength ◽

Whole Body ◽

Australian Population ◽

Timed Up And Go ◽

Cross Sectional ◽

Cut Points ◽

European Working ◽

Prevalence Estimates ◽

Geelong Osteoporosis Study

Background: Prevalence estimates for sarcopenia vary depending on the ascertainment criteria and thresholds applied. We aimed to estimate the prevalence of sarcopenia using two international definitions but employing Australian population-specific cut-points. Methods: Participants (n = 665; 323 women) aged 60–96 years old were from the Geelong Osteoporosis Study. Handgrip strength (HGS) was measured by dynamometers and appendicular lean mass (ALM) by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using gait speed (GS, men only) and/or the timed up-and-go (TUG) test. Using cut-points equivalent to two standard deviations (SDs) below the mean young reference range from the same population and recommendations from the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was identified by low ALM/height2 (<5.30 kg for women; <6.94 kg for men) + low HGS (<16 kg women; <31 kg men); low ALM/height2 + slow TUG (>9.3 s); low ALM/height2 + slow GS (<0.8 m/s). For the Foundation for the National Institutes of Health (FNIH) equivalent, sarcopenia was identified as low ALM/BMI (<0.512 m2 women, <0.827 m2 men) + low HGS (<16 kg women, <31 kg men). Receiver Operating Characteristic curves were also applied to determine optimal cut-points for ALM/BMI (<0.579 m2 women, <0.913 m2 men) that discriminated poor physical performance. Prevalence estimates were standardized to the Australian population and compared to estimates using international thresholds. Results: Using population-specific cut-points and low ALM/height2 + HGS, point-estimates for sarcopenia prevalence were 0.9% for women and 2.9% for men. Using ALM/height2 + TUG, prevalence was 2.5% for women and 4.1% for men, and using ALM/height2 + GS, sarcopenia was identified for 1.6% of men. Using ALM/BMI + HGS, prevalence estimates were 5.5–10.4% for women and 11.6–18.4% for men. Conclusions: This study highlights the range of prevalence estimates that result from employing different criteria for sarcopenia. While population-specific criteria could be pertinent for some populations, a consensus is needed to identify which deficits in skeletal muscle health are important for establishing an operational definition for sarcopenia.

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Associations Between Muscle Mass, Muscle Morphology and Bone Health in Older Men With Sarcopenia: A Cross-sectional Study

10.21203/rs.3.rs-66725/v1 ◽

2020 ◽

Author(s):

Asta Mastaviciute ◽

Justina Kilaite ◽

Donatas Petroska ◽

Arvydas Laurinavičius ◽

Marija Tamulaitiene ◽

...

Keyword(s):

Bone Mineral Density ◽

Muscle Mass ◽

Physical Performance ◽

Bone Mineral ◽

Muscle Fiber ◽

Lean Mass ◽

Older Men ◽

Mineral Density ◽

Balance Test ◽

Cross Sectional

Abstract Background: The aim of this study was to explore the association between muscle mass, morphology, bone mineral density, and physical function in community-dwelling older men with sarcopenia.Methods: A total of 151 men, 60 years or older were included in this study. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Low bone mineral density was diagnosed if T-score was equal to or below -1.0 SD of mean young men reference range. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People (EWGSOP) criteria: low muscle mass and low muscle strength or low physical performance. Physical performance was evaluated by short physical performance battery. Microbiopsy of musculus vastus lateralis was performed with disposable muscle microbiopsy system. The perimeter and cross-section area of muscle fibers were calculated using image analysis software in whole slide images; type of fiber and their distribution were evaluated as well. Relationship between variables were examined using Spearman’s and Pearson’s correlations. The level of significance (p-value) of < 0.05 was considered as statistically significant.Results: Mean age of the subjects was 72.9 ± 8.02 years. Sarcopenia was diagnosed in 45 (29.8%) men. In the sarcopenia group, 25 muscle biopsies were examined. The average muscle fiber length was 217.47 ± 25.22 microm and average fiber cross-sectional area was 2446 ± 608.87 microm2. In 9 sarcopenic men with T-scores equal or below -2.5, the muscle fiber area had a significant correlation with balance test (r = 0.73, p = 0.025). Multiple significant correlations were found between bone mineral density, lean mass, appendicular lean mass, arm and leg lean mass, gait speed, balance test and handgrip strength.Conclusions: In men with sarcopenia, low lean muscle mass was associated with low femoral neck and hip BMD, and lower muscle strength. In sarcopenic men with osteoporosis, lower muscle fiber area was associated with lower scores of balance test.Trial registration: study protocol has been approved by Lithuanian regional biomedical research ethics committee (No. 158200-03-208-75).

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Functional and Clinical Characteristics for Predicting Sarcopenia in Institutionalised Older Adults: Identifying Tools for Clinical Screening

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124483 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4483 ◽

Cited By ~ 1

Author(s):

Maria A. Cebrià i Iranzo ◽

Anna Arnal-Gómez ◽

Maria A. Tortosa-Chuliá ◽

Mercè Balasch-Bernat ◽

Silvia Forcano ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Handgrip Strength ◽

Objective Evaluation ◽

Cross Sectional Study ◽

Clinical Aspects ◽

Cross Sectional ◽

European Working ◽

Appendicular Skeletal Muscle ◽

Hospital Stays

Background: Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. Methods: A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson’s Comorbidity Index (ACCI), number of medications, hospital stays and falls. Results: Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke’s R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). Conclusion: BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.

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Variables associated with frailty in a hospital population in Colombia

Geriatrics Gerontology and Aging ◽

10.5327/z2447-212320202000029 ◽

2020 ◽

Vol 14 (2) ◽

pp. 114-119

Author(s):

Diego Moreno Díaz ◽

Andrés Ochoa ◽

Mario Alberto Corzo ◽

Miguel Cadena Sanabria ◽

Claudia Lucía Figueroa

Keyword(s):

Functional Decline ◽

Predictive Ability ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

Adverse Outcomes ◽

Cross Sectional ◽

Medicine Service ◽

Measurement Tools ◽

Hospitalized Older Adults

INTRODUCTION: Frailty predicts functional decline and could be associated with adverse outcomes such as disability, multiple hospitalizations, falls, loss of mobility, and cardiovascular disease. In Colombia 12.5% of prevalence has been reported. In the present study, the different clinical variables associated with frailty were evaluated in a population of hospitalized patients older than 65 years in Bucaramanga, Colombia, in order to predict the behavior of these variables to generate measurement tools of greater applicability than that of currently existing tools. METHODS: An analytical observational cross-sectional study with nonprobabilistic sampling was conducted from January 2016 to June 2017 in patients older than 65 years of follow-up > 48 hours by the internal medicine service. Fried criteria were used to evaluate patients on their last day of hospitalization. RESULTS: A total of 155 patients were included, of whom 60.6% were frail. A combined analysis of the variables that showed association with frailty revealed that a calf circumference lower than or equal to 31 cm, a gait speed lower than or equal to 0.8 m/s, and age above 75 years were associated with frailty. It was also shown that being male and having a BMI > 27 kg/m2 are protective factors for frailty. CONCLUSIONS: The prevalence of frailty in hospitalized older adults was higher than that reported in local studies for the community population. According to multivariate analysis, the variables, when analyzed together, have a predictive ability of 92% to estimate frailty in hospitalized patients.

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SARCOPENIA VERSUS DYNAPENIA: FUNCTIONAL PERFORMANCE AND PHYSICAL DISABILITY IN CROSS SECTIONAL STUDY

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2018.12 ◽

2018 ◽

pp. 1-9

Author(s):

T. Neves ◽

M. Bomfim Martin Lopes ◽

M.G. Crespilho Souza ◽

E. Ferriolli ◽

C.A. Fett ◽

...

Keyword(s):

Muscle Mass ◽

Physical Performance ◽

Physical Disability ◽

Public Health Problem ◽

The Elderly ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Mato Grosso ◽

European Working

Background: The magnitude of “Sarcopenia” and “Dynapenia” as a public health problem is not well established, nor is the relationship of declines strength and muscle mass to physical disability and/or loss of mobility. Objectives: Test the hypothesis that the elderly with sarcopenia are more likely to physical disability than are those with dynapenia. Design: Cross-sectional study. Setting/Participants: A total of 387 older adults (≥65 years old) from the FIBRA Study in Cuiabá, Mato Grosso, Brazil. Measurements: Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP), which includes the presence of low muscle mass, plus low muscle strength or low physical performance. Dynapenia was defined as handgrip strength <30kgf (men) and <20kgf (women). Data relating to socio-demographic, behavioral, health conditions, physical disability, the level of physical activity, body composition, hand grip strength and the Short Physical Performance Battery were collected. Results: Regarding the loss of mobility, sarcopenia was associated with age ≥75 years, female, sedentary lifestyle, stroke, arthritis, and falls (OR = 2.95, 95% CI: 1.07 – 8.09); with no association for physical disability in BADL and IADL. Dynapenia had no association with loss of mobility; however, for disability in BADL and IADL, it was associated with the elderly aged ≥80 years old and arthritis (OR = 2.35, 95% CI: 1.42 – 3.88). Conclusion: Dynapenia is more sensitive to the prevention of future self-reported physical disability, in comparison to sarcopenia which can be used in clinical practice as a screening tool for the early decline in mobility.

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

Nutrition Research Reviews ◽

10.1017/s095442242100010x ◽

2021 ◽

pp. 1-36

Author(s):

Rachele De Giuseppe ◽

Chiara Elena Tomasinelli ◽

Alessandra Vincenti ◽

Ilaria Di Napoli ◽

Massimo Negro ◽

...

Keyword(s):

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Working Group ◽

The Elderly ◽

Adverse Outcomes ◽

Narrative Review ◽

Increased Risk ◽

European Working ◽

Muscle Homeostasis

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.

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