scholarly journals Sarcopenia assessed by 4-step EWGSOP2 in elderly hemodialysis patients: Feasibility and limitations

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261459
Author(s):  
M. Luz Sánchez-Tocino ◽  
Blanca Miranda-Serrano ◽  
Carolina Gracia-Iguacel ◽  
Ana María de-Alba-Peñaranda ◽  
Sebastian Mas-Fontao ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Diagnostic Algorithm ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Elderly Persons ◽  
Prognostic Information ◽  
Timed Up And Go ◽  
Sit To Stand ◽  
Appendicular Skeletal Muscle ◽  
Elderly Hemodialysis Patients

Background In 2019, EWGSOP2 proposed 4 steps to diagnose and assess sarcopenia. We aimed to quantify the prevalence of sarcopenia according to the EWGSOP2 diagnostic algorithm and to assess its applicability in elderly patients on hemodialysis. Methods Prospective study of 60 outpatients on chronic hemodialysis aged 75- to 95-years, sarcopenia was assessed according to the 4-step EWGSOP2: Find: Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls (SARC-F); Assess: grip strength by dynamometry (GSD) and sit to stand to sit 5 (STS5); Confirm: appendicular skeletal muscle mass (ASM) by bioimpedance; Severity: gait speed (GS), Timed-Up and Go (TUG), and Short Physical Performance Battery (SPPB). Results The sequential four steps resulted in a prevalence of confirmed or severe sarcopenia of 20%. Most (97%) patients fulfilled at least one criterion for probable sarcopenia. The sensitivity of SARC-F for confirmed sarcopenia was low (46%). Skipping the SARC-F step increased the prevalence of confirmed and severe sarcopenia to 40% and 37%, respectively. However, 78% of all patients had evidence of dynapenia consistent with severe sarcopenia. Muscle mass (ASM) was normal in 60% of patients, while only 25% had normal muscle strength values (GSD). Conclusions According to the 4-step EWGSOP2, the prevalence of confirmed or severe sarcopenia was low in elderly hemodialysis patients. The diagnosis of confirmed sarcopenia underestimated the prevalence of dynapenia consistent with severe sarcopenia. Future studies should address whether a 2-step EWGSOP2 assessment (Assess-Severity) is simpler to apply and may provide better prognostic information than 4-step EWGSOP2 in elderly persons on hemodialysis.

MO906DIAGNOSIS OF SARCOPENIA ACCORDING TO THE EWGSOP2 STEPS IN VERY ELDERLY HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Maria Luz Sánchez-Tocino ◽  
Blanca Miranda ◽  
Sebastián Mas ◽  
Ana Maria De Alba-Peñaranda ◽  
Antonio Lopez-Gonzalez ◽  
...  
Keyword(s):  
Older People ◽  
Muscle Mass ◽  
Working Group ◽  
Hemodialysis Patients ◽  
Measurement Scales ◽  
Very Elderly ◽  
Timed Up And Go ◽  
European Working Group ◽  
European Working ◽  
Elderly Hemodialysis Patients

Abstract Background and Aims Sarcopenia, defined as the loss of muscle mass and strength, is common in patients with chronic kidney disease. The variability of the prevalence of sarcopenia depends in part on the diagnostic criteria applied. In 2019, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed four steps to diagnose and assess sarcopenia. The concept of sarcopenia is encompassed within the broader concept of frailty. The aim of this study was to analyse the incidence of sarcopenia in very elderly patients on haemodialysis following the criteria recently established by the European Working Group on Sarcopenia in Older People EWGSOP2. Additionally, to assess the usefulness of the diagnostic algorithm in the very elderly haemodialysis population, and its association with functionally scales related to sarcopenia, such as dependency, frailty, and nutrition. Method In a prospective study of 60 patients on chronic hemodialysis aged 75- to 95-years, sarcopenia was assessed according to the 4 EWGSOP2 steps: Find-Assess-Confirm-Severity, using Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls (SARC-F) to find, grip strength by dynamometry (GFD) and sit to stand to sit 5 (STS5) test to assess, appendicular skeletal muscle mass by bioimpedance to confirm and gait speed, the Timed-Up and Go (TUG) test, and the Short Physical Performance Battery (SPPB) for severity. Functionality scales of malnutrition inflammation (MIS), comorbility of Charlson, dependence of Barthel, fragility by FRAIL index2 and Physical Activity Scale for the Elderly (PASE) were conducted. Results Sixty patients were involved in the study. Sixty-eight percent (41) were men, with a mean age of 81.85±5.58 years and length of stay in HD 49.88±40.29 months. The sequential four steps resulted in a prevalence of confirmed sarcopenia of 20% and of severe sarcopenia of 20%. Correlation of the different variables defined by the EWGSOP2 with the scales of MIS, Barthel, Frail, Charlson and PASE was analyzed. It is observed that the SARC-F but not BIA correlates with the functionality tests. The GFD is the test that correlates with more variables, both functional and anthropometric. Of the severity measurement scales, the SPPB is the one that correlates with the greatest number of variables. Conclusion These findings question the four-step EWGSOP2 assessment for very elderly hemodialysis patients and suggest that 20% had confirmed severe sarcopenia. Functionality scales correlated better with GFD and SPPB.

scholarly journals Prevalence of Sarcopenia in Community-Dwelling Older Adults in Valencia, Spain

2020 ◽  
Vol 17 (23) ◽  
pp. 9130
Author(s):  
Carlos Guillamón-Escudero ◽  
Angela Diago-Galmés ◽  
Jose M. Tenías-Burillo ◽  
Jose M. Soriano ◽  
Julio J. Fernández-Garrido
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Men And Women ◽  
Sit To Stand ◽  
European Working ◽  
Appendicular Skeletal Muscle ◽  
Different Populations

This study is an observational and cross-sectional study on the prevalence of sarcopenic disease in 202 autonomous older adults; 18.8 and 81.2% were men and women, respectively, living in their own homes in Valencia, Spain. Sarcopenia was diagnosed using the criteria and cutting points for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), using the tests: SARC-F, grip strength, sit-to-stand, gait speed, appendicular skeletal muscle mass and short physical performance battery. According to the EWGSOP2 criteria, probable sarcopenia was present in 21.1% and 18.3% of men and women, respectively, and the sum of confirmed and severe sarcopenia was 7.9% and 7.3% in men and in women, respectively. A relationship was shown between the prevalence of the disease and the age of the participants, but no significant differences were found between the sum of confirmed and severe sarcopenia between the sexes, nor a relationship between the amount of muscle mass and the strength of grip. The SARC-F questionnaire diagnosed 40% of the sarcopenia cases present in the study. More thorough research is needed to continue using the EWGSOP2 criteria in different populations to establish a correct prevalence of sarcopenic disease in different populations of the world.

scholarly journals Appendicular skeletal muscle mass and quality estimated by bioelectrical impedance analysis in the assessment of frailty syndrome risk in older individuals

2021 ◽  
Author(s):  
Małgorzata Kołodziej ◽  
Anna Sebastjan ◽  
Zofia Ignasiak
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Bioelectrical Impedance Analysis ◽  
Skeletal Muscle Mass ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Muscle Quality ◽  
Elderly Persons ◽  
Appendicular Skeletal Muscle ◽  
Appendicular Skeletal Muscle Mass

Abstract Background and aim The rising aging index of many populations necessitates the continuous evolution of geriatric assessment methods, especially the ones used to identify frailty and the risk of frailty. An appropriately early diagnosis of adverse changes in skeletal muscles can reduce the risk of functional limitations in elderly persons. The aim of this study was to assess the correlation between the appendicular skeletal muscle mass and quality, estimated by the bioelectrical impedance analysis method, and the risk of prevalence of the pre-frailty state in elderly persons. Methods One-thousand-and-fifteen subjectively healthy persons aged 60–87 years were tested. Anthropometric measurements and physical fitness and activity measurements were carried out and the frailty phenotype was evaluated. Appendicular skeletal muscle mass was estimated using the bioelectrical impedance analysis method. Muscle quality was assessed through an index correcting strength relative to muscle mass and through the impedance phase angle. The correlation between the muscle mass and quality estimating parameters and the probability of identifying pre-frailty was checked using multiple logistic regression. Results The prevalence of pre-frailty was 38%. The pre-frail persons were found to have a significantly lower muscle mass and quality than the non-frail persons, with the difference in the case of the muscle quality index nearly twice larger than for the muscle mass index. A significant logit model was obtained for pre-frailty prevalence, which was strongly dependent on the appendicular skeletal muscle mass (adjusted odds ratio (OR): 0.43, 95% CI 0.36–0.52, p < 0.001) and functional quality (adjusted OR: 0.26, 95% CI 0.18–0.38, p < 0.001) and less on age (adjusted OR: 1.10, 95% CI 1.07–1.13, p < 0.001). Conclusion The strong correlation between the frailty phenotype and appendicular skeletal muscle mass and functional quality suggests that the two variables should be included in routine geriatric assessment with regard to frailty.

scholarly journals Intradialytic exercise in the treatment of social frailty during the COVID-19 pandemic: A single-center prospective study

2020 ◽  
Author(s):  
Koki Abe ◽  
Yoshinosuke Shimamura ◽  
Takuto Maeda ◽  
Yoshikazu Kato ◽  
Yasuyoshi Yoshimura ◽  
...  
Keyword(s):  
Physical Function ◽  
Muscle Mass ◽  
Exercise Therapy ◽  
Walking Speed ◽  
Medical Center ◽  
Hemodialysis Patients ◽  
Single Center ◽  
Appendicular Skeletal Muscle ◽  
Intradialytic Exercise ◽  
Appendicular Skeletal Muscle Mass

Abstract Background: Social frailty—the lack of a connection to society and infrequent social activities—has been reported to be associated with future declines in physical function in elderly individuals. This study aimed to evaluate both the association of social frailty with the physical function and the efficacy of intradialytic exercise as a therapy for social frailty among hemodialysis patients.Methods: A total of 16 hemodialysis patients in the hemodialysis department of a single medical center were enrolled in this single-center prospective single-arm interventional study. Patients received five questions which asked about going out infrequently, lack of visiting friends, feeling unhelpful to friends or family, living alone, and lack of talking with someone. Those to whom two or more of the above were applicable were categorized as socially frail. All patients were placed into exercise therapy to be performed during their thrice-weekly hemodialysis visits. Participants’ physical function (walking speed), muscle strength (grip strength), muscle mass (appendicular skeletal muscle mass index), and social frailty were evaluated at baseline and after three months of therapy.Results: Four (25%) of the 16 participants (median age 71.5 years, 8 women) were categorized as being socially frail. In comparison to the non-socially frail group (non-SF), the socially frail group (SF) had a significantly lower walking speed (0.70 ± 0.12 m/s vs 1.15 ± 0.26 m/s, p= 0.005) and significantly worse performance on the Short Physical Performance Battery. Three months of intradialytic exercise therapy significantly improved their walking speed, from 1.04 ± 0.30 m/s to 1.16 ± 0.29 m/s (p= 0.003). Intradialytic exercise therapy significantly improved walking speed in both the SF group and the non-SF group. The 2019 coronavirus disease pandemic occurred in the middle of the intervention period of this study, and although it was not statistically significant, the number of socially frail individuals among our participants increased to seven (43.8%, p= 0.248).Conclusions: Social frailty was associated with reduced physical function among hemodialysis patients. Intradialytic exercise therapy improved physical function regardless of the presence of social frailty.Trial registration: UMIN-CTR, UMIN-CTR000038313. Registered November 1, 2019,https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043639.

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