Sarcopenia and Liver Cirrhosis—Comparison of the European Working Group on Sarcopenia Criteria 2010 and 2019

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.

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Comparison between Original and Reviewed Consensus of European Working Group on Sarcopenia in Older People: A Probabilistic Cross-Sectional Survey among Community-Dwelling Older People

Gerontology ◽

10.1159/000519304 ◽

2021 ◽

pp. 1-8

Author(s):

Erik Ramirez ◽

Rogelio Salas ◽

Cristina Bouzas ◽

Rosario Pastor ◽

Josep A. Tur

Keyword(s):

Muscle Strength ◽

Older People ◽

Muscle Mass ◽

Working Group ◽

Handgrip Strength ◽

Community Dwelling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

European Working Group ◽

European Working

Introduction: The European Working Group on Sarcopenia in Older People (EWGSOP) published a consensus on sarcopenia in 2010 and updated it in 2019 (EWGSOP2) which included the use of specific cut-off points. The aim was to assess how much prevalence of sarcopenia differed between EWGSOP2 and EWGSOP, as well as the use of specific cut-off points to assess differences in presarcopenia versus probable sarcopenia. Methods: Observational, transversal, and comparative study (n = 1,283 older adults; 57% women). Anthropometrics and handgrip strength were measured, and appendicular skeletal muscle mass equation was defined. Conceptual and methodological definitions of EWGSOP and EWGSOP2 consensus were applied to calculate prevalence of presarcopenia, probable sarcopenia, and sarcopenia. Results: Using cut-off points recommended for European population, prevalence of sarcopenia with EWGSOP2 was lower (−6.6%; p < 0.001) than EWGSOP. The prevalence of probable sarcopenia (EWGSOP2) was higher (+7.8%; p < 0.001) than EWGSOP presarcopenia. The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.45; IC = 0.40–0.51). Using specific-population cut-off points for muscle strength and appendicular muscle mass, the prevalence of probable sarcopenia with EWGSOP2 was higher (46.5%; p < 0.001) than EWGSOP (1.8%). The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.48; IC = 0.42–0.52). Conclusion: The new EWGSOP2 consensus underestimates the prevalence of sarcopenia, compared with EWGSOP using conventional cut-off points. The prevalence of presarcopenia with EWGSOP (low muscle mass) was lower than probable sarcopenia (low muscle strength) with the new EWGSOP2. In both cases, agreements between EWGSOP2 and EWGSOP were moderated. Discrepancies between the original and new consensus have implications on the primary health setting for identifying old and new cases for prevention and treatment.

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AB0154 USAGE OF THE SARC-F QUESTIONNAIRE FOR SARCOPENIA SCREENING IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1303 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1104.2-1104

Author(s):

O. Dobrovolskaya ◽

N. Toroptsova ◽

O. Nikitinskaya ◽

A. Efremova ◽

N. Demin

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Practice ◽

Muscle Strength ◽

Older People ◽

Working Group ◽

Handgrip Strength ◽

Diagnostic Value ◽

Screening Methods ◽

European Working Group ◽

European Working

Background:Sarcopenia, characterized by low muscle strength and low muscle quantity or quality and associated with increased risks of falling and mortality. The prevalence of sarcopenia is 37% among patients with RA [1]. However, in clinical practice settings, sarcopenia among RA patients remains underdiagnosed. The SARC-F questionnaire [2] was recommended by the European Working Group on Sarcopenia in Older People (EWGSOP) before performing muscle strength tests and assessment muscle mass.Objectives:To evaluate the diagnostic value of the SARC-F questionnaire for the screening of sarcopenia (SP) in women with rheumatoid arthritis (RA).Methods:83 women (average age 59±8 years) with RA without aseptic bone necrosis, joint replacement and severe comorbidities were recruited. All patients were interviewed with the SARC-F questionnaire. The summation score ≥ 4 corresponded to cut-off for suspected sarcopenia. Sarcopenia was evaluated using the European Working Group on Sarcopenia in Older People (EWGSOP2), which included dual-energy X-ray absorptiometry (DXA), handgrip strength or chair stand test, and gait speed. The sensitivity, specificity, positive and negative prognostic values of the SARC-F questionnaire were estimated.Results:Confirmed SP was diagnosed in 20 (24%) RA patients, who had low muscle strength and mass. When conventional cut-off point (≥4) for SARC-F questionnaire was applied, only 30% of the patients with SP met this condition (sensitivity 30%, 95% confidence interval [95% CI] 13% to 54%), and 41% of the patients without SP did not meet this condition (specificity 41%, 95% CI 29% to 54%). Positive and negative prognostic values were 14% (95% CI 6% to 29%) and 65% (95% CI 48% to 79%), respectively.Conclusion:The SARC-F questionnaire alone is not adequate for screening of SP in RA patient. It is necessary to develop other simple screening methods that can easily be carried out in real clinical practice to identify individuals with possible SP for further diagnostic tests.References:[1]Torii M, Hashimoto M, Hanai A, et al. Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis. Modern Rheumatology, 2018;29(4):589-595. doi:10.1080/14397595.2018.1510565.[2]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169.Disclosure of Interests:None declared

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Prevalence of sarcopenia in community-dwelling older adults using the definition of the European Working Group on Sarcopenia in Older People 2: findings from the Korean Frailty and Aging Cohort Study

Age and Ageing ◽

10.1093/ageing/afz091 ◽

2019 ◽

Vol 48 (6) ◽

pp. 910-916 ◽

Cited By ~ 22

Author(s):

Miji Kim ◽

Chang Won Won

Keyword(s):

Older Adults ◽

Cohort Study ◽

Muscle Strength ◽

Older People ◽

Muscle Mass ◽

Working Group ◽

Community Dwelling ◽

European Working ◽

Definition Of ◽

Community Dwelling Older Adults

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.

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Sarcopenia as a mortality predictor in community-dwelling older adults: a comparison of the diagnostic criteria of the European Working Group on Sarcopenia in Older People

European Journal of Clinical Nutrition ◽

10.1038/s41430-019-0508-8 ◽

2019 ◽

Vol 74 (4) ◽

pp. 573-580 ◽

Cited By ~ 4

Author(s):

Nathalia Perleberg Bachettini ◽

Renata Moraes Bielemann ◽

Thiago Gonzalez Barbosa-Silva ◽

Ana Maria Baptista Menezes ◽

Elaine Tomasi ◽

...

Keyword(s):

Older Adults ◽

Older People ◽

Diagnostic Criteria ◽

Working Group ◽

Community Dwelling ◽

European Working Group ◽

European Working ◽

Community Dwelling Older Adults

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Performance of the European Working Group on Sarcopenia in Older People algorithm in screening older adults for muscle mass assessment

Age and Ageing ◽

10.1093/ageing/afu192 ◽

2014 ◽

Vol 44 (2) ◽

pp. 334-338 ◽

Cited By ~ 30

Author(s):

Roberto Alves Lourenço ◽

Mario Pérez-Zepeda ◽

Luis Gutiérrez-Robledo ◽

Francisco J. García-García ◽

Leocadio Rodríguez Mañas

Keyword(s):

Older Adults ◽

Older People ◽

Muscle Mass ◽

Working Group ◽

European Working Group ◽

European Working

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Diagnosis of sarcopenia in primary health care

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.10.633 ◽

2020 ◽

Vol 63 (10) ◽

pp. 633-641

Author(s):

Chang Won Won

Keyword(s):

Primary Care ◽

Muscle Strength ◽

Muscle Mass ◽

Handgrip Strength ◽

Muscle Performance ◽

Chair Stand ◽

Stand Test ◽

Chair Stand Test ◽

Primary Care Settings ◽

Increased Risk

With aging, there is a loss of skeletal muscle mass and function, which leads to an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even mortality. Sarcopenia has been defined as a condition characterized by low muscle mass together with low muscle strength and/or low muscle performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, in particular, presented strategies for case-finding and assessment, which could aid in the diagnosis of possible sarcopenia in primary care settings. AWGS 2019 proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaire (cut-off ≥4), followed by handgrip strength measurement (cut-off <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds). Finally, “possible sarcopenia” is defined by either low muscle strength (handgrip strength) or low physical performance (5-time chair stand test). This paper will address the way in which sarcopenic patients can be identified and assessed practically in primary care settings.

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Sarcopenia em idosas quilombolas : Análise das variáveis antropométricas e de força de preensão manual

Revista de Patologia do Tocantins ◽

10.20873/uft.2446-6492.2017v4n3p9 ◽

2017 ◽

Vol 4 (3) ◽

pp. 9 ◽

Cited By ~ 1

Author(s):

Brigida Silva Cunha ◽

Carla Rejane Gonçalves de Souza ◽

Lorena Ohrana Braz Prudente ◽

Neila Barbosa Osório ◽

Luiz Sinésio da Silva Neto

Keyword(s):

Muscle Mass ◽

Physical Performance ◽

Working Group ◽

Elderly Women ◽

Fat Free Mass ◽

Geriatric Syndrome ◽

Group Consensus ◽

Functional Impairments ◽

European Working Group ◽

European Working

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.

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Effects of Two Types of 9-Month Adapted Physical Activity Program on Muscle Mass, Muscle Strength, and Balance in Moderate Sarcopenic Older Women

BioMed Research International ◽

10.1155/2018/5095673 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

G. Piastra ◽

L. Perasso ◽

S. Lucarini ◽

F. Monacelli ◽

A. Bisio ◽

...

Keyword(s):

Physical Activity ◽

Muscle Strength ◽

Older Women ◽

Muscle Mass ◽

Handgrip Strength ◽

Training Group ◽

Static Balance ◽

Adapted Physical Activity ◽

European Working ◽

Postural Training

The present study aimed to evaluate the effects of two types of 9-month adapted physical activity (APA) program, based on a muscle reinforcement training and a postural training, respectively, on muscle mass, muscle strength, and static balance in moderate sarcopenic older women. The diagnosis of sarcopenia was done in accordance with measurable variables and cut-off points suggested by the European Working Group on Sarcopenia in Older People (EWGSOP). Seventy-two participants were randomly assigned to two groups: the muscle reinforcement training group (RESISTANCE) (n=35; 69.9 ± 2.7 years) and the postural training group (POSTURAL) (n=37; 70.0±2.8 years). Body composition, muscle mass, skeletal muscle mass index (SMI), and handgrip strength (HGS) were evaluated for sarcopenia assessment, whereas Sway Path, Sway Area, Stay Time, and Spatial Distance were evaluated for static balance assessment. Sixty-six participants completed the study (RESISTANCE group: n=33; POSTURAL group: n=33). Significant increases of muscle mass, SMI, and handgrip strength values were found in the RESISTANCE group, after muscle reinforcement program. No significant differences appeared in the POSTURAL group, after postural training. Furthermore, RESISTANCE group showed significant improvements in static balance parameters, whereas no significant differences appeared in the POSTURAL group. On the whole, the results of this study suggest that the APA program based on muscle reinforcement applied on moderate sarcopenic older women was able to significantly improve muscle mass and muscle strength, and it was also more effective than the applied postural protocol in determining positive effects on static balance.

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Comparative assessment of sarcopenia using the JSH, AWGS, and EWGSOP2 criteria and the relationship between sarcopenia, osteoporosis, and osteosarcopenia in patients with liver cirrhosis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2983-4 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Chisato Saeki ◽

Keiko Takano ◽

Tsunekazu Oikawa ◽

Yuma Aoki ◽

Tomoya Kanai ◽

...

Keyword(s):

Liver Cirrhosis ◽

Vertebral Fracture ◽

Working Group ◽

Close Association ◽

Handgrip Strength ◽

X Rays ◽

Mineral Density ◽

Number Of Patients ◽

European Working ◽

The Relationship

Abstract Background Sarcopenia and osteoporosis reduce life quality and worsen prognosis in patients with liver cirrhosis (LC). When these two complications coexist, a diagnosis of osteosarcopenia is made. We aimed to investigate the actual situations of sarcopenia, osteoporosis, osteosarcopenia, and vertebral fracture, and to clarify the relationship among these events in patients with LC. Methods We describe a cross-sectional study of 142 patients with LC. Sarcopenia was defined according to the Japan Society of Hepatology (JSH) criteria, Asian Working Group for Sarcopenia (AWGS) criteria, and European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. The skeletal muscle mass index (SMI) and handgrip strength were assessed using bioelectrical impedance analysis and a digital grip strength dynamometer, respectively. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry, and vertebral fracture was evaluated using spinal lateral X-rays. The severity of LC was assessed using the Child-Pugh classification. Results Among the 142 patients, the prevalence of sarcopenia was 33.8% (48/142) according to the JSH and AWGS criteria and 28.2% (40/142) according to the EWGSOP2 criteria. The number of patients with osteoporosis, osteosarcopenia, and vertebral fracture was 49 (34.5%), 31 (21.8%), and 41 (28.9%), respectively. Multivariate analysis revealed a close association between sarcopenia and osteoporosis. Osteoporosis was independently associated with sarcopenia [odds ratio (OR) = 3.923, P = 0.010]. Conversely, sarcopenia was independently associated with osteoporosis (OR = 5.722, P < 0.001). Vertebral fracture occurred most frequently in patients with osteosarcopenia (19/31; 61.3%) and least frequently in those without both sarcopenia and osteoporosis (12/76; 15.8%). The SMI and handgrip strength values were significantly correlated with the BMD of the lumbar spine (r = 0.55 and 0.51, respectively; P < 0.001 for both), femoral neck, (r = 0.67 and 0.62, respectively; P < 0.001 for both), and total hip (r = 0.67 and 0.61, respectively; P < 0.001 for both). Conclusions Sarcopenia, osteoporosis, osteosarcopenia, and vertebral fracture were highly prevalent and closely associated with one another in patients with LC. Specifically, patients with osteosarcopenia had the highest risk of vertebral fractures. Early diagnosis of these complications is essential for treatment intervention.

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