scholarly journals Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health

2021 ◽  
Vol 36 (6) ◽  
pp. 1161-1174
Author(s):  
Hong-Kyu Kim ◽  
Chul-Hee Kim
Keyword(s):  
Cardiovascular Health ◽  
Clinical Care ◽  
Functional Decline ◽  
Fatty Infiltration ◽  
Muscle Quality ◽  
Cardiometabolic Health ◽  
Abdominal Muscles ◽  
Cardiometabolic Diseases ◽  
Age Related ◽  
Definition Of

Although age-related changes in skeletal muscles are closely associated with decreases in muscle strength and functional decline, their associations with cardiometabolic diseases in the literature are inconsistent. Such inconsistency could be explained by the fact that muscle quality—which is closely associated with fatty infiltration of the muscle (i.e., myosteatosis)—is as important as muscle quantity in cardiometabolic health. However, muscle quality has been less explored compared with muscle mass. Moreover, the standard definition of myosteatosis and its assessment methods have not been established yet. Recently, some techniques using single axial computed tomography (CT) images have been introduced and utilized in many studies, as the mass and quality of abdominal muscles could be measured opportunistically on abdominal CT scans obtained during routine clinical care. Yet, the mechanisms by which myosteatosis affect metabolic and cardiovascular health remain largely unknown. In this review, we explore the recent advances in the assessment of myosteatosis and its changes associated with aging. We also review the recent literature on the clinical implication of myosteatosis by focusing on metabolic and cardiovascular diseases. Finally, we discuss the challenges and unanswered questions that need addressing to set myosteatosis as a therapeutic target for the prevention or treatment of cardiometabolic diseases.

Frailty, fitness, and the mathematics of deficit accumulation

2007 ◽  
Vol 17 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Kenneth Rockwood ◽  
Arnold Mitnitski
Keyword(s):  
Cardiovascular Health ◽  
Geriatric Medicine ◽  
The Elderly ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Deficit Accumulation ◽  
Medical Problems ◽  
Consensus Conferences ◽  
Age Related ◽  
Definition Of

The daily clinical practice of geriatric medicine is a grapple with complexity. The elderly patients who come to geriatricians typically have multiple, interacting, age-related physiological impairments, some of which manifest as medical problems. These interact with various social vulnerability factors to put them at risk, and to define them as being frail. This view of frailty, as a multiple-determined state of vulnerability has broad support, but how best to operationalize frailty is rather more controversial. Some of the proposed operational definitions receive more widespread support than others. In particular, the ‘phenotypic’ definition of frailty used in the Cardiovascular Health Study (CHS) has been endorsed at consensus conferences and employed by several groups. Indeed, it has even been claimed that ‘the terms “frail” and “frailty” should be avoided except when used in the context of a CHS assessment.’

scholarly journals Central and Peripheral Neuromuscular Adaptations to Ageing

2020 ◽  
Vol 9 (3) ◽  
pp. 741 ◽  
Author(s):  
Riccardo Borzuola ◽  
Arrigo Giombini ◽  
Guglielmo Torre ◽  
Stefano Campi ◽  
Erika Albo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Functional Decline ◽  
Leading Edge ◽  
Diagnostic Procedures ◽  
Voluntary Activation ◽  
Muscle Quality ◽  
Compensatory Mechanism ◽  
Age Related ◽  
The Central Nervous System

Ageing is accompanied by a severe muscle function decline presumably caused by structural and functional adaptations at the central and peripheral level. Although researchers have reported an extensive analysis of the alterations involving muscle intrinsic properties, only a limited number of studies have recognised the importance of the central nervous system, and its reorganisation, on neuromuscular decline. Neural changes, such as degeneration of the human cortex and function of spinal circuitry, as well as the remodelling of the neuromuscular junction and motor units, appear to play a fundamental role in muscle quality decay and culminate with considerable impairments in voluntary activation and motor performance. Modern diagnostic techniques have provided indisputable evidence of a structural and morphological rearrangement of the central nervous system during ageing. Nevertheless, there is no clear insight on how such structural reorganisation contributes to the age-related functional decline and whether it is a result of a neural malfunction or serves as a compensatory mechanism to preserve motor control and performance in the elderly population. Combining leading-edge techniques such as high-density surface electromyography (EMG) and improved diagnostic procedures such as functional magnetic resonance imaging (fMRI) or high-resolution electroencephalography (EEG) could be essential to address the unresolved controversies and achieve an extensive understanding of the relationship between neural adaptations and muscle decline.

Biomarkers of Acromegaly and Growth Hormone Action

2020 ◽  
Vol 27 (12) ◽  
pp. 1231-1245
Author(s):  
Filippo Maffezzoni ◽  
Teresa Porcelli ◽  
Andrea Delbarba ◽  
Letizia Pezzaioli ◽  
Carlo Cappelli ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Biological Markers ◽  
Clinical Care ◽  
Hormone Deficiency ◽  
Surrogate Outcomes ◽  
Current State ◽  
Growth Hormone Action ◽  
Igf I ◽  
Definition Of

: Biological markers (biomarkers) play a key role in drug development, regulatory approval and clinical care of patients and are linked to clinical and surrogate outcomes. : Both acromegaly and Growth Hormone Deficiency (GHD) are pathological conditions related to important comorbidities that, in addition to having stringent diagnostic criteria, require valid markers for the definition of treatment, treatment monitoring and follow-up. GH and insulin-like growth factor-I (IGF-I) are the main biomarkers of GH action in children and adults while, in acromegaly, both GH and IGF-I are established biomarkers of disease activity. : However, although GH and IGF-I are widely validated biomarkers of GHD and acromegaly, their role is not completely exhaustive or suitable for clinical classification and follow-up. Therefore, new biological markers for acromegaly and GH replacement therapy are strongly needed. : The aim of this paper is to review and summarize the current state in the field pointing out new potential biomarkers for acromegaly and GH use/abuse.

scholarly journals Spontaneous Eye Blinks Predict Executive Functioning in Seniors

2021 ◽  
Author(s):  
Jessika I. V. Buitenweg ◽  
Jaap M. J. Murre ◽  
K. Richard Ridderinkhof
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Executive Functioning ◽  
Cognitive Training ◽  
Functional Decline ◽  
Future Research ◽  
Blink Rate ◽  
Memory Updating ◽  
Age Related ◽  
Working Memory Updating

AbstractAs the world’s population is aging rapidly, cognitive training is an extensively used approach to attempt improvement of age-related cognitive functioning. With increasing numbers of older adults required to remain in the workforce, it is important to be able to reliably predict future functional decline, as well as the individual advantages of cognitive training. Given the correlation between age-related decline and striatal dopaminergic function, we investigated whether eye blink rate (EBR), a non-invasive, indirect indicator of dopaminergic activity, could predict executive functioning (response inhibition, switching and working memory updating) as well as trainability of executive functioning in older adults. EBR was collected before and after a cognitive flexibility training, cognitive training without flexibility, or a mock training. EBR predicted working memory updating performance on two measures of updating, as well as trainability of working memory updating, whereas performance and trainability in inhibition and switching tasks could not be predicted by EBR. Our findings tentatively indicate that EBR permits prediction of working memory performance in older adults. To fully interpret the relationship with executive functioning, we suggest future research should assess both EBR and dopamine receptor availability among seniors.

scholarly journals Role of CMR Imaging in Diagnostics and Evaluation of Cardiac Involvement in Muscle Dystrophies

2021 ◽  
Author(s):  
Edyta Blaszczyk ◽  
Jan Gröschel ◽  
Jeanette Schulz-Menger
Keyword(s):  
Clinical Care ◽  
Fatty Infiltration ◽  
Severe Heart Failure ◽  
Diffuse Fibrosis ◽  
Muscular Dystrophies ◽  
Invasive Technique ◽  
Myocardial Tissue ◽  
Therapeutic Decisions ◽  
Cardiovascular Evaluation ◽  
Unique Capability

Abstract Purpose of Review This review aims to outline the utility of cardiac magnetic resonance (CMR) in patients with different types of muscular dystrophies for the assessment of myocardial involvement, risk stratification and in guiding therapeutic decisions. Recent Findings In patients suffering from muscular dystrophies (MD), even mild initial dysfunction may lead to severe heart failure over a time course of years. CMR plays an increasing role in the diagnosis and clinical care of these patients, mostly due to its unique capability to precisely characterize subclinical and progressive changes in cardiac geometry, function in order to differentiate myocardial injury it allows the identification of inflammation, focal and diffuse fibrosis as well as fatty infiltration. CMR may provide additional information in addition to the physical examination, laboratory tests, ECG, and echocardiography. Summary Further trials are needed to investigate the potential impact of CMR on the therapeutic decision-making as well as the assessment of long-term prognosis in different forms of muscular dystrophies. In addition to the basic cardiovascular evaluation, CMR can provide a robust, non-invasive technique for the evaluation of subclinical myocardial tissue injury like fat infiltration and focal and diffuse fibrosis. Furthermore, CMR has a unique capability to detect the progression of myocardial tissue damage in patients with a preserved systolic function.

scholarly journals Cardiovascular Health, Functional Disability, and Leisure Activities Profiles in Relation to Mental Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 663-663
Author(s):  
Dorina Cadar ◽  
Celine De Looze ◽  
Christine McGarrigle
Keyword(s):  
Longitudinal Study ◽  
Cognitive Aging ◽  
Representative Sample ◽  
Cardiovascular Health ◽  
Functional Disability ◽  
Physiological Stress ◽  
Leisure Activities ◽  
Functional Decline ◽  
Functional Impairments ◽  
Ideal Cardiovascular Health

Abstract We investigated cardiovascular health, functional disability and leisure activities profiles independently and in relation to cognitive decline and dementia in high and low-medium income countries using data from the English Longitudinal Study of Ageing, Irish Longitudinal Study on Ageing and Brazilian Bambui Cohort Study of Aging. Functional loss among older Brazilians has shown a hierarchical sequence over the 15-year follow-up, with the highest incidence in functional disability reported for dressing, followed by getting out of bed, bathing/showering, walking across a room, using the toilet and eating (de Oliveira). Using the Life’s Simple 7, an ideal cardiovascular health scoring system evaluating the muscular strength, mobility and physiological stress, we showed a reliable prediction of cognitive trajectories in a representative sample of Irish individuals (De Looze). Within the same cohort, we report discrepancies between men and women in functional decline driven by domestic tasks, rather than determining differential cognitive trajectories (McGarrigle). In an English representative sample, we found that participants with an increasing number of functional impairments over almost a decade were more likely to be classified with subsequent dementia compared with those with no impairments and this may imply a more comprehensive ascertainment during the prodromal stage of dementia (Cadar). In contrast, a reduced risk of dementia was found for individuals with higher levels of engagement in cognitively stimulating activities, that may preserve cognitive reserve until later in life (Almeida). Identifying factors that influence cognitive aging and dementia risk in a multifactorial perspective is critical toward developing adequate intervention and treatment.

scholarly journals 103 Periodontal Health and Sarcopenia: Cross-Sectional Evidence From A Cohort of 2040 Twin Volunteers

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
M B Zazzara ◽  
P M Wells ◽  
R C E Bowyer ◽  
M N Lochlainn ◽  
E J Thompson ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Frailty Index ◽  
Muscle Quality ◽  
Low Grade ◽  
Periodontal Health ◽  
Cross Sectional ◽  
Age Related ◽  
European Working ◽  
Generalised Linear Mixed Model

Abstract Introduction Periodontitis is a chronic inflammatory disease affecting the periodontium, ultimately leading to looseness and/or loss of teeth. Sarcopenia refers to age-related reduction in muscle mass and strength. Similar to periodontitis, chronic low-grade inflammation is thought to play a key role in its development. In addition, both increase in prevalence with advancing age. Despite known associations with other diseases involving a dysregulated inflammatory response, for example rheumatoid arthritis,, the relationship between periodontitis and sarcopenia, and whether they could be driven by similar processes, remains uncertain. The aim of this study was to explore the association between periodontitis and sarcopenia. Methods Observational study of 2040 adult volunteers [age 67.18 (12.17)] enrolled in the TwinsUK cohort study. Presence of tooth mobility and number of teeth lost were used to assess periodontal health. A binary variable was created to define periodontitis. Measurements of muscle strength, muscle quality/quantity and physical performance were used to assess sarcopenia. A categorical variable was created according to the European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, to define sarcopenia (1: probable; 2: positive; 3: severe). Generalised linear mixed model analysis used on complete cases and age-matched (n = 1,288) samples to ascertain associations between periodontitis and sarcopenia. Results No significant association was found between periodontitis and sarcopenia in both the complete cases analysis and age-matched analysis. Results were consistent when analysis was adjusted for potential confounders including body mass index, frailty index, Mini Mental State Examination smoking, nutritional status and educational level. Conclusions This study found no significant association between periodontitis and sarcopenia in a cohort of 2040 adults. Although both periodontitis and sarcopenia have been linked to a dysregulated immune response and demonstrate an increase in prevalence with increasing age, our work is inconclusive due to the plethora of possible aetiopathogenetic pathways.

scholarly journals Electromyographic activation patterns during swallowing in older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jin Young Ko ◽  
Hayoung Kim ◽  
Joonyoung Jang ◽  
Jun Chang Lee ◽  
Ju Seok Ryu
Keyword(s):  
Older Adults ◽  
Viscous Fluid ◽  
Muscle Activation ◽  
Fatty Infiltration ◽  
Liquid Volume ◽  
Type I ◽  
Type Ii ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Age Related

AbstractAge-related weakness due to atrophy and fatty infiltration in oropharyngeal muscles may be related to dysphagia in older adults. However, little is known about changes in the oropharyngeal muscle activation pattern in older adults. This was a prospective and experimental study. Forty healthy participants (20 older [> 60 years] and 20 young [< 60 years] adults) were enrolled. Six channel surface electrodes were placed over the bilateral suprahyoid (SH), bilateral retrohyoid (RH), thyrohyoid (TH), and sternothyroid (StH) muscles. Electromyography signals were then recorded twice for each patient during swallowing of 2 cc of water, 5 cc of water, and 5 cc of a highly viscous fluid. Latency, duration, and peak amplitude were measured. The activation patterns were the same, in the order of SH, TH, and StH, in both groups. The muscle activation patterns were classified as type I and II; the type I pattern was characterized by a monophasic shape, and the type II comprised a pre-reflex phase and a main phase. The oropharyngeal muscles and SH muscles were found to develop a pre-reflex phase specifically with increasing volume and viscosity of the swallowed fluid. Type I showed a different response to the highly viscous fluid in the older group compared to that in the younger group. However, type II showed concordant changes in the groups. Therefore, healthy older people were found to compensate for swallowing with a pre-reflex phase of muscle activation in response to increased liquid volume and viscosity, to adjust for age-related muscle weakness.

scholarly journals Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mercedes Sotos-Prieto ◽  
Rosario Ortolá ◽  
Miguel Ruiz-Canela ◽  
Esther Garcia-Esquinas ◽  
David Martínez-Gómez ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Mortality ◽  
Cardiovascular Health ◽  
Total Mortality ◽  
Hdl Cholesterol ◽  
Cardiometabolic Health ◽  
The Metabolic Syndrome ◽  
Mediterranean Countries ◽  
Low Hdl ◽  
The Mediterranean

Abstract Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.

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