Diagnostic Performance of Clinical Laboratory Indicators With Sarcopenia: Results From the West China Health and Aging Trend Study

BackgroundSarcopenia is an age-related and skeletal muscle disorder involving the loss of muscle mass or strength, and physiological function. Although the diagnostic indicators used in the different guidelines are for muscle mass, strength and physical performance, there are currently no uniform diagnostic criteria. Therefore, we aimed to explore the relationship between a series of biomarkers with sarcopenia in southwest China.MethodsWe included 4302 patients from West China Health and Aging Trend (WCHAT) study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Thyroxine、albumin、total protein、prealbumin、albumin to globulin ratio (A/G)、25(OH)VD、fasting insulin、adrenal cortisol、triglyceride、high-density lipoprotein、hemoglobin and aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) were measured. The receiver operating characteristic curves (ROC) were established to describe the predictive value for sarcopenia and we also used multivariate logistic regression analysis to identify risk factors of the disease.ResultsIn terms of protein state, patients with sarcopenia had lower value in total protein, albumin, prealbumin, A/G than the control (P<0.001). Patients had lower value in triglyceride but higher value in high-density lipoprotein compared with the healthy in the indicators of lipid metabolism (P<0.001). In the aspect of hormone state, patients had lower free triiodothyronine, fasting insulin but higher free tetraiodothyronine and adrenal cortisol than the healthy (P<0.001). The fasting insulin level (AUC=0.686) and the AST/ALT ratio (AUC=0.682) were the best predictors of sarcopenia among biomarkers. The diagnostic performance of fasting insulin combined with the AST/ALT ratio (AUC=0.720) is equal to multiple indicators (AUC=0.742).ConclusionThe fasting insulin combined with the AST/ALT ratio exhibits good diagnostic performance for sarcopenia.

Pre-Pandemic Social Isolation: Protection or Vulnerability in the Time of COVID?

How do older adults at risk of social isolation before the pandemic fare during the COVID-19 outbreak? Using data from two waves (Round 9 [2019] and COVID-19 Supplement) of the National Health and Aging Trend Study (NHATS), we examined the relationship between pre-pandemic social isolation and psychological distress during the outbreak among community-living older adults (age 65+). Results show that the most socially integrated respondents had more PTSD (β=1.47, SE=.37, p<.001) and depression/anxiety (β=.34, SE=.11, p=.002) symptoms than the most isolated. Older adults who were not homebound had more PTSD (β=2.0, SE= .76, p=.01) and depression/anxiety (β=1.05, SE=.20, p<.001) than the completely homebound. With shelter-in-place and social distancing requirements, older adults who have been socially active and integrated may experience high-stress levels and may need extra support to adjust to the changes. Relatively, those who have been very isolated and homebound may experience fewer changes in their lives.

Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study

Objective To investigate the association between sleep duration and cognitive frailty among older adults dwelling in western China. Methods We used the baseline data from West China Health and Aging Trend (WCHAT) study. Sleep duration was classified as short sleep duration (< 6 h), normal sleep duration (6–8 h) and long sleep duration (≥ 9 h). Fried frailty criteria and Short Portable Mental Status Questionnaire were used to measure cognitive frailty. Multinomial logistic regression was conducted to estimate odds ratio (OR) and 95% confidence interval (CI). Results A total of 4093 older adults (age = 67.8 ± 5.9 years, 1708 males and 2385 females) were included in the analysis. The prevalence of cognitive frailty was 11.8% among older adults in western China. Approximately 11.9% participants had short sleep duration (< 6 h); 22.2% had a long sleep duration (≥ 9 h). After adjusting for covariates, only long sleep duration was significantly associated with high risk of cognitive frailty (OR = 2.07, 95%CI = 1.60–2.68, P < 0.001) in western China older adults compared to normal sleep duration. Conclusions Long sleep duration was significantly related to cognitive frailty in older adults. Intervention for long sleep duration may be helpful to prevent cognitive frailty. Trial registration Chinese Clinical Trial Registry: ChiCTR1800018895.

The Strategy of Geriatric Nursing Personnel Training Based on the Demand of Geriatric Nursing

With the increasingly serious aging trend in China, the incidence of some chronic diseasesrelated to it is also increasing. In this regard, the demands of elderly care gradually show a trend of diversified development, and the requirements of nursing quality become more and more strict. In China, most nursing personnel training is accomplished through colleges and universities, many of which come from the nursing profession. However, there is no division of nursing disciplinesfor elderly patients at present, and the corresponding training plan, content and target for elderly care are not specific. Next, we focus on the implementation strategy of training elderly nursing talents based on the needs of elderly care.