Journal of Clinical Medicine

Research

19 pages, 3230 KiB

Open AccessArticle

Measures Derived from Panoramic Ultrasonography and Animal-Based Protein Intake Are Related to Muscular Performance in Middle-Aged Adults

by Nathaniel R. Johnson, Christopher J. Kotarsky, Kyle J. Hackney, Kara A. Trautman, Nathan D. Dicks, Wonwoo Byun, Jill F. Keith, Shannon L. David and Sherri N. Stastny

J. Clin. Med. 2021, 10(5), 988; https://doi.org/10.3390/jcm10050988 - 02 Mar 2021

Cited by 2 | Viewed by 2084

Abstract

Ultrasonography advantageously measures skeletal muscle size and quality, but some muscles may be too large to capture with standardized brightness mode (B-mode) imaging. Panoramic ultrasonography can capture more complete images and may more accurately measure muscle size. We investigated measurements made using panoramic [...] Read more.

Ultrasonography advantageously measures skeletal muscle size and quality, but some muscles may be too large to capture with standardized brightness mode (B-mode) imaging. Panoramic ultrasonography can capture more complete images and may more accurately measure muscle size. We investigated measurements made using panoramic compared to B-mode ultrasonography images of the rectus femoris with muscular performance. Concurrently, protein intake plays an important role in preventing sarcopenia; therefore, we also sought to investigate the association between animal-based protein intake (ABPI) and muscular performance. Ninety-one middle-aged adults were recruited. Muscle cross-sectional area (CSA) and thickness were obtained using B-mode and panoramic ultrasound and analyzed with Image J software. Muscular performance was assessed using isokinetic dynamometry, a 30-s chair test, and handgrip strength. Three-day food diaries estimated dietary intakes. Linear regression models determined relationships between measures from ultrasonography and muscular performance. Mixed linear models were used to evaluate the association between ABPI and muscular performance. Muscle CSA from panoramic ultrasonography and ABPI were positively associated with lower-body strength (β ± S.E.; CSA, 42.622 ± 20.024, p = 0.005; ABPI, 65.874 ± 19.855, p = 0.001), lower-body endurance (β ± S.E.; CSA, 595 ± 200.221, p = 0.001; ABPI, 549.944 ± 232.478, p = 0.020), and handgrip strength (β ± S.E.; CSA, 6.966 ± 3.328, p = 0.004; ABPI, 0.349 ± 0.171, p = 0.045). Panoramic ultrasound shows promise as a method for assessing sarcopenia. ABPI is related to better muscular performance. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

13 pages, 1052 KiB

Open AccessArticle

Using the Updated EWGSOP2 Definition in Diagnosing Sarcopenia in Spanish Older Adults: Clinical Approach

by Anna Arnal-Gómez, Maria A. Cebrià i Iranzo, Jose M. Tomas, Maria A. Tortosa-Chuliá, Mercè Balasch-Bernat, Trinidad Sentandreu-Mañó, Silvia Forcano and Natalia Cezón-Serrano

J. Clin. Med. 2021, 10(5), 1018; https://doi.org/10.3390/jcm10051018 - 02 Mar 2021

Cited by 12 | Viewed by 2400

Abstract

Recently the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated diagnostic criteria for sarcopenia, which consist of one or more measures of muscle strength, muscle mass, and physical performance, plus an initial screening test called SARC-F. The main objective was [...] Read more.

Recently the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated diagnostic criteria for sarcopenia, which consist of one or more measures of muscle strength, muscle mass, and physical performance, plus an initial screening test called SARC-F. The main objective was to compare the number of cases of sarcopenia, using the different measurements and screening options. A cross-sectional study was conducted on Spanish older adults (n = 272, 72% women). Combining the different measures proposed by the steps described in the EWGSOP2 algorithm, 12 options were obtained (A–L). These options were studied in each of the three models: (1) using SARC-F as initial screening; (2) not using SARC-F; and (3) using SARC-CalF instead of SARC-F. A χ² independence test was statistically significant (χ²(6) = 88.41, p < 0.001), and the association between the algorithm used and the classification of sarcopenia was moderate (Cramer’s V = 0.226). We conclude that the different EWGSOP2 measurement options imply case-finding differences in the studied population. Moreover, when applying the SARC-F, the number of people classified as sarcopenic decreases. Finally, when SARC-CalF is used as screening, case finding of sarcopenic people decreases. Thus, clinical settings should consider these outcomes, since these steps can make preventive and therapeutic interventions on sarcopenia vary widely. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

13 pages, 880 KiB

Open AccessArticle

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

by Sophia X. Sui, Kara L. Holloway-Kew, Natalie K. Hyde, Lana J. Williams, Monica C. Tembo, Sarah Leach and Julie A. Pasco

J. Clin. Med. 2021, 10(2), 343; https://doi.org/10.3390/jcm10020343 - 18 Jan 2021

Cited by 17 | Viewed by 3293

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

15 pages, 1275 KiB

Open AccessArticle

Effect of Aerobic Exercise Training and Deconditioning on Oxidative Capacity and Muscle Mitochondrial Enzyme Machinery in Young and Elderly Individuals

by Andreas Mæchel Fritzen, Søren Peter Andersen, Khaled Abdul Nasser Qadri, Frank D. Thøgersen, Thomas Krag, Mette C. Ørngreen, John Vissing and Tina D. Jeppesen

J. Clin. Med. 2020, 9(10), 3113; https://doi.org/10.3390/jcm9103113 - 26 Sep 2020

Cited by 19 | Viewed by 4505

Abstract

Mitochondrial dysfunction is thought to be involved in age-related loss of muscle mass and function (sarcopenia). Since the degree of physical activity is vital for skeletal muscle mitochondrial function and content, the aim of this study was to investigate the effect of 6 [...] Read more.

Mitochondrial dysfunction is thought to be involved in age-related loss of muscle mass and function (sarcopenia). Since the degree of physical activity is vital for skeletal muscle mitochondrial function and content, the aim of this study was to investigate the effect of 6 weeks of aerobic exercise training and 8 weeks of deconditioning on functional parameters of aerobic capacity and markers of muscle mitochondrial function in elderly compared to young individuals. In 11 healthy, elderly (80 ± 4 years old) and 10 healthy, young (24 ± 3 years old) volunteers, aerobic training improved maximal oxygen consumption rate by 13%, maximal workload by 34%, endurance capacity by 2.4-fold and exercise economy by 12% in the elderly to the same extent as in young individuals. This evidence was accompanied by a similar training-induced increase in muscle citrate synthase (CS) (31%) and mitochondrial complex I–IV activities (51–163%) in elderly and young individuals. After 8 weeks of deconditioning, endurance capacity (−20%), and enzyme activity of CS (−18%) and complex I (−40%), III (−25%), and IV (−26%) decreased in the elderly to a larger extent than in young individuals. In conclusion, we found that elderly have a physiological normal ability to improve aerobic capacity and mitochondrial function with aerobic training compared to young individuals, but had a faster decline in endurance performance and muscle mitochondrial enzyme activity after deconditioning, suggesting an age-related issue in maintaining oxidative metabolism. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

11 pages, 1916 KiB

Open AccessArticle

Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake

by Ilse J. M. Hagedoorn, Niala den Braber, Milou M. Oosterwijk, Christina M. Gant, Gerjan Navis, Miriam M. R. Vollenbroek-Hutten, Bert-Jan F. van Beijnum, Stephan J. L. Bakker and Gozewijn D. Laverman

J. Clin. Med. 2020, 9(10), 3104; https://doi.org/10.3390/jcm9103104 - 25 Sep 2020

Cited by 9 | Viewed by 2093

Abstract

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary [...] Read more.

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: <5000, 5000–6999, 7000–9999, ≥ 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115–8638). Of these patients, 48 patients (22%) took 7000–9999 steps/day, 37 patients (17%) took ≥ 10,000 steps/day, and 78 patients (36%) took <5000 steps/day. Patients with <5000 steps/day had, in comparison to patients who took ≥10,000 steps/day, a higher body mass index (BMI) (33 ± 6 vs. 30 ± 5 kg/m², p = 0.009), lower CER (11.7 ± 4.8 vs. 14.8 ± 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 ± 0.29 vs. 1.08 ± 0.22 g/kg/day, p < 0.001). Both creatinine excretion (β = 0.26, p < 0.001) and dietary protein intake (β = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

10 pages, 285 KiB

Open AccessArticle

Impact of Psychological Distress and Sleep Quality on Balance Confidence, Muscle Strength, and Functional Balance in Community-Dwelling Middle-Aged and Older People

by Raquel Fábrega-Cuadros, Agustín Aibar-Almazán, Antonio Martínez-Amat and Fidel Hita-Contreras

J. Clin. Med. 2020, 9(9), 3059; https://doi.org/10.3390/jcm9093059 - 22 Sep 2020

Cited by 6 | Viewed by 2429

Abstract

The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, [...] Read more.

The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, ABC), muscle strength (hand grip dynamometer), and functional balance (Timed Up-and-Go test) were assessed. Psychological distress and sleep quality were evaluated by the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Age, sex, physical activity level, nutritional status, and fatigue were included as possible confounders. Multivariate linear and logistic regressions were performed. Higher values of anxiety (OR = 1.10), fatigue (OR = 1.04), and older age (OR = 1.08) were associated with an increased risk of falling (ABC < 67%). Greater muscle strength was associated with male sex and improved nutritional status (adjusted R² = 0.39). On the other hand, being older and using sleeping medication were linked to poorer functional balance (adjusted R² = 0.115). In conclusion, greater anxiety levels and the use of sleep medication were linked to a high risk of falling and poorer functional balance, respectively. No associations were found between muscle strength and sleep quality, anxiety, or depression. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

18 pages, 2335 KiB

Open AccessArticle

Respiratory Muscle Strengths and Their Association with Lean Mass and Handgrip Strengths in Older Institutionalized Individuals

by Francisco Miguel Martínez-Arnau, Cristina Buigues, Rosa Fonfría-Vivas and Omar Cauli

J. Clin. Med. 2020, 9(9), 2727; https://doi.org/10.3390/jcm9092727 - 24 Aug 2020

Cited by 9 | Viewed by 2860

Abstract

The study of reduced respiratory muscle strengths in relation to the loss of muscular function associated with ageing is of great interest in the study of sarcopenia in older institutionalized individuals. The present study assesses the association between respiratory muscle parameters and skeletal [...] Read more.

The study of reduced respiratory muscle strengths in relation to the loss of muscular function associated with ageing is of great interest in the study of sarcopenia in older institutionalized individuals. The present study assesses the association between respiratory muscle parameters and skeletal mass content and strength, and analyzes associations with blood cell counts and biochemical parameters related to protein, lipid, glucose and ion profiles. A multicenter cross-sectional study was performed among patients institutionalized in nursing homes. The respiratory muscle function was evaluated by peak expiratory flow, maximal respiratory pressures and spirometry parameters, and skeletal mass function and lean mass content with handgrip strength, walking speed and bioimpedance, respectively. The prevalence of reduced respiratory muscle strength in the sample ranged from 37.9% to 80.7%. Peak expiratory flow significantly (p < 0.05) correlated to handgrip strength and gait speed, as well as maximal inspiratory pressure (p < 0.01). Maximal expiratory pressure significantly (p < 0.01) correlated to handgrip strength. No correlation was obtained with muscle mass in any of parameters related to reduced respiratory muscle strength. The most significant associations within the blood biochemical parameters were observed for some protein and lipid biomarkers e.g., glutamate-oxaloacetate transaminase (GOT), urea, triglycerides and cholesterol. Respiratory function muscle parameters, peak expiratory flow and maximal respiratory pressures were correlated with reduced strength and functional impairment but not with lean mass content. We identified for the first time a relationship between peak expiratory flow (PEF) values and GOT and urea concentrations in blood which deserves future investigations in order to manage these parameters as a possible biomarkers of reduced respiratory muscle strength. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

12 pages, 266 KiB

Open AccessArticle

Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity

by Máximo Bernabeu-Wittel, Raquel Gómez-Díaz, Álvaro González-Molina, Sofía Vidal-Serrano, Jesús Díez-Manglano, Fernando Salgado, María Soto-Martín, Manuel Ollero-Baturone and on behalf of the PROTEO RESEARCHERS

J. Clin. Med. 2020, 9(8), 2669; https://doi.org/10.3390/jcm9082669 - 18 Aug 2020

Cited by 27 | Viewed by 2976

Abstract

Background: The presence of oxidative stress, telomere shortening, and apoptosis in polypathological patients (PP) with sarcopenia and frailty remains unknown. Methods: Multicentric prospective observational study in order to assess oxidative stress markers (catalase, glutathione reductase (GR), total antioxidant capacity to reactive oxygen species [...] Read more.

Background: The presence of oxidative stress, telomere shortening, and apoptosis in polypathological patients (PP) with sarcopenia and frailty remains unknown. Methods: Multicentric prospective observational study in order to assess oxidative stress markers (catalase, glutathione reductase (GR), total antioxidant capacity to reactive oxygen species (TAC-ROS), and superoxide dismutase (SOD)), absolute telomere length (aTL), and apoptosis (DNA fragmentation) in peripheral blood samples of a hospital-based population of PP. Associations of these biomarkers to sarcopenia, frailty, functional status, and 12-month mortality were analyzed. Results: Of the 444 recruited patients, 97 (21.8%), 278 (62.6%), and 80 (18%) were sarcopenic, frail, or both, respectively. Oxidative stress markers (lower TAC-ROS and higher SOD) were significantly enhanced and aTL significantly shortened in patients with sarcopenia, frailty or both syndromes. No evidence of apoptosis was detected in blood leukocytes of any of the patients. Both oxidative stress markers (GR, p = 0.04) and telomere shortening (p = 0.001) were associated to death risk and to less survival days. Conclusions: Oxidative stress markers and telomere length were enhanced and shortened, respectively, in blood samples of polypathological patients with sarcopenia and/or frailty. Both were associated to decreased survival. They could be useful in the clinical practice to assess vulnerable populations with multimorbidity and of potential interest as therapeutic targets. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

15 pages, 1650 KiB

Open AccessArticle

Preserved Capacity for Adaptations in Strength and Muscle Regulatory Factors in Elderly in Response to Resistance Exercise Training and Deconditioning

by Andreas Mæchel Fritzen, Frank D. Thøgersen, Khaled Abdul Nasser Qadri, Thomas Krag, Marie-Louise Sveen, John Vissing and Tina D. Jeppesen

J. Clin. Med. 2020, 9(7), 2188; https://doi.org/10.3390/jcm9072188 - 10 Jul 2020

Cited by 8 | Viewed by 3382

Abstract

Aging is related to an inevitable loss of muscle mass and strength. The mechanisms behind age-related loss of muscle tissue are not fully understood but may, among other things, be induced by age-related differences in myogenic regulatory factors. Resistance exercise training and deconditioning [...] Read more.

Aging is related to an inevitable loss of muscle mass and strength. The mechanisms behind age-related loss of muscle tissue are not fully understood but may, among other things, be induced by age-related differences in myogenic regulatory factors. Resistance exercise training and deconditioning offers a model to investigate differences in myogenic regulatory factors that may be important for age-related loss of muscle mass and strength. Nine elderly (82 ± 7 years old) and nine young, healthy persons (22 ± 2 years old) participated in the study. Exercise consisted of six weeks of resistance training of the quadriceps muscle followed by eight weeks of deconditioning. Muscle biopsy samples before and after training and during the deconditioning period were analyzed for MyoD, myogenin, insulin-like growth-factor I receptor, activin receptor IIB, smad2, porin, and citrate synthase. Muscle strength improved with resistance training by 78% (95.0 ± 22.0 kg) in the elderly to a similar extent as in the young participants (83.5%; 178.2 ± 44.2 kg) and returned to baseline in both groups after eight weeks of deconditioning. No difference was seen in expression of muscle regulatory factors between elderly and young in response to exercise training and deconditioning. In conclusion, the capacity to gain muscle strength with resistance exercise training in elderly was not impaired, highlighting this as a potent tool to combat age-related loss of muscle function, possibly due to preserved regulation of myogenic factors in elderly compared with young muscle. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

12 pages, 848 KiB

Open AccessArticle

Comparison of Three Nutritional Screening Tools with the New Glim Criteria for Malnutrition and Association with Sarcopenia in Hospitalized Older Patients

by Francesco Bellanti, Aurelio Lo Buglio, Stefano Quiete, Giuseppe Pellegrino, Michał Dobrakowski, Aleksandra Kasperczyk, Sławomir Kasperczyk and Gianluigi Vendemiale

J. Clin. Med. 2020, 9(6), 1898; https://doi.org/10.3390/jcm9061898 - 17 Jun 2020

Cited by 50 | Viewed by 4990

Abstract

The integrated assessment of nutritional status and presence of sarcopenia would help improve clinical outcomes of in-hospital aged patients. We compared three common nutritional screening tools with the new Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria among hospitalized older patients. To this, [...] Read more.

The integrated assessment of nutritional status and presence of sarcopenia would help improve clinical outcomes of in-hospital aged patients. We compared three common nutritional screening tools with the new Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria among hospitalized older patients. To this, 152 older patients were assessed consecutively at hospital admission by the Malnutrition Universal Screening Tool (MUST), the Subjective Global Assessment (SGA), and the Nutritional Risk Screening 2002 (NRS-2002). A 46% prevalence of malnutrition was reported according to GLIM. Sensitivity was 64%, 96% and 47%, and specificity was 82%, 15% and 76% with the MUST, SGA, and NRS-2002, respectively. The concordance with GLIM criteria was 89%, 53% and 62% for the MUST, SGA, and NRS-2002, respectively. All the screening tools had a moderate value to diagnose malnutrition. Moreover, patients at high nutritional risk by MUST were more likely to present with sarcopenia than those at low risk (OR 2.5, CI 1.3-3.6). To conclude, MUST is better than SGA and NRS-2002 at detecting malnutrition in hospitalized older patients diagnosed by the new GLIM criteria. Furthermore, hospitalized older patients at high risk of malnutrition according to MUST are at high risk of presenting with sarcopenia. Nutritional status should be determined by MUST in older patients at hospital admission, followed by both GLIM and the European Working Group on Sarcopenia in Older People (EWGSOP2) assessment. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

12 pages, 1506 KiB

Open AccessArticle

Effects of a Multicomponent Exercise Program in Physical Function and Muscle Mass in Sarcopenic/Pre-Sarcopenic Adults

by Hyuma Makizako, Yuki Nakai, Kazutoshi Tomioka, Yoshiaki Taniguchi, Nana Sato, Ayumi Wada, Ryoji Kiyama, Kota Tsutsumimoto, Mitsuru Ohishi, Yuto Kiuchi, Takuro Kubozono and Toshihiro Takenaka

J. Clin. Med. 2020, 9(5), 1386; https://doi.org/10.3390/jcm9051386 - 08 May 2020

Cited by 26 | Viewed by 4185

Abstract

This study aimed to assess the effects of a multicomponent exercise program on physical function and muscle mass in older adults with sarcopenia or pre-sarcopenia. Moreover, we aim to standardize the exercise program for easy incorporation in the daily life of community-dwelling older [...] Read more.

This study aimed to assess the effects of a multicomponent exercise program on physical function and muscle mass in older adults with sarcopenia or pre-sarcopenia. Moreover, we aim to standardize the exercise program for easy incorporation in the daily life of community-dwelling older adults as a secondary outcome. A single-blind randomized controlled trial was conducted with individuals (≥60 years) who had sarcopenia or pre-sarcopenia (n = 72). Participants were randomly assigned to the exercise and control groups. The exercise program consisted of 12 weekly 60-min sessions that included resistance, balance, flexibility, and aerobic training. Outcome measures were physical function and muscle mass. Assessments were conducted before and immediately after the intervention. Among the 72 participants (mean age: 75.0 ± 6.9 years; 70.8% women), 67 (93.1%) completed the trial. Group-by-time interactions on the chair stand (p = 0.02) and timed “up and go” (p = 0.01) tests increased significantly in the exercise group. Although the exercise group showed a tendency to prevent loss of muscle mass, no significant interaction effects were observed for cross-sectional muscle area and muscle volume. The 12-week exercise program improved physical function in the intervention group. Although it is unclear whether the program is effective in increasing muscle mass, a multicomponent exercise program would be an effective treatment for physical function among older adults with sarcopenia. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

12 pages, 911 KiB

Open AccessArticle

Impact of Decorin on the Physical Function and Prognosis of Patients with Hepatocellular Carcinoma

by Takumi Kawaguchi, Sachiyo Yoshio, Yuzuru Sakamoto, Ryuki Hashida, Shunji Koya, Keisuke Hirota, Dan Nakano, Sakura Yamamura, Takashi Niizeki, Hiroo Matsuse and Takuji Torimura

J. Clin. Med. 2020, 9(4), 936; https://doi.org/10.3390/jcm9040936 - 28 Mar 2020

Cited by 11 | Viewed by 4289

Abstract

The outcome of patients with hepatocellular carcinoma (HCC) is still poor. Decorin is a small leucine-rich proteoglycan, which exerts antiproliferative and antiangiogenic properties in vitro. We aimed to investigate the associations of decorin with physical function and prognosis in patients with HCC. We [...] Read more.

The outcome of patients with hepatocellular carcinoma (HCC) is still poor. Decorin is a small leucine-rich proteoglycan, which exerts antiproliferative and antiangiogenic properties in vitro. We aimed to investigate the associations of decorin with physical function and prognosis in patients with HCC. We enrolled 65 patients with HCC treated with transcatheter arterial chemoembolization (median age, 75 years; female/male, 25/40). Serum decorin levels were measured using enzyme-linked immunosorbent assays; patients were classified into the High or Low decorin groups by median levels. Associations of decorin with physical function and prognosis were evaluated by multivariate correlation and Cox regression analyses, respectively. Age and skeletal muscle indices were not significantly different between the High and Low decorin groups. In the High decorin group, the 6-min walking distance was significantly longer than the Low decorin group and was significantly correlated with serum decorin levels (r = 0.2927, p = 0.0353). In multivariate analysis, the High decorin group was independently associated with overall survival (hazard ratio 2.808, 95% confidence interval 1.016–8.018, p = 0.0498). In the High decorin group, overall survival rate was significantly higher than in the Low decorin group (median 732 days vs. 463 days, p = 0.010). In conclusion, decorin may be associated with physical function and prognosis in patients with HCC. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Graphical abstract

19 pages, 491 KiB

Open AccessArticle

Effects of Physical Exercises and Verbal Stimulation on the Functional Efficiency and Use of Free Time in an Older Population under Institutional Care: A Randomized Controlled Trial

by Agnieszka Wiśniowska-Szurlej, Agnieszka Ćwirlej-Sozańska, Natalia Wołoszyn, Bernard Sozański and Anna Wilmowska-Pietruszyńska

J. Clin. Med. 2020, 9(2), 477; https://doi.org/10.3390/jcm9020477 - 09 Feb 2020

Cited by 4 | Viewed by 2805

Abstract

Older people in institutional care are, for the most part, physically inactive and do not interact with each other or medical staff. Therefore, reducing sedentary behaviour is a new, important, and modifiable lifestyle variable that can improve the health of elderly people. The [...] Read more.

Older people in institutional care are, for the most part, physically inactive and do not interact with each other or medical staff. Therefore, reducing sedentary behaviour is a new, important, and modifiable lifestyle variable that can improve the health of elderly people. The aim of the project was to assess the degree of improvement in functional performance and the possibility of changing habitual, free time behaviour among elderly people under institutional care by applying physical training with verbal stimulation. The study covered older people, aged 65–85 years, who are living a sedentary lifestyle in care homes in Southeastern Poland. Those who met the eligibility criteria were enrolled in the study and were assigned, at random, to one of four parallel groups: basic exercises (n = 51), basic exercises combined with verbal stimulation (n = 51), functional exercise training (n = 51), and functional exercise training with verbal stimulation (n = 51). No statistically significant differences in baseline characteristics were observed across the groups. Data were collected at baseline and at 12 and 24-weeks following the completion of the intervention. In the group with functional exercise training with verbal stimulation, in comparison to the group with basic exercises, the greatest positive short-term impact of intervention was demonstrated in terms of functional fitness (increased by 1.31 points; 95% confidence interval (CI) = 0.93–1.70), gait speed (improved by 0.17 m/s, 95% CI = 0.13–0.22), hand grip strength (by over 4 kg; 95% CI = 2.51–4.95), and upper-limb flexibility (by 10 cm; 95% CI = 5.82–12.65). There was also a significant increase in the level of free-time physical activity and an improvement in the quality of life, especially as expressed in the domain of overall physical functioning. Our study showed that a functional exercise program, combined with verbal stimulation, is effective at improving physical fitness and raising the level of free-time physical activity. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

12 pages, 281 KiB

Open AccessArticle

Correlations between the Quality of Life Domains and Clinical Variables in Sarcopenic Osteoporotic Postmenopausal Women

by Mariana Cevei, Roxana Ramona Onofrei, Felicia Cioara and Dorina Stoicanescu

J. Clin. Med. 2020, 9(2), 441; https://doi.org/10.3390/jcm9020441 - 06 Feb 2020

Cited by 20 | Viewed by 2680

Abstract

(1) Background: both sarcopenia and osteoporosis are major health problems in postmenopausal women. The aim of the study was to evaluate the quality of life (QoL) and the associated factors for sarcopenia in osteoporotic postmenopausal women, diagnosed according to EWGSOP2 criteria. (2) Methods: [...] Read more.

(1) Background: both sarcopenia and osteoporosis are major health problems in postmenopausal women. The aim of the study was to evaluate the quality of life (QoL) and the associated factors for sarcopenia in osteoporotic postmenopausal women, diagnosed according to EWGSOP2 criteria. (2) Methods: the study sample comprised 122 osteoporotic postmenopausal women with low hand grip strength and was divided into two groups: group 1 (probable sarcopenia) and group 2 (sarcopenia). QoL was assessed using the validated Romanian version of SarQol questionnaire. (3) Results: the D1, D4, D5, D7 and total SarQoL scores were significantly lower in women from group 2 compared to group 1. In group 2, women older than 70 years had significant lower values for D1, D3, D4, D6 and total SarQoL scores. Age, history of falls and the presence of confirmed and severe sarcopenia were predictors for overall QoL. (4) Conclusions: the frequency of sarcopenia was relatively high in our sample, with body mass index and history of falls as predictors for sarcopenia. Older osteoporotic postmenopausal women, with previous falls and an established sarcopenia diagnosis (low muscle strength and low muscle mass), were more likely to have a decreased quality of life. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

Review

Jump to: Research, Other

16 pages, 276 KiB

Open AccessFeature PaperReview

Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review

by Marianna Avola, Giulia Rita Agata Mangano, Gianluca Testa, Sebastiano Mangano, Andrea Vescio, Vito Pavone and Michele Vecchio

J. Clin. Med. 2020, 9(10), 3115; https://doi.org/10.3390/jcm9103115 - 26 Sep 2020

Cited by 13 | Viewed by 4850

Abstract

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It has been identified as one of the most common comorbidities associated with femoral neck fracture (FNF). The aim of this review was to evaluate [...] Read more.

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It has been identified as one of the most common comorbidities associated with femoral neck fracture (FNF). The aim of this review was to evaluate the impact of physical therapy on FNF patients’ function and rehabilitation. The selected articles were randomized controlled trials (RCTs), published in the last 10 years. Seven full texts were eligible for this review: three examined the impact of conventional rehabilitation and nutritional supplementation, three evaluated the effects of rehabilitation protocols compared to new methods and a study explored the intervention with erythropoietin (EPO) in sarcopenic patients with FNF and its potential effects on postoperative rehabilitation. Physical activity and dietary supplementation are the basic tools of prevention and rehabilitation of sarcopenia in elderly patients after hip surgery. The most effective physical therapy seems to be exercise of progressive resistance. Occupational therapy should be included in sarcopenic patients for its importance in cognitive rehabilitation. Erythropoietin and bisphosphonates could represent medical therapy resources. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

13 pages, 459 KiB

Open AccessReview

Diagnosis, Treatment and Prevention of Sarcopenia in Hip Fractured Patients: Where We Are and Where We Are Going: A Systematic Review

by Gianluca Testa, Andrea Vescio, Danilo Zuccalà, Vincenzo Petrantoni, Mirko Amico, Giorgio Ivan Russo, Giuseppe Sessa and Vito Pavone

J. Clin. Med. 2020, 9(9), 2997; https://doi.org/10.3390/jcm9092997 - 17 Sep 2020

Cited by 11 | Viewed by 2976

Abstract

Background: Sarcopenia is defined as a progressive loss of muscle mass and muscle strength associated to increased adverse events, such as falls and hip fractures. The aim of this systematic review is to analyse diagnosis methods of sarcopenia in patients with hip fracture [...] Read more.

Background: Sarcopenia is defined as a progressive loss of muscle mass and muscle strength associated to increased adverse events, such as falls and hip fractures. The aim of this systematic review is to analyse diagnosis methods of sarcopenia in patients with hip fracture and evaluate prevention and treatment strategies described in literature. Methods: Three independent authors performed a systematic review of two electronic medical databases using the following inclusion criteria: Sarcopenia, hip fractures, diagnosis, treatment, and prevention with a minimum average of 6-months follow-up. Any evidence-level studies reporting clinical data and dealing with sarcopenia diagnosis, or the treatment and prevention in hip fracture-affected patients, were considered. Results: A total of 32 articles were found. After the first screening, we selected 19 articles eligible for full-text reading. Ultimately, following full-text reading, and checking of the reference list, seven articles were included. Conclusions: Sarcopenia diagnosis is challenging, as no standardized diagnostic and therapeutic protocols are present. The development of medical management programs is mandatory for good prevention. To ensure adequate resource provision, care models should be reviewed, and new welfare policies should be adopted in the future. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

21 pages, 7022 KiB

Open AccessReview

Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Nejc Šarabon, Žiga Kozinc, Stefan Löfler and Christian Hofer

J. Clin. Med. 2020, 9(9), 2902; https://doi.org/10.3390/jcm9092902 - 08 Sep 2020

Cited by 27 | Viewed by 6792

Abstract

It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) [...] Read more.

It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) on muscle strength, body composition, and functional performance in older adults. A thorough literature review was conducted, and the analyses were limited to randomized controlled trials. In total, 63 studies were included in the meta-analysis (48 RT, 11 WBV, and 4 EMS). The results showed that RT and WBV are comparably effective for improving muscle strength, while the effects of EMS remains debated. RT interventions also improved some outcome measures related to functional performance, as well as the cross-sectional area of the quadriceps. Muscle mass was not significantly affected by RT. A limitation of the review is the smaller number of WBV and particularly EMS studies. For this reason, the effects of WBV and EMS could not be comprehensively compared to the effect of RT for all outcome measures. For the moment, RT or combinations of RT and WBV or EMS, is probably the most reliable way to improve muscle strength and functional performance, while the best approach to increase muscle mass in older adults remains open to further studies. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

13 pages, 1058 KiB

Open AccessReview

Effect of Sleep Quality on the Prevalence of Sarcopenia in Older Adults: A Systematic Review with Meta-Analysis

by Jacobo Á. Rubio-Arias, Raquel Rodríguez-Fernández, Luis Andreu, Luis M. Martínez-Aranda, Alejandro Martínez-Rodriguez and Domingo J. Ramos-Campo

J. Clin. Med. 2019, 8(12), 2156; https://doi.org/10.3390/jcm8122156 - 06 Dec 2019

Cited by 32 | Viewed by 5238

Abstract

Sarcopenia is an age-related condition. However, the prevalence of sarcopenia may increase due to a range of other factors, such as sleep quality/duration. Therefore, the aim of the study is to conduct a systematic review with meta-analysis to determine the prevalence of sarcopenia [...] Read more.

Sarcopenia is an age-related condition. However, the prevalence of sarcopenia may increase due to a range of other factors, such as sleep quality/duration. Therefore, the aim of the study is to conduct a systematic review with meta-analysis to determine the prevalence of sarcopenia in older adults based on their self-reported sleep duration. Methods: Three electronic databases were used—PubMed-Medline, Web of Science, and Cochrane Library. We included studies that measured the prevalence of sarcopenia, divided according to sleep quality and excluded studies (a) involving populations with neuromuscular pathologies, (b) not showing prevalence values (cases/control) on sarcopenia, and (c) not including classificatory models to determine sleep quality. Results: high prevalence values in older adults with both long and short sleep duration were shown. However, prevalence values were higher in those with inadequate sleep (<6–8 h or low efficiency) (OR 0.76; 95% CI (0.70–0.83); Q = 1.446; p = 0.695; test for overall effect, Z = 6.01, p < 0.00001). Likewise, higher prevalence levels were shown in men (OR 1.61; 95% CI (0.82–3.16); Q = 11.80; p = 0.0189) compared to women (OR 0.77; 95% CI (0.29–2.03); Q = 21.35; p = 0.0003). Therefore, the prevalence of sarcopenia appears to be associated with sleep quality, with higher prevalence values in older adults who have inadequate sleep. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

► Show Figures

Figure 1

Other

Jump to: Research, Review

7 pages, 237 KiB

Open AccessBrief Report

Dynapenia and Low Cognition: A Cross-Sectional Association in Postmenopausal Women

by Julie A. Pasco, Amanda L. Stuart, Sophia X. Sui, Kara L. Holloway-Kew, Natalie K. Hyde, Monica C. Tembo, Pamela Rufus-Membere, Mark A. Kotowicz and Lana J. Williams

J. Clin. Med. 2021, 10(2), 173; https://doi.org/10.3390/jcm10020173 - 06 Jan 2021

Cited by 12 | Viewed by 2829

Abstract

Dynapenia is a key contributor to physical frailty. Cognitive impairment and dementia accompany frailty, yet links between skeletal muscle and neurocognition are poorly understood. We examined the cross-sectional relationship between lower limb muscle strength and global cognitive function. Participants were 127 women aged [...] Read more.

Dynapenia is a key contributor to physical frailty. Cognitive impairment and dementia accompany frailty, yet links between skeletal muscle and neurocognition are poorly understood. We examined the cross-sectional relationship between lower limb muscle strength and global cognitive function. Participants were 127 women aged 51–87 years, from the Geelong Osteoporosis Study. Peak eccentric strength of the hip-flexors and hip abductors was determined using a hand-held dynamometer, and dynapenia identified as muscle strength t-scores < −1. Cognition was assessed using the Mini-Mental State Examination (MMSE), and MMSE scores below the median were rated as low. Associations between dynapenia and low cognition were examined using logistic regression models. Hip-flexor dynapenia was detected in 38 (71.7%) women with low cognition and 36 (48.7%) with good cognition (p = 0.009); for hip abductor dynapenia, the pattern was similar (21 (39.6%) vs. 9 (12.2%); p < 0.001). While the observed difference for hip-flexor strength was attenuated after adjusting for age and height (adjusted Odds Ratio (OR) 1.95, 95%CI 0.86–4.41), low cognition was nearly 4-fold more likely in association with hip abductor dynapenia (adjusted OR 3.76, 95%CI 1.44–9.83). No other confounders were identified. Our data suggest that low strength of the hip abductors and low cognition are associated and this could be a consequence of poor muscle function contributing to cognitive decline or vice versa. As muscle weakness is responsive to physical interventions, this warrants further investigation. Full article

(This article belongs to the Special Issue Prevention and Treatment of Sarcopenia)

Journal Menu

Journal Browser

Prevention and Treatment of Sarcopenia

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (19 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI