Rehabilitation and Management of Frailty, Sarcopenia and Malnutrition — 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 2675

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Guest Editor
Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie 514-8507, Japan
Interests: rehabilitation medicine; dysphagia; clinical nutrition; aspiration pneumonia; health service research
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Special Issue Information

Dear Colleagues,

We are pleased to announce the 2nd Edition of this Special Issue, “Rehabilitation and Management of Frailty, Sarcopenia and Malnutrition” (https://www.mdpi.com/journal/jcm/special_issues/1AI400N08F).

The prevalence of sarcopenia, frailty, and malnutrition is increasing with the growing number of older adults. Sarcopenia, frailty, and malnutrition are associated with functional impairment, physical disability, and handicap. They are often comorbid, and their synergistic effects could lead to worsening clinical outcomes.

Management, including rehabilitation, is critical for older patients with sarcopenia, frailty, and malnutrition. Rehabilitation and nutritional care have the potential to improve physical function, activities related to daily living, and the quality of life of these older adults. Further research is required on better assessment methods for malnutrition, sarcopenia, and frailty, as well as management methods, including appropriate rehabilitation and nutritional support.

The aim of this Special Issue is to update the knowledge regarding the management and rehabilitation of frailty, sarcopenia and malnutrition. We invite the submission of clinical research, epidemiological research, and up-to-date reviews (scoping and systematic reviews).

Prof. Dr. Ryo Momosaki
Guest Editor

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Keywords

  • rehabilitation
  • frailty
  • sarcopenia
  • malnutrition
  • older
  • disability
  • dysphagia

Published Papers (4 papers)

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Research

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12 pages, 669 KiB  
Article
Sarcopenia Prevalence among Hospitalized Patients with Severe Obesity: An Observational Study
by Raffaella Cancello, Ettore Brenna, Davide Soranna, Antonella Zambon, Valentina Villa, Gianluca Castelnuovo, Lorenzo Maria Donini, Luca Busetto, Paolo Capodaglio and Amelia Brunani
J. Clin. Med. 2024, 13(10), 2880; https://doi.org/10.3390/jcm13102880 - 13 May 2024
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Abstract
Background: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was [...] Read more.
Background: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients with obesity, considering sex, age, BMI, type, and number of concomitant diseases. Methods: Patient data of both genders aged between 18 and 90 years with a body mass index (BMI) of ≥30 kg/m2 underwent hospital evaluation including bioelectrical impedance analysis (BIA) and handgrip strength (HS). QoL scores were obtained by the Psychological General Well-Being Index questionnaire. The study was approved by the institutional Ethic Committee. Results: Among the 3858 patients, 444 (11.51%) exhibited a strength deficit, while 3847 (99.71%) had skeletal muscle mass deficit. The prevalence of SO was then 11.48%, with higher rates in women (12.39%), in individuals aged >70 years (27%), and in those reporting a ‘poor’ QoL (12.6%). No significant difference in SO prevalence was found when stratifying by BMI (30–40 kg/m2 vs. >40 kg/m2, p = 0.1710). In SO patients, osteoarticular diseases (57%), hypertension/heart failure (38%), type 2 diabetes mellitus (34%), and obstructive sleep apnea (32%) were the more frequent comorbidities. Conclusions: The application of ESPEN/EASO-SO criteria in a cohort of inpatients with severe obesity revealed 11.48% SO prevalence, which was associated with age (particularly > 70 years), gender (women), but not BMI, as determinants. Disease staging and QoL screening may improve the identification of SO high-risk patients. Full article
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21 pages, 6685 KiB  
Article
Using Sequence Analyses to Quantitatively Measure Oropharyngeal Swallowing Temporality in Point-of-Care Ultrasound Examinations: A Pilot Study
by Wilson Yiu Shun Lam, Elaine Kwong, Huberta Wai Tung Chan and Yong-Ping Zheng
J. Clin. Med. 2024, 13(8), 2288; https://doi.org/10.3390/jcm13082288 - 15 Apr 2024
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Abstract
(1) Background: Swallowing is a complex process that comprises well-timed control of oropharyngeal and laryngeal structures to achieve airway protection and swallowing efficiency. To understand its temporality, previous research adopted adherence measures and revealed obligatory pairs in healthy swallows and the effect [...] Read more.
(1) Background: Swallowing is a complex process that comprises well-timed control of oropharyngeal and laryngeal structures to achieve airway protection and swallowing efficiency. To understand its temporality, previous research adopted adherence measures and revealed obligatory pairs in healthy swallows and the effect of aging and bolus type on the variability of event timing and order. This study aimed to (i) propose a systemic conceptualization of swallowing physiology, (ii) apply sequence analyses, a set of information-theoretic and bioinformatic methods, to quantify and characterize swallowing temporality, and (iii) investigate the effect of aging and dysphagia on the quantified variables using sequence analyses measures. (2) Method: Forty-three participants (17 young adults, 15 older adults, and 11 dysphagic adults) underwent B-mode ultrasound swallowing examinations at the mid-sagittal plane of the submental region. The onset, maximum, and offset states of hyoid bone displacement, geniohyoid muscle contraction, and tongue base retraction were identified and sorted to form sequences which were analyzed using an inventory of sequence analytic techniques; namely, overlap coefficients, Shannon entropy, and longest common subsequence algorithms. (3) Results: The concurrency of movement sequence was found to be significantly impacted by aging and dysphagia. Swallowing sequence variability was also found to be reduced with age and the presence of dysphagia (H(2) = 52.253, p < 0.001, η2 = 0.260). Four obligatory sequences were identified, and high adherence was also indicated in two previously reported pairs. These results provided preliminary support for the validity of sequence analyses for quantifying swallowing sequence temporality. (4) Conclusions: A systemic conceptualization of human deglutition permits a multi-level quantitative analysis of swallowing physiology. Sequence analyses are a set of promising quantitative measurement techniques for point-of-care ultrasound (POCUS) swallowing examinations and outcome measures for swallowing rehabilitation and evaluation of associated physiological conditions, such as sarcopenia. Findings in the current study revealed physiological differences among healthy young, healthy older, and dysphagic adults. They also helped lay the groundwork for future AI-assisted dysphagia assessment and outcome measures using POCUSs. Arguably, the proposed conceptualization and analyses are also modality-independent measures that can potentially be generalized for other instrumental swallowing assessment modalities. Full article
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18 pages, 632 KiB  
Systematic Review
Different Diagnostic Criteria for Determining the Prevalence of Sarcopenia in Older Adults: A Systematic Review
by Blanca Pedauyé-Rueda, Pablo García-Fernández, Luis Maicas-Pérez, José Luis Maté-Muñoz and Juan Hernández-Lougedo
J. Clin. Med. 2024, 13(9), 2520; https://doi.org/10.3390/jcm13092520 - 25 Apr 2024
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Abstract
Background: Sarcopenia is defined as a loss of muscle mass, strength, and physical function associated with aging. It is due to a combination of genetic, environmental, and physiological factors. It is also associated with an increased risk of health problems. Since there [...] Read more.
Background: Sarcopenia is defined as a loss of muscle mass, strength, and physical function associated with aging. It is due to a combination of genetic, environmental, and physiological factors. It is also associated with an increased risk of health problems. Since there are many different researchers in the field, with their own algorithms and cut-off points, there is no single criterion for diagnosis. This review aims to compare the prevalence of sarcopenia according to these different diagnostic criteria in older adult populations by age group and sex. Methods: Different databases were searched: Web of Science, Pubmed, Dialnet, Scopus, and Cochrane. The keywords used were “sarcopenia”, “diagnosis”, “prevalence”, “assessment”, “aged”, “aging” and “older”. Studies conducted in a population aged ≥65 assessing the prevalence of sarcopenia were selected. Results: Nineteen articles met the inclusion criteria, with a total of 33,515 subjects, 38.08% female and 61.42% male, at a mean age of 74.52. The diagnostic algorithms used were 52.63% AWGS2, 21.05% EWGSOP2, 10.53% AWGS1 and EWGS1, and 5.26% FNIH. Prevalence ranged from 1.7% to 37.47%, but was higher in males and increased with age. Conclusions: The prevalence of sarcopenia varies depending on the diagnostic algorithm used, but it increases with age and is higher in men. The EWGSOP2 and AWGS2 are the most used diagnostic criteria and measure the same variables but have different cut-off points. Of these two diagnostic algorithms, the one with the highest prevalence of sarcopenia and severe sarcopenia is the AWGS2. These differences may be due to the use of different tools and cut-off points. Therefore, a universal diagnostic criterion should be developed to allow early diagnosis of sarcopenia. Full article
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19 pages, 839 KiB  
Systematic Review
Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis
by Jia Liu, Yuezhi Zhu, Jen Kit Tan, Azera Hasra Ismail, Roszita Ibrahim and Nor Haty Hassan
J. Clin. Med. 2024, 13(8), 2382; https://doi.org/10.3390/jcm13082382 - 19 Apr 2024
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Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and [...] Read more.
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them. Full article
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