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Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly

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

Deadline for manuscript submissions: closed (20 August 2024) | Viewed by 16369

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Special Issue Editors

Dr. Dario Fernandez

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Guest Editor

Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
Interests: nutrition; muscle recovery; exercise; sarcopenia; frailty

Prof. Dr. Juan Mielgo-Ayuso

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Guest Editor

Department of Health Sciences, University of Burgos, Physiology Area, 09001 Burgos, Spain
Interests: physical exercise; aging; sarcopenia; frailty
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Dear Colleagues,

In the global population, increased survival to old age is leading to rapid aging of populations. The World Health Organization (WHO) proposed in 2015 a new vision for healthy ageing. Rather than a disease-free concept, he proposed that the concept of healthy aging focuses on the notion of functional capacity: the combination of intrinsic capacity (all physical and mental capacities), the environment, and the interaction between them.

Sarcopenia is a public health challenge due to the associated increased risk of falls, functional impairment, frailty, and mortality. Varying degrees of decline in muscle mass and strength, however, point to modifiable behavioral factors, such as diet and lifestyle, as important influencers of muscle changes, suggesting that these factors may play a role in both prevention as well as treatment.

Decreased food and energy intake contribute to weight loss, with implications for muscle mass and function. Therefore, malnutrition has become an important potential risk factor in the development of sarcopenia. However, much of the research exploring the effects of individual nutrients on sarcopenia and related muscle components is relatively recent.

If we can understand what factors influence the rate of decline in muscle mass and function in old age and the underlying mechanisms involved, we may be able to lay the groundwork for specific strategies aimed at preventing or delaying sarcopenia. Such foundations will enable older adults to maintain a better quality of life and promote healthy aging.

Dr. Dario Fernandez
Prof. Dr. Juan Mielgo-Ayuso
Guest Editors

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Keywords

sarcopenia
oxidative stress
inflammation
endocrine changes
inactivity
undernutrition

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Published Papers (6 papers)

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Research

13 pages, 1269 KiB

Open AccessArticle

Comparing Sarcopenia Definitions and Muscle Power Reduction: Associations with Health Outcomes in Spanish Community-Dwelling Older Adults

by Juan Diego Ruiz-Cárdenas, Juan José Rodríguez-Juan, María del Mar Martínez-García and Alessio Montemurro

J. Clin. Med. 2024, 13(17), 4988; https://doi.org/10.3390/jcm13174988 - 23 Aug 2024

Cited by 2 | Viewed by 1365

Abstract

Objectives: To analyze the associations between the different operational definitions of sarcopenia published in the last decade and reduced muscle power with a set of adverse health-related outcomes, such as comorbidities, depression, polypharmacy, self-perceived health, educational attainment, socioeconomic status, falls, and hospitalizations in Spanish community-dwelling older adults. Methods: A total of 686 community-dwelling older adults (median age: 72; women: 59.2%; physically active: 84%) were included in this cross-sectional analysis (ClinicalTrials.gov: NCT05148351). Sarcopenia was assessed using the FNIH, EWGSOP2, AWGS, and SDOC algorithms. Reduced muscle power was defined as the lowest sex-specific tertile and measured during the rising phase of the sit-to-stand test using a validated mobile application. Unadjusted and adjusted logistic regressions by potential confounders were performed to identify the association between sarcopenia and reduced muscle power with health-related outcomes. Results: Sarcopenia prevalence was 3.4%, 3.8%, 12.4%, and 21.3% according to the SDOC, FNIH, EWGSOP2, and AWGS, respectively. Among these definitions, moderate and large associations with health-related outcomes were observed for EWGSOP2 and SDOC, respectively, but few associations were found for FNIH and AWGS criteria. Reduced muscle power was associated more frequently and moderately with health-related outcomes compared to sarcopenia definitions. These associations remained constant after adjusting for confounders. Conclusions: The prevalence and impact of sarcopenia varied depending on the definitions used. Among the sarcopenia definitions, the SDOC exhibited the strongest associations, while reduced muscle power was the variable most frequently associated with health-related outcomes compared to any of the four sarcopenia definitions in well-functioning and physically active community-dwelling older adults. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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18 pages, 1123 KiB

Open AccessArticle

Evaluation of Serum Myostatin Concentration in Chronic Heart Failure with Preserved and Impaired Left Ventricular Ejection Fraction

by Jan Bączek, Mirosław Charkiewicz, Agnieszka Kasiukiewicz, Anna Maria Witkowska, Łukasz Magnuszewski, Marta Bączek and Zyta Beata Wojszel

J. Clin. Med. 2024, 13(6), 1741; https://doi.org/10.3390/jcm13061741 - 18 Mar 2024

Viewed by 1679

Abstract

Background: Chronic heart failure (CHF) is a complex clinical syndrome associated with muscle wasting, which can progress to cardiac cachexia. Myostatin, a negative regulator of muscle growth, has been implicated in the pathophysiology of muscle wasting in CHF patients and suggested as a potential biomarker. The objective of this study was to investigate serum myostatin concentration in patients with CHF with preserved and reduced ejection fraction. Methods: The authors conducted a single-centre study comparing serum myostatin levels, functional and echocardiographic parameters, muscle mass, strength and function in patients with CHF to a control group without CHF. The study group was further divided into sub-groups with preserved and reduced or mildly reduced ejection fraction. Results: Results showed no significant differences in myostatin concentration between CHF patients and controls, and no correlation with sarcopenia or dynapenia. However, a higher myostatin concentration was found in patients with impaired systolic function (Me = 1675 pg/mL vs. Me—884.5 pg/mL; p = 0.007). A positive correlation between myostatin concentration and muscle mass (r = 0.27; p = 0.04), and functional parameters such as Norton (r = 0.35; p < 0.01), I-ADL (r = 0.28; p = 0.02) and Barthel scale (r = 0.27; p = 0.03) scores, was also observed. Conclusions: Myostatin appears to play a role in muscle wasting and its progression to cardiac cachexia in patients with impaired ejection fraction. Further research is needed to confirm these findings and explore myostatin’s potential as a biomarker for muscle loss and a target for pharmacotherapeutic agents in this population of patients. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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12 pages, 915 KiB

Open AccessArticle

Associations of Serum CXCL12α and CK Levels with Skeletal Muscle Mass in Older Adults

by Ze Chen, Thea Laurentius, Yvonne Fait, Aline Müller, Eva Mückter, Leo Cornelius Bollheimer and Mahtab Nourbakhsh

J. Clin. Med. 2023, 12(11), 3800; https://doi.org/10.3390/jcm12113800 - 31 May 2023

Cited by 4 | Viewed by 2684

Abstract

Sarcopenia, a condition characterized by gradual loss of skeletal muscle mass and function, is a complex diagnosis; the decisive criterion in this diagnosis is the measurement of appendicular skeletal muscle index (ASMI). To identify potential serum markers predictive of sarcopenia in older adults, we evaluated correlations between ASMI, clinical data, and 34 serum inflammation markers in 80 older adults. Pearson’s correlation analyses confirmed that ASMI was positively correlated with nutritional status (p = 0.001) and serum creatine kinase (CK) (p = 0.019) but negatively correlated with serum CXCL12α (p = 0.023), a chemoattractant for muscle stem cells. In the case group, ASMI was negatively correlated with serum interleukin (IL)-7 (p = 0.024), a myokine expressed and secreted from skeletal muscle cells in vitro. Multivariate binary logistic regression analyses identified four risk factors for sarcopenia in our study: advanced age (p = 0.012), malnutrition (p = 0.038), low serum CK levels (p = 0.044), and high serum CXCL12α levels (p = 0.029). Low CK and high CXCL12α levels serve as combinatorial serum markers of sarcopenia in older adults. The linear correlation between ASMI and CXCL12α levels may facilitate the development of new regression models for future studies on sarcopenia. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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9 pages, 492 KiB

Open AccessArticle

The Association of Low Skeletal Muscle Mass with Complex Distal Radius Fracture

by Chi-Hoon Oh, Junhyun Kim, Junhan Kim, Siyeong Yoon, Younghoon Jung, Hyun Il Lee, Junwon Choi, Soonchul Lee and Soo-Hong Han

J. Clin. Med. 2022, 11(19), 5581; https://doi.org/10.3390/jcm11195581 - 22 Sep 2022

Cited by 7 | Viewed by 2111

Abstract

Objectives: Sarcopenia is a skeletal muscle loss disease with adverse outcomes, including falls, mortality, and cardiovascular disease (CVD) in older patients. Distal radius fractures (DRF), common in older people, are strongly related to falls. We aimed to investigate the correlation between DRF and low skeletal muscle mass, which strongly correlated to sarcopenia. Methods: We performed a retrospective review of data from patients diagnosed with or without DRF in our institute between 2015 and 2020. Finally, after propensity score matching, data from 115 patients with and 115 patients without DRF were used for analyses. Multivariate logistic regression analysis was performed for sex, body mass index (BMI), the presence of low skeletal muscle mass, bone quality measured by dual-energy X-ray absorptiometry (DXA), and comorbidities (diabetes mellitus, CVD). Results: We found that female sex (odds ratio = 3.435, p = 0.015), CVD (odds ratio = 5.431, p < 0.001) and low skeletal muscle mass (odds ratio = 8.062, p = 0.001) were significant predictors for DRF. BMI and osteoporosis were not statistically significantly related to DRF. Conclusions: Women with low skeletal muscle mass and CVD may be more responsible for DRF than osteoporosis. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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11 pages, 585 KiB

Open AccessArticle

Influence of Preoperative Handgrip Strength on Length of Stay after Lumbar Fusion Surgery

by Seo Hee Ko, Sang Jun Park, Na Young Kim, Woohyuk Jeon, Dong Ah Shin and Shin Hyung Kim

J. Clin. Med. 2022, 11(14), 3928; https://doi.org/10.3390/jcm11143928 - 6 Jul 2022

Cited by 4 | Viewed by 1775

Abstract

Preoperative sarcopenic status can affect length of hospital stay and patient outcomes after surgery. The aim of this study was to investigate the impacts of preoperative handgrip strength (HGS) on length of stay (LOS) and outcomes after lumbar fusion surgery. HGS was measured preoperatively, and the cut-off value for low HGS was <28 kg for men and <18 kg for women. Perioperative patient outcomes were compared between patients with low and normal HGS. A total of 225 patients, consisting of 86 and 139 patients in the low and normal HGS groups, respectively, fully satisfied the study criteria for analysis. A longer LOS (median 10 vs. 8 days, p = 0.013) and a higher incidence of serious postoperative complications (15.1 vs. 3.6%, p = 0.002) were observed in the low HGS group. In the multivariate analysis, a low HGS (odds ratio (OR) = 1.917, 95% confidence interval (CI) = 1.046–3.513, p = 0.035) was significantly associated with a longer LOS after surgery. Preoperative HGS below the reference values by sex appeared to be an independent factor associated with longer LOS after lumbar fusion surgery. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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12 pages, 628 KiB

Open AccessArticle

Association between Masseter Muscle Area and Thickness and Outcome after Carotid Endarterectomy: A Retrospective Cohort Study

by Rianne N. M. Hogenbirk, Louise B. D. Banning, Anita Visser, Harriet Jager-Wittenaar, Robert A. Pol, Clark J. Zeebregts and Joost M. Klaase

J. Clin. Med. 2022, 11(11), 3087; https://doi.org/10.3390/jcm11113087 - 30 May 2022

Cited by 8 | Viewed by 5402

Abstract

Low muscle mass is associated with adverse outcomes after surgery. This study examined whether facial muscles, such as the masseter muscle, could be used as a proxy for generalized low muscle mass and could be associated with deviant outcomes after carotid endarterectomy (CEA). As a part of the Vascular Ageing study, patients with an available preoperative CT-scan, who underwent an elective CEA between December 2009 and May 2018, were included. Bilateral masseter muscle area and thickness were measured on preoperative CT scans. A masseter muscle area or thickness of one standard deviation below the sex-based mean was considered low masseter muscle area (LMA) or low masseter muscle thickness (LMT). Of the 123 included patients (73.3% men; mean age 68 (9.7) years), 22 (17.9%) patients had LMA, and 18 (14.6%) patients had LMT. A total of 41 (33.3%) patients had a complicated postoperative course and median length of hospital stay was four (4–5) days. Recurrent stroke within 5 years occurred in eight (6.6%) patients. Univariable analysis showed an association between LMA, complications and prolonged hospital stay. LMT was associated with a prolonged hospital stay (OR 8.78 [1.15–66.85]; p = 0.036) and recurrent stroke within 5 years (HR 12.40 [1.83–84.09]; p = 0.010) in multivariable logistic regression analysis. Masseter muscle might be useful in preoperative risk assessment for adverse short- and long-term postoperative outcomes. Full article

(This article belongs to the Special Issue Risk Factors, Prevention and Management of Frailty and Sarcopenia in Elderly)

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