Search Results (168)

Background/Objectives: Sarcopenia may compound mobility limitations and fall vulnerability among older adults with coexisting knee osteoarthritis (KOA) and chronic spinal pain. This secondary analysis of a previously reported or substantially overlapping cohort estimated the proportion meeting Asian Working Group for Sarcopenia (AWGS) 2019 criteria and explored additional adjusted associations in a selected Vietnamese outpatient sample. Methods: A hospital-based secondary cross-sectional analysis included 88 outpatients aged ≥60 years (mean age, 70.5 ± 6.7 years; 69 women, 78.4%) with coexisting KOA and chronic spinal pain who were recruited by convenience sampling at Thai Binh General Hospital from May to October 2024. Source-record verification confirmed that all of the analytic participants had both diagnoses. Their muscle mass, grip strength, and gait speed were assessed using the InBody 770, an InGrip handgrip dynamometer, and a 15-foot walk test, respectively. The prespecified primary classification used AWGS 2019. The AWGS 2025 framework was considered during revision, but numerical reclassification was not feasible because the retained participant-level analytic dataset contained the derived AWGS 2019 outcome and covariates used in the reported regression and CHAID analyses, but not the original continuous age, appendicular skeletal muscle mass index, handgrip values, or a complete raw component record sufficient to independently reconstruct the AWGS 2019 status or apply AWGS 2025 thresholds. Multivariable logistic regression and CHAID were treated as exploratory. Results: Under AWGS 2019, 36/88 participants (40.9%) had sarcopenia, including 15 (17.0%) with severe sarcopenia. All 88 participants had both KOA and chronic spinal pain; therefore, diagnostic-category subgroup comparisons were not applicable. In the exploratory adjusted analysis, an age >70 years (adjusted odds ratio [AOR]: 9.00, 95% confidence interval [CI]: 2.40–33.60), a history of falls (AOR: 6.33, 95% CI: 2.77–14.45), low educational attainment (AOR: 2.86, 95% CI: 1.46–5.61), and a higher Pittsburgh Sleep Quality Index score (AOR: 1.16, 95% CI: 1.02–1.32) remained associated with sarcopenia. Wide CIs and approximately 4.5 events per regression coefficient indicated substantial imprecision. Conclusions: This secondary report provides setting-specific descriptive evidence rather than independent replication, a validated prediction tool, or a fully auditable reconstruction of the original AWGS component measurements. Because AWGS 2025 reclassification could not be reconstructed from the retained dataset and raw component records, the AWGS 2019 estimate should not be treated as directly interchangeable with the estimates generated under the updated framework. The observed associations and within-sample subgroup patterns require confirmation in larger, prospectively auditable studies. Full article

Background: Cognitive impairment (CI) may be overdiagnosed in individuals with vision impairment (VI) due to the vision-dependent design of current cognitive assessment tools. This cross-sectional study evaluated the acceptability and diagnostic accuracy (pilot) of the Visually Independent Test Battery of Neurocognition (VISION-Cog) protocol, against gold-standard neurologist diagnosis. Methods: Community-dwelling older adults with near binocular presenting VI (near visual acuity [NVA] ≥ 0.2 logarithm of the minimum angle of resolution [LogMAR] units) were recruited from the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study. Participants underwent VISION-Cog and the Singapore-validated Montreal Cognitive Assessment (MoCA-SG) testing and were referred for neurologist evaluation based on standardized referral protocols. The acceptability of the VISION-Cog was assessed through study completion rates, test duration, and the qualitative feedback. Vision-Cog’s diagnostic accuracy (pilot) against neurologist evaluation was analyzed using binary logistic regression and C-statistics to estimate area under the receiver operating curve (AUC) with corresponding sensitivity and specificity. Results: Out of forty-five participants (mean age [SD]: 73.8 [6.1 years]; mean NVA [SD]: 0.47 [0.14] LogMAR; and 54.1% female), 37 (82.2%) completed the protocol. The mean VISION-Cog completion time [SD] was 59 m 57 s (7 m 18 s). Qualitatively, participants found the testing time acceptable. The VISION-Cog achieved an AUC of 0.930 against neurologist diagnosis, with 100.0% sensitivity and 78.0% specificity. Conclusions:The VISION-Cog demonstrated satisfactory preliminary diagnostic accuracy and good acceptability indices in older Asian adults, supporting the need of larger studies to confirm its diagnostic accuracy of CI and clinical utility in those with VI. Full article

Background/Objectives: Secondary malignant neoplasms of the bone are a major concern for cancer patients, with significant morbidity and mortality despite advancements in cancer care. The current literature reports demographic variability, but population-level trends and survivor-specific risk factors remain poorly characterized for bone metastasis. This study aims to provide a comprehensive temporal analysis of the trends and disparities of secondary malignant neoplasms of the bone. Methods: Deidentified death certificate data from the United States as reported in the CDC WONDER database (1999–2023) were analyzed for secondary malignant bone neoplasms (ICD-10 C79.5). Age-adjusted mortality rates per 100,000 were calculated and stratified by gender, age, and race. Temporal trends were assessed using Joinpoint Regression, yielding APCs, AAPCs, and 95% CIs. Results: Between 1999 and 2023, there were 424,811 deaths in U.S. adults over the age of 25 years related to secondary malignant bone neoplasms. The overall age-adjusted mortality rate (AAMR) increased from 5.77 (95% CI 5.67 to 5.87) in 1999 to 11.92 (95% CI 11.79 to 12.05) in 2023. The average annual percentage change (AAPC) over this period was 3.28 (95% CI 2.63 to 3.94). From 1999 to 2009, mortality decreased with an annual percentage change (APC) in AAMR of −3.62 (95% CI −4.92 to −2.30), followed by a sharp increase in mortality between 2009 and 2023 with an APC of 8.52 (95% CI 7.83 to 9.19). Certain populations had greater increases in AAMR over the study period. The population aged 85 years and older had the largest increase in mortality from secondary malignant bone neoplasms with an AAPC of 4.77 (95% CI 3.38 to 4.77). Over the study period, Black individuals had an overall AAPC of 1.53 (95% CI 0.11 to 2.97), White individuals had an AAPC of 2.60 (95% CI 1.61 to 3.60), and Asian or Pacific Islanders had an AAPC of 3.74 (95% CI 1.17 to 6.38). Rural areas had overall higher AAMRs compared to urban areas, with an AAPC of 2.27 (95% CI 1.52 to 3.02). Conclusions: Overall, AAMR increased from 1999 to 2023, though there was a period of decreasing AAMR from 1999 to 2009. We suggest that due to increased rates of screening, it is possible that rates of secondary metastases of the bone have been constant over the years, but they were not diagnosed, leading to a false increase in AAMR. Mortality rates were highest in Black individuals in our study, possibly pointing towards discrepancies in cancer screening and treatment between races. Additionally, the AAMR was higher in rural than in urban areas, which we hypothesize may be due to limited access to treatment, such as surgery. Our study was limited by its nature as a database study, but future studies should focus on the prevention of primary malignancies and minimizing risk factors for the development of secondary malignancies. Full article

Background and Objectives: Aging is associated with sarcopenia and increased adiposity, which may impair mobility and increase fall risk. Although sarcopenic obesity is associated with an increased fall risk compared with either condition alone, evidence regarding sex-specific associations remains limited. This study aimed to examine the sex-specific associations between sarcopenia, obesity parameters, and falls among older Korean community-dwellers. Materials and Methods: This cross-sectional study analyzed baseline data from the Korean Frailty and Aging Cohort Study, including 2039 participants aged 70–84 years (men, 973; women, 1066). Sarcopenia was defined using the Asian Working Group for Sarcopenia 2025 criteria, and obesity was categorized as general (body mass index and percentage body fat [PBF]) or central obesity (waist circumference [WC] and conicity index [C-index]). Falls were assessed by self-report. Logistic regression analyses were performed after adjusting for potential confounders. Results: Among 2039 participants, 395 (19.4%) reported falls. In the total population, higher PBF and C-index were independently associated with increased fall risk after adjustment. Men showed significantly higher odds of falls with low handgrip strength, high WC, PBF, and C-index than women. In women, only low appendicular skeletal muscle mass index was independently associated with falls. Sarcopenic obesity was not significantly associated with falls in either sex. Conclusions: Although sarcopenic obesity itself was not independently associated with falls in either sex, distinct sex-specific associations were observed between individual components of sarcopenia, obesity, and fall risk among older Korean adults. Reduced muscle strength and central obesity were more strongly associated with falls in men, whereas reduced muscle mass was independently associated with falls in women. These findings suggest that sex-specific approaches targeting muscle function and body composition may be important for fall prevention in aging populations. Full article

How older adults psychologically appraise their health while managing multiple chronic conditions is a behavioral-science question as much as a clinical one. This study estimated the weighted prevalence of favorable mental-health self-appraisal, identified its behavioral, social, and functional correlates, and compared the relative salience of diagnosed-condition burden and functional limitation among U.S. adults aged ≥ 50 years with multimorbidity. This retrospective cross-sectional secondary analysis used the 2023 Medical Expenditure Panel Survey (MEPS) Full Year Consolidated Data File (HC-251). Multimorbidity was defined as at least two diagnosed chronic priority conditions. The primary outcome represents favorable mental-health self-appraisal, derived from MNHLTH53 (excellent/very good/good vs. fair/poor). Covariates were organized using Andersen’s Behavioral Model and health-psychology concepts of adaptation, resources, and lived functional burden. Weighted prevalence estimates and survey-weighted logistic regression models were fitted using PERWT23F, VARSTR, and VARPSU. Robustness checks examined a stricter outcome threshold, proxy adjustment/non-proxy restriction, and a physical-health extension model. The analytic sample included 5523 respondents, representing approximately 77.9 million U.S. adults aged ≥ 50 years with multimorbidity. The weighted prevalence of favorable perceived mental-health self-appraisal was 86.6% (95% CI 85.4–87.7). In the fully adjusted core model (complete-case n = 5330), age 65–74 years (aOR 1.52, 95% CI 1.17–1.98) and age ≥ 75 years (aOR 1.79, 95% CI 1.36–2.36) were associated with higher odds of favorable appraisal. Lower odds were observed for Hispanic respondents, non-Hispanic Asian respondents, lower educational attainment, lower income, non-employment, ≥4 diagnosed conditions, and any functional limitation. The strongest inverse association was limitation status (aOR 0.32, 95% CI 0.27–0.39). Sensitivity analyses were directionally consistent. Favorable mental-health self-appraisal remained common in this medically complex older population, but it was socially and functionally patterned. Functional limitation appeared more behaviorally salient than diagnosis count alone. Because the analysis was cross-sectional and based on household-interview reported measures, these results should be interpreted as associations rather than causal effects. Full article

Oral squamous cell carcinoma (OSCC), comprising ~90% of oral malignancies, remains a major global health burden with rising incidence despite declining tobacco use. While tobacco and alcohol are classic dominant risk factors, a distinct subgroup of nonsmoking, nondrinking (NSND) patients is increasingly recognized, accounting for 15–35% of OSCC cases in many cohorts, particularly in developed countries. This emerging epidemic shows striking demographic patterns: strong female predominance (often 65–77% of cases), bimodal age distribution with peaks in young adults (<45 years) and elderly individuals (>70 years), and overrepresentation among non-Hispanic White and certain Asian populations. Unlike traditional habit-related OSCC, which favors the floor of the mouth in older males, NSND tumors predominantly arise on the lateral tongue, gingiva, and buccal mucosa. Etiopathogenesis extends far beyond conventional carcinogens and involves multifactorial mechanisms, including chronic mechanical irritation from dental factors, oral microbiome dysbiosis enriched with periodontal pathogens (e.g., Fusobacterium nucleatum and Porphyromonas gingivalis), limited roles for viruses (minimal HPV contribution, possible EBV or “hit-and-run” HSV effects), genetic susceptibilities (e.g., Fanconi anemia and CDKN2A mutations), epigenetic changes, hormonal influences contributing to female bias, metabolic conditions (diabetes and hyperlipidemia), poor oral hygiene, and chronic inflammation. NSND OSCC frequently exhibits a distinct immunological profile with higher tumor-infiltrating lymphocytes and PD-L1 expression, potentially favoring immunotherapy, though prognosis remains heterogeneous—better in some cohorts due to fewer comorbidities, yet worse in young patients with higher recurrence and second primary tumor risks. Delayed diagnosis is common due to low suspicion in “low-risk” individuals. This review underscores NSND OSCC as a unique entity requiring expanded risk assessment, heightened clinical vigilance for persistent oral lesions regardless of habit history, and targeted research into novel prevention and therapeutic strategies. Full article

Background: Depression has become a prevalent and serious public health problem worldwide, attracting widespread attention from governments and international organizations and being included in key health policy issues. There is a close interaction between depression and economic factors such as household savings, a link particularly pronounced in Asian countries. However, evidence of a two-way association is limited. This study aims to explore the two-way relationship between depression and savings among middle-aged and older adults. Methods: Data were collected from 6746 respondents in the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, and 2018. A cross-lagged panel model was used to test the two-way relationship between depression and savings. Results: The results showed a significant cross-time effect of depression on savings (T0 → T1: β = −0.052; T1 → T2: β = −0.077), suggesting that higher levels of depression in the early stages are associated with lower levels of savings later. Moreover, savings had a stronger negative predictive effect on depression (T0 → T1: β = −0.463; T1 → T2: β = −0.510), indicating that higher levels of savings in the early stages are associated with lower levels of depression later. Furthermore, the grouping test showed that the two-way negative effect remained stable in both male and female groups (p ≤ 0.001). Conclusions: This study reveals the dynamic two-way influence between depression and savings, providing a basis for policy formulation that synergistically promotes residents’ mental health and household financial stability. Full article

Background: Family caregivers are essential partners in the outpatient care of older adults with cancer, yet the knowledge, skills, and confidence, collectively, of caregiver activation are not well characterized in Asian settings. Understanding activation can inform tailored support to sustain effective caregiving. Accordingly, this study assessed the overall activation levels among cancer caregivers in the three most common cancer diagnoses in Singapore by using the Caregiver-Patient Activation Measure (CG-PAM). Methods: A total of 103 informal caregivers of patients ≥60 years (lung, GI, or myeloma) at Singapore’s largest public cancer hospitals completed the 13-item CG-PAM, scored 0–100 and classified into four activation levels. Descriptive statistics summarized characteristics and CG-PAM responses, and logistic regression analyses assessed the degree of activation for individual demographic and other characteristics (p < 0.05). Results: Caregivers showed moderate–high activation (mean 65.9 ± 16.1) and the following levels: L1, 4.9%; L2, 23.3%; L3, 38.8%; L4, 31.1%. They strongly endorsed personal responsibility and active engagement, reporting confidence in key self-management tasks, but struggled to sustain behaviors under stress. Activation was not significantly associated with demographic factors or any other measured characteristics. Conclusions: Caregivers of older adults with cancer in Singapore included in this study showed moderate–high activation and strong self-management confidence but struggled to sustain behaviors under stress. Routine activation assessment and tailored support (education, coaching) could strengthen outpatient care. Longitudinal and interventional research, alongside follow-up interviews, is needed to identify unmet needs, existing support systems, and inform scalable, sustainable models. Full article

Background: Magnesium is an essential dietary mineral, and low magnesium status has been associated with adverse cardiometabolic and renal outcomes. In chronic kidney disease (CKD), the prevalence of magnesium deficiency remains uncertain because serum magnesium alone may not accurately reflect overall magnesium status. We aimed to characterize magnesium status in a multi-ethnic Asian CKD cohort compared with healthy participants using combined serum and 24-h urinary magnesium (24U-Mg) measurements. Methods: This cross-sectional observational study included 232 adults with CKD and 103 healthy participants. Serum magnesium and 24-h urinary magnesium excretion were measured concurrently. Magnesium deficiency was defined as serum magnesium ≤0.75 mmol/L; probable magnesium deficiency was defined as serum magnesium 0.76–0.85 mmol/L with 24U-Mg ≤ 3.29 mmol/day; and possible magnesium deficiency was defined as either normal serum Mg with low 24U-Mg ≤ 1.65 mmol/day or serum Mg 0.76–0.85 mmol/L with 24U-Mg > 3.29 mmol/day. Associations with age, sex, body mass index, diabetes, blood pressure, and kidney function were examined. Results: CKD participants had lower mean serum magnesium (0.86 vs. 0.90 mmol/L, p < 0.001) and lower 24U-Mg (2.50 vs. 2.93 mmol/day, p = 0.006) compared with healthy participants. Using the proposed combined serum and 24U-Mg criteria, magnesium deficiency was present in 13.8% of CKD participants and 0% of healthy participants, while probable deficiency was observed in an additional 25.8% of CKD and 16.5% of healthy participants. Multivariate analysis demonstrated that CKD, older age, high BMI, and diabetes status were independently associated with lower serum magnesium levels, and female sex was associated with lower serum and urinary magnesium in healthy participants. Conclusions: Magnesium deficiency is common in non-dialysis CKD patients and is frequently not identified by serum magnesium alone. Combined assessment using serum and urinary magnesium may better identify individuals at risk of magnesium deficiency and inform future prospective studies in CKD. Full article

Background and Objectives: Continuous positive airway pressure (CPAP) is the standard first-line treatment for patients with obstructive sleep apnea (OSA). Patients with OSA exhibit a higher prevalence of vitamin D deficiency, and CPAP treatment has been reported to improve vitamin D levels. Therefore, the aim of this study was to investigate the association between vitamin D deficiency and the risk of patients receiving a diagnosis of OSA or utilizing CPAP, using the TriNetX research network to obtain real-world data. Materials and Methods: A retrospective cohort study using the TriNetX database was conducted to investigate the relationship between vitamin D deficiency and patients with risk of receiving an OSA diagnosis or patients treated with CPAP in older adults (≥65 years). Patients were stratified into four groups according to serum 25-hydroxyvitamin D [25(OH)D] levels: severe deficiency (D10, ≤10 ng/mL), mild deficiency (D20, 11–20 ng/mL), insufficient vitamin D status (S30, 21–30 ng/mL), and normal vitamin D status (N100, 31–100 ng/mL). After 1:1 propensity score matching (PSM) to adjust for baseline covariates, patients were followed for up to 5 years for newly diagnosed OSA and CPAP use (an administrative-clinical outcome influenced by non-disease-related factors such as healthcare access and clinical practice), with vitamin D status assessed at the index date. An anchor-based network meta-analysis was also performed to integrate direct and indirect evidence across groups. Results: A total of 2,289,855 eligible patients were included and stratified into four groups: D10 (n = 161,610; 7.06%), D20 (n = 404,954; 17.68%), S30 (n = 648,989; 28.34%), and N100 (n = 1,074,302; 46.92%). Across the six pairwise comparisons, pre-matching baseline imbalances showed consistent patterns: lower vitamin D groups (particularly D10 and D20) generally had older age at index (in comparisons with S30 or D20), a higher proportion of males, and higher proportions of Black/African American patients, whereas higher vitamin D groups (especially N100 and S30) had higher proportions of White patients (and, in some comparisons, Asian patients). Comorbidity differences were modest overall, and these imbalances were substantially reduced after PSM. In both pairwise PSM analyses and the anchor-based network meta-analysis, severe vitamin D deficiency was observationally associated with the risk of receiving an OSA diagnosis and CPAP use. An observational trend appeared across vitamin D categories (D10 > D20 > S30), suggesting an association. The associations were strongest at 1 year and gradually attenuated over the 3- and 5-year follow-up periods. An E-value greater than 3 was observed only for the comparison between the D10 and N100 groups. Conclusions: In this real-world analysis of older adults, vitamin D deficiency, particularly severe deficiency, was observationally associated with increased 5-year risk of receiving an OSA diagnosis and CPAP use. Similarly, anchor-based network meta-analysis also showed an association between vitamin D deficiency severity and the risk of receiving an OSA diagnosis and CPAP use. Full article

Background/Objectives: Sarcopenia, characterized by progressive loss of skeletal muscle mass and function, is a major public health concern among aging populations. While physical activity is recognized as protective, the comparative effectiveness of different exercise modalities remains understudied in Asian populations. This cross-sectional study investigated the association between exercise type and sarcopenia prevalence among Korean adults aged 40 years and older. Methods: This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2024. A total of 1688 adults aged ≥40 years were included. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, incorporating dual-energy X-ray absorptiometry (DXA)-based appendicular skeletal muscle mass index (ASMI) and handgrip strength. Due to the absence of physical performance measures in this survey cycle, the operational definition required both low ASMI and low handgrip strength. Exercise types were categorized into four groups: no exercise, aerobic only, resistance only, and combined exercise. Multivariable logistic regression, adjusting for age, sex, socioeconomic status, lifestyle factors, nutritional intake, and comorbidities, was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Sarcopenia prevalence was 13.2% (n = 223). In the fully adjusted model, resistance-only exercise was associated with 56% lower odds of sarcopenia (OR 0.44, 95% CI 0.23–0.82, p = 0.010), and combined exercise with 69% lower odds (OR 0.31, 95% CI 0.13–0.78, p = 0.012). Aerobic-only exercise showed no significant association (OR 0.88, 95% CI 0.54–1.42, p = 0.594). The protective association was statistically significant in the 60–69 age group (OR 0.28, 95% CI 0.11–0.74), with similar but non-significant trends in other age groups. Conclusions: Resistance exercise, either alone or combined with aerobic exercise, is associated with lower odds of sarcopenia in Korean adults aged 40 and older. These observational findings warrant further investigation through prospective and interventional studies before informing public health strategies. Interpretation should consider the limited sample size in the resistance-only subgroup (n = 18 with sarcopenia) and the cross-sectional design, which precludes causal inference. Full article

Background/Objective: Accurate resting energy expenditure (REE) estimation is paramount for the nutritional management of older Asian adults with multimorbidity. However, standard predictive equations (PEs) lack precision for this cohort. This study aimed to recalibrate PEs using BMI-stratified, slope-only regression to enhance bedside accuracy. Methods: REE was measured via indirect calorimetry in 400 hospitalized patients (age ≥ 65). Sensitivity analyses identified significant proportional bias in existing models. Models were recalibrated and validated using 1000-iteration bootstrap resampling. Results: Standard PEs exhibited significant bias, particularly overpredicting requirements for 68% of underweight patients. The new Singapore Older Adults Resting energy expenditure (SOAR) PE 1 (963.67 + 8.56 × weight − 5.6 × age) eliminated weight-dependent systematic errors. The recalibrated models utilizing actual body weight achieved accuracy rates of up to 64% in obese cohorts, comparable to complex adjusted-weight protocols. Conclusions: Population-specific recalibration is essential to mitigate the bidirectional risks of malnutrition and overfeeding in geriatric rehabilitation. The BMI-stratified multipliers provided offer a robust, clinically efficient framework for individualized nutritional care. Full article

Background/Objectives: Sarcopenia frequently coexists with other geriatric syndromes, and its severity may influence their clinical manifestation. This study examines the prevalence of geriatric syndromes in older adults with non-severe and severe sarcopenia and explores the associations between sarcopenia severity and individual geriatric syndromes in Vietnam. Methods: A cross-sectional study was conducted among 726 older outpatients with sarcopenia. Non-severe and severe sarcopenia were diagnosed according to the Asian Working Group for Sarcopenia algorithm. Fifteen geriatric conditions spanning physical and psychological health, functional status, and social circumstances were assessed using components of the Comprehensive Geriatric Assessment. Logistic regression models were used to examine associations between sarcopenia severity and geriatric syndromes. Results: A total of 726 older patients with sarcopenia (mean age 74.4 years, 77.4% females) were included, of whom 53.4% had severe sarcopenia. A significantly higher prevalence of geriatric syndromes was observed in patients with severe compared with non-severe sarcopenia, including sleep disturbances (79.4% vs. 67.5%), frailty (71.4% vs. 54.7%), malnourishment/risk of malnutrition (61.9% vs. 50.0%), depression (54.9% vs. 34.9%), polypharmacy (49.5% vs. 42.0%), impairment in activities of daily living (52.8% vs. 32.5%), and impairment in instrumental activities of daily living (58.2% vs. 39.3%). After adjustment for potential confounders, severe sarcopenia remained associated with sleep disturbance (adjusted OR 1.49, 95%CI 1.02–2.18, p = 0.046), depression (adjusted OR 1.90, 95%CI 1.36–2.66, p < 0.001), and mobility impairment (adjusted OR 3.01, 95%CI 2.12–4.27, p < 0.001). Conclusions: Older Vietnamese adults with sarcopenia had a high burden of geriatric syndromes, particularly among those with severe disease. Severe sarcopenia was independently associated with sleep disturbance, depression, and impaired mobility—clinically relevant and potentially modifiable conditions. These findings highlight the importance of evaluating sarcopenia within a broader geriatric framework and may inform early identification and prioritization of coexisting geriatric syndromes, especially in resource-limited settings. Full article

Background/Objectives: Cardiovascular disease is the leading cause of adult deaths globally and has recently been reported to be on the rise in younger adult women. The present study examined the impact of physical and lifestyle predictors of vascular health in 125 apparently healthy premenopausal East Asian volunteers. Methods: Vascular health outcomes included carotid–femoral pulse wave velocity (cfPWV), central augmentation index (cAIx), and mean arterial pressure (MAP). Body composition/anthropometric predictors included total adiposity, visceral adipose tissue (VAT) and skeletal muscle mass (SMM), as well as body mass index (BMI) and waist circumference (WC). Lifestyle predictors included the International Physical Activity Questionnaire (IPAQ) and dietary recall. Multivariate linear regression was used to identify independent predictors of combined vascular health and individual vascular outcome variables. The analysis for independent vascular outcomes was repeated after age stratification (<35 years versus $\ge$35 years). Results: VAT showed a significant multivariate effect on combined vascular health outcomes (p = 0.002) and independently contributed to cfPWV (p = 0.013). WC positively predicted cAIx (p = 0.010) while SMM was inversely related to cAIx (p = 0.024). BMI positively predicted MAP (p = 0.039) in the multivariate analysis. After age adjustment however, only BMI emerged as a significant independent predictor of both cfPWV (p = 0.040) and MAP (p = 0.024). Furthermore, WC remained positively associated with cAIx (p = 0.042) while SMM remained inversely related to cAIx (p = 0.038). After age stratification, IPAQ was inversely related to cfPWV while BMI was positively associated with MAP (p = 0.035) in women < 35 years only. However, in older women, total adiposity (p = 0.040) and total cholesterol (p = 0.011) were both positively, while SMM (p = 0.046) was negatively associated with cAIx. Conclusions: With the exception of age, VAT was the single best predictor of general vascular health in East Asian women. Independent of age, however, BMI, WC, and SMM significantly contributed to independent vascular outcome measures and in combination with age, substantially add to the prediction of vascular risk. Furthermore, stratifying younger versus older premenopausal women resulted in different associations with independent vascular outcome measures demonstrating that across a large age range of premenopausal women, it is important to consider age in the evaluation of vascular health. Full article

Background/Objectives: Sarcopenia is a progressive decline in skeletal muscle strength and mass, leading to decreased functionality, metabolic disorders, morbidity, and mortality. There are a number of sarcopenia screening tools, such as the SARC-F questionnaire (that includes noting strength, assistance with walking, ability to raise from the chair, climb stairs, and falls), with its augmented forms that have added calf circumference (SARC-CalF), BMI and age (SARC-F + EBM), and the Ishii score, which show variable performance across populations. However, these were developed and validated mostly in Asian cohorts. To evaluate the diagnostic accuracy of these tools for the European Working Group on Sarcopenia in Older People (EWGSOP2), as well as define sarcopenia in hospitalized East European older adults, with sex and obesity stratification. Methods: Sarcopenia was diagnosed using the EWGSOP2. ROC analyses with DeLong tests assessed SARC-F, SARC-CalF, SARC-F + EBM, and the Ishii score in 278 Romanian inpatients (probable sarcopenia n = 201/278, 72.3%; confirmed n = 77/278, 27.7%). Results: Probable sarcopenia was noted as good-excellent discrimination against across all tools (AUCs 0.764–0.812); confirmed sarcopenia was noted as SARC-CalF superior (AUC = 0.743), followed by SARC-F + EBM (0.697), the Ishii score as moderate (0.667), and SARC-F was limited (0.591; p < 0.001 vs. augmented). SARC-CalF optimal cut-offs varied significantly: 4–6 (probable) vs. ≥11 (confirmed). Sex-stratified outcomes had excellent probable detection in both sexes, and this was confirmed to be superior in men. The Ishii score thresholds were 152/244 vs. Asian ≥ 105/120. Obesity required higher cut-offs with high NPVs (77–100%), confirming rule-out utility and SARC-F + EBM performing the best, both in the obesity and sarcopenic obesity subgroups (AUCs 0.742, 0.964). Conclusions: Augmented SARC-F scores outperformed the original SARC-F for confirmed sarcopenia in multimorbid Europeans, with SARC-F CalF having the best performance overall. Population-specific (sex/obesity) data-driven thresholds are essential, especially for the Ishii score, as this first Romanian validation reveals limitations of Asian norms in European cohorts, thus advocating for European recalibration. Full article