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16 pages, 367 KB  
Article
Translation, Cross-Cultural Adaptation, and Validation of the Croatian Version of the SARC-F Questionnaire for Assessing Sarcopenia in Older Adults
by Edina Pulić, Ivna Kocijan, Mirjana Telebuh, Ivan Jurak, Tatjana Njegovan Zvonarević, Lana Feher Turković, Vlatko Brezac, Želimir Bertić, Miljenko Franić, Klara Turković and Ana Mojsović Ćuić
Healthcare 2026, 14(2), 151; https://doi.org/10.3390/healthcare14020151 - 7 Jan 2026
Abstract
Background/Objectives: Sarcopenia is a growing public health challenge in older adults, being associated with functional decline, frailty, and increased mortality. The SARC-F questionnaire is a widely recommended screening tool for sarcopenia; however, no validated Croatian version has been available so far. This study [...] Read more.
Background/Objectives: Sarcopenia is a growing public health challenge in older adults, being associated with functional decline, frailty, and increased mortality. The SARC-F questionnaire is a widely recommended screening tool for sarcopenia; however, no validated Croatian version has been available so far. This study aimed to translate, culturally adapt, and validate the Croatian version of the SARC-F questionnaire for older adults. Methods: In a cross-sectional design, 153 participants aged ≥ 65 years from Zagreb and Bjelovar were enrolled between March and September 2025. Psychometric evaluation included internal consistency (Cronbach’s α), test–retest reliability (intraclass correlation coefficient, ICC), item–total correlations, and split-half reliability. Convergent validity was assessed via correlations with handgrip strength (HGS), Short Physical Performance Battery (SPPB), and timed up-and-go (TUG) tests. Known groups and construct validity were also examined. Results: The Croatian SARC-F showed good internal consistency (Cronbach’s α = 0.76; 95% CI: 0.70–0.82), with item–total correlations ranging from 0.34 (falls) to 0.80 (stairs) and excellent test–retest reliability (ICC = 0.86). Strong correlations were found with SPPB (ρ = −0.50; p < 0.001), TUG (ρ = 0.50; p < 0.001), and handgrip strength (ρ = −0.42; p < 0.001), supporting convergent validity. An exploratory factor analysis indicated a unidimensional structure explaining 43% of the variance. Conclusions: The Croatian version of SARC-F is a reliable, valid, and clinically feasible tool for identifying older adults who are at risk of sarcopenia. The results support its use in national screening and cross-cultural research across Europe. Full article
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11 pages, 645 KB  
Article
Association Between Fibromyalgia and Risk of Developing Sarcopenia According SARC-F: A Cross-Sectional Study
by Blanca Pedauyé-Rueda, Eduardo Cimadevilla Fernández-Pola, Hilin Hussein, Cristina Ojedo-Martín, María Jesús Fernández-Aceñero, Juan Hernández-Lougedo, Noemí Mayoral-Gonzalo, Juan Pablo Hervás-Pérez and Edurne Úbeda-D’Ocasar
Diagnostics 2026, 16(1), 62; https://doi.org/10.3390/diagnostics16010062 - 24 Dec 2025
Viewed by 261
Abstract
Background: Fibromyalgia (FM) is a condition characterised by chronic pain, which may or may not be associated with muscular stiffness. Sarcopenia is the progressive loss of muscle mass and strength. The loss of muscle mass is a key factor in the progression of [...] Read more.
Background: Fibromyalgia (FM) is a condition characterised by chronic pain, which may or may not be associated with muscular stiffness. Sarcopenia is the progressive loss of muscle mass and strength. The loss of muscle mass is a key factor in the progression of both fibromyalgia and sarcopenia and therefore warrants thorough evaluation. It has been demonstrated that obesity directly influences factors that increase pain perception and disease severity and reduce quality of life. The primary objective of this study was to examine the association between fibromyalgia and the increased risk of developing sarcopenia. Methods: The sample consisted of 84 patients diagnosed with FM. We assessed sociodemographic characteristics, anthropometric variables (circumferential and ultrasound) pain with a Visual Analogue Scale (VAS) and algometry, risk of developing sarcopenia with SARC-F, quality of sleep, anxiety, and depression using validated questionnaires. Results: A total of 96.3% of the participants were women. Overall, 56.3% of the sample presented a high risk of sarcopenia according to SARC-F, VAS scores showed significant negative correlations with anxiety (p < 0.01) and with almost all algometric measures (p < 0.05). The Fibromyalgia Impact Questionnaire (FIQ) demonstrated a positive and significant correlation with sleep quality (p < 0.01) and depression (p < 0.01). Furthermore, presence of a high risk of sarcopenia according to SARC-F was significantly associated with FIQ scores (p = 0.002) and depression (p < 0.001). Conclusions: There is a significant association between the impact of FM and a high risk of developing sarcopenia according to SARC-F. This population exhibits a high degree of pain, which are significantly associated with elevated levels of anxiety and depression. Full article
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17 pages, 654 KB  
Article
Hierarchical Evaluation of Predictive Models for Confirmed Sarcopenia: Discrimination, Calibration, and Clinical Applicability in a Cross-Sectional Study of Older Adults
by Ludwig Álvarez-Córdova, Daniel Simancas-Racines, Claudia Reytor-González, Diana Fonseca-Pérez, Víctor Sierra-Nieto, Cecilia Arteaga-Pazmiño, Natasha Giler-Párraga, Jaen Cagua-Ordoñez and Martha Montalvan
J. Clin. Med. 2025, 14(24), 8707; https://doi.org/10.3390/jcm14248707 - 9 Dec 2025
Viewed by 452
Abstract
Background: Sarcopenia is a progressive and multifactorial condition linked to aging, malnutrition, and chronic diseases, presenting significant clinical and public health challenges. Current screening tools vary in complexity and diagnostic accuracy, emphasizing the need for simple, evidence-based predictive models suitable for settings [...] Read more.
Background: Sarcopenia is a progressive and multifactorial condition linked to aging, malnutrition, and chronic diseases, presenting significant clinical and public health challenges. Current screening tools vary in complexity and diagnostic accuracy, emphasizing the need for simple, evidence-based predictive models suitable for settings with limited resources. Methods: A cross-sectional study was conducted among community-dwelling older adults to develop and internally validate hierarchical predictive models for sarcopenia using readily available primary care variables. Three models were built: (1) a basic clinical model (age, sex, BMI, calf circumference, and SARC-F), (2) a model including nutritional status (Mini Nutritional Assessment, MNA), and (3) an extended model adding bioelectrical impedance parameters (phase angle, PhA). Model performance was assessed using AUC, Brier score, Hosmer–Lemeshow test, and decision curve analysis. Results: The parsimonious model demonstrated excellent discrimination (AUC = 0.91) and good calibration (Hosmer–Lemeshow p = 0.36), while the extended model with MNA and PhA achieved the highest overall performance (AUC = 0.95; Brier = 0.064; p = 0.97). Incorporating MNA and PhA enhanced calibration and clinical utility, especially for risk probabilities between 0.10 and 0.40. Internal validation showed minimal optimism and stable coefficients, with BMI, sex, and PhA as consistent predictors. Conclusions: A model combining anthropometric, nutritional, and bioelectrical variables provides high diagnostic accuracy for sarcopenia while remaining practical for clinical use. Its stepwise design facilitates application at various healthcare levels, supporting early detection and targeted interventions in aging populations. Full article
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23 pages, 855 KB  
Review
Narrative Review on Post-Stroke Outcomes Through Recognition of Frailty, Sarcopenia, and Palliative Care Needs
by Dariusz Kotlega, Katarzyna Kobus-Kotlega and Malgorzata Szczuko
Healthcare 2025, 13(23), 3011; https://doi.org/10.3390/healthcare13233011 - 21 Nov 2025
Viewed by 1009
Abstract
Stroke survivors frequently experience long-term disability, post-stroke fatigue, frailty, sarcopenia, falls, and psychosocial distress, which together drive poorer functional recovery, rehospitalization, institutionalization, and caregiver burden. This narrative review synthesizes contemporary evidence on the prevalence, mechanisms, and clinical impact of post-stroke fatigue, frailty, sarcopenia, [...] Read more.
Stroke survivors frequently experience long-term disability, post-stroke fatigue, frailty, sarcopenia, falls, and psychosocial distress, which together drive poorer functional recovery, rehospitalization, institutionalization, and caregiver burden. This narrative review synthesizes contemporary evidence on the prevalence, mechanisms, and clinical impact of post-stroke fatigue, frailty, sarcopenia, and falls and examines their links with palliative care needs, healthcare costs, and emerging telehealth models. A PubMed and Google Scholar search up to October 2025 identified studies on stroke and fatigue, frailty, sarcopenia, falls, palliative care, and telehealth, with an emphasis on clinical studies, trials, systematic reviews, and guidelines in adults. Frailty and sarcopenia are highly prevalent after stroke and predict mortality, poor functional outcome, reduced rehabilitation response, and higher care needs. Post-stroke fatigue is common, multifactorial, and associated with worse quality of life and reduced return-to-work rates. Falls are frequent and arise from the combined effects of focal neurological deficits and systemic frailty/sarcopenia. Despite substantial symptom burden, palliative care is often introduced late and inconsistently. We summarize brief, validated screening tools, such as the Clinical Frailty Scale, SARC-F plus grip strength, Malnutrition Universal Screening Tool, Fatigue Severity Scale/Neurological Fatigue Index for Stroke, Short Physical Performance Battery, and fall-risk instruments. We propose pragmatic timepoints and referral thresholds for their use in stroke services. Multicomponent interventions that integrate exercise, nutritional optimization, psychosocial support, and structured fall prevention can reduce frailty, sarcopenia, and falls and improve function and mood. Telemedicine and telerehabilitation may enhance access and continuity but risk widening digital inequities. Earlier, structured palliative approaches aligned with patient goals are needed across the frailty–sarcopenia–stroke continuum. Implementing integrated screening–intervention pathways and hybrid telehealth models could improve long-term outcomes for stroke survivors and their caregivers while supporting more efficient use of healthcare resources. Full article
(This article belongs to the Section Chronic Care)
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19 pages, 290 KB  
Article
Prevalence and Clinical Associations of Malnutrition and Sarcopenia Risk in Gastroenterology Inpatients: A Multicenter Cross-Sectional Study in Turkey
by Göksel Bengi, Süleyman Dolu, Yavuz Özden, Nevin Oruç, Mukaddes Tozlu, Gözde Derviş Hakim, Genco Gençdal, Ali Rıza Çalışkan, Müge Ustaoğlu, Ufuk Kutluana, Engin Altıntaş, Galip Egemen Atar, Ahmet Uyanıkoğlu, Sezgin Barutçu, Kader Irak, Deniz Koç, Berat Ebik, Züleyha Akkan Çetinkaya, Haluk Tarık Kani, Dilek Oğuz, Filiz Araz, Altay Kandemir, Nermin Mutlu Bilgiç, Özdal Ersoy, Özlem Gül, Banu Kara, Burak Özşeker, Hüseyin Alkım, Sedat Boyacıoğlu, Ayşe Kefeli, Hasan Yılmaz, Pembe Keskinoğlu, Yasemin Gökden Gök, Çağlayan Keklikkıran, Müjde Soytürk, Salih Tokmak, Murat Aladağ, Hakan Ünal, Funda Uğur Kantar, Yusuf Serdar Sakin, Meral Kayhan, Ozan Cengiz, Tolga Gözmen, İsmail Atasoy and Hale Akpınaradd Show full author list remove Hide full author list
Diagnostics 2025, 15(22), 2935; https://doi.org/10.3390/diagnostics15222935 - 20 Nov 2025
Viewed by 701
Abstract
Background/Objectives: This study aimed to determine the prevalence of malnutrition and sarcopenia risk among patients hospitalized in gastroenterology clinics across different geographical regions of Turkey, to identify their risk factors, and to evaluate their associations with clinical outcomes. Methods: A total [...] Read more.
Background/Objectives: This study aimed to determine the prevalence of malnutrition and sarcopenia risk among patients hospitalized in gastroenterology clinics across different geographical regions of Turkey, to identify their risk factors, and to evaluate their associations with clinical outcomes. Methods: A total of 1051 patients admitted to 36 gastroenterology clinics across six geographical regions of Turkey during the week of 14 November 2024 were evaluated in a cross-sectional design. The nutritional status of the patients was assessed using the NRS-2002 questionnaire, while the risk of sarcopenia was evaluated with the SARC-F questionnaire. Demographic data, clinical diagnoses, disease severity scores, and comorbidities were also recorded and analyzed. Results: Of the patients included in the study, 54.7% were female, and the mean age was 61.7 ± 17.2 years. The prevalence of malnutrition risk was 27.8%, while the prevalence of sarcopenia risk was 32.7%. Patients with malnutrition risk had a lower BMI (24.7 ± 5.3 vs. 27.1 ± 5.4, p < 0.001) and were older (67.6 ± 16.0 vs. 56.5 ± 17.1, p < 0.001). The risks of sarcopenia and malnutrition were significantly higher in patients with liver cirrhosis (40.7% malnutrition; 54.5% sarcopenia), gastrointestinal malignancy (50.5%; 44.2%), and diabetes mellitus. Logistic regression analysis identified older age, male sex, and presence of malignancy as independent risk factors for malnutrition, whereas older age, female sex, presence of malnutrition, liver cirrhosis, and heart failure were independent risk factors for sarcopenia. A strong correlation was also found between malnutrition and sarcopenia (r = 0.544, p < 0.001). Conclusions: Approximately one-third of patients hospitalized in gastroenterology clinics across Turkey are at risk of malnutrition and sarcopenia. These conditions are particularly associated with malignancy, cirrhosis, and metabolic comorbidities. Our findings highlight the necessity of systematic nutritional and sarcopenia screening upon hospital admission. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
12 pages, 238 KB  
Article
Associations Between Frailty, Sarcopenia, and Nutritional Status in Older Adults Living in Nursing Homes
by Serap İncedal Irgat and Gül Kızıltan
Nutrients 2025, 17(22), 3574; https://doi.org/10.3390/nu17223574 - 15 Nov 2025
Viewed by 786
Abstract
Background/Objectives: Increasing awareness of factors that put the population at high risk of frailty is essential to prevent frailty and minimize its adverse consequences. Methods: In this cross-sectional study, participants were over the age of 65 and living in nursing homes. The Edmonton [...] Read more.
Background/Objectives: Increasing awareness of factors that put the population at high risk of frailty is essential to prevent frailty and minimize its adverse consequences. Methods: In this cross-sectional study, participants were over the age of 65 and living in nursing homes. The Edmonton Frailty Scale was used to determine frailty, the Sarcopenia Rapid Screening Test (SARC-F) was used to assess sarcopenia, and the Mini Nutritional Assessment (MNA) questionnaire and 7-day 24-h dietary recall were used to determine the nutritional status of the older adult population. Data were analyzed by SPSS 25.0 for Windows (Statistical Package for Social Sciences). Results: The frailty scale score of gender was statistically significant (p < 0.05). There was a statistically significant difference in sarcopenia status and malnutrition based on the distribution of the frailty status among the participants (p < 0.05). There was a statistically significant difference in vitamin C intake adequacy according to the distribution of frailty status among older adults (p < 0.05). There was a positive correlation between frailty status and sarcopenia (r = 0.773; p < 0.05). Frailty and nutritional status were significantly negatively correlated (r = −0.496; p < 0.05). There was a significant positive correlation between the sarcopenia status and malnutrition status of the participants (r = 0.489; p < 0.005). Conclusions: Older adults living in nursing homes are at risk for frailty syndrome, malnutrition, and sarcopenia. Evaluating older adults in terms of all these factors and implementing daily nutrition plans and support according to these results is of great importance for promoting a healthy life. Full article
(This article belongs to the Section Geriatric Nutrition)
13 pages, 406 KB  
Article
Performance of Five Thai Versions of Sarcopenia Screening Questionnaires (SARC-F, SARC-CalF, MSRA-7, MSRA-5, and Modified MSRA-5) in Thai Rheumatoid Arthritis Patients: A Cross-Sectional Study
by Wanitcha Gumtorntip, Phichayut Phinyo, Nuntana Kasitanon and Worawit Louthrenoo
J. Clin. Med. 2025, 14(22), 8029; https://doi.org/10.3390/jcm14228029 - 12 Nov 2025
Viewed by 580
Abstract
Background/Objectives: The external validity of sarcopenia screening questionnaires in the elderly has been examined in several conditions but rarely evaluated in patients with rheumatoid arthritis (RA). This study aimed to determine the performance of five Thai versions of sarcopenia screening questionnaires (SARC-F [Strength, [...] Read more.
Background/Objectives: The external validity of sarcopenia screening questionnaires in the elderly has been examined in several conditions but rarely evaluated in patients with rheumatoid arthritis (RA). This study aimed to determine the performance of five Thai versions of sarcopenia screening questionnaires (SARC-F [Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls], SARC-CalF [SARC-F plus calf circumference], MSRA [Mini Sarcopenia Risk Assessment]-7, MSRA-5, and modified MSRA-5 questionnaires) in Thai RA patients, and evaluate the correlations among these instruments. Methods: In this cross-sectional study, consecutive adult RA patients (aged ≥20 years) from an outpatient rheumatology clinic completed the five sarcopenia screening questionnaires listed above. Sarcopenia was defined according to criteria of the 2019 Asian Working Group for Sarcopenia (AWGS). Appendicular skeletal muscle mass, grip strength, and physical performance were assessed using bioelectrical impedance analysis, a hand dynamometer, and a 6 m gait speed test, respectively. The cut-off values used for each sarcopenia screening questionnaire were pre-specified according to their respective established thresholds. Results: Of 299 RA patients (89.0% female, mean age of 61.3 ± 11.6 years, median [interquartile range] disease duration of 12.8 [8.2, 20.0] years), 37.5% and 27.4% of them had sarcopenia and severe sarcopenia, respectively. The areas under the receiver operating characteristic (ROC) curve for the SARC-F, SARC-CalF, MSRA-7, MSRA-5, and modified MSRA-5 questionnaires were 0.60, 0.74, 0.65, 0.62, and 0.65, respectively, with sensitivities of 34.8%, 73.2%, 77.7%, 68.8%, and 72.3% and specificities of 84.5%, 75.4%, 51.3%, 55.1%, and 58.3%, respectively. SARC-F demonstrated moderate correlations with the other questionnaires: SARC-CalF (r = 0.57), MSRA-7 (r = −0.52), MSRA-5 (r = −0.55), and modified MSRA-5 (r = −0.65), all with a p-value of <0.001. Conclusions: Sarcopenia is common among Thai RA patients. SARC-CalF had the best balance of sensitivity and specificity and is likely the most suitable sarcopenia screening questionnaire for Thai RA patients. Full article
(This article belongs to the Section Immunology & Rheumatology)
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10 pages, 313 KB  
Article
SARC-F as a Screening Tool in Rheumatoid Arthritis: Real-World Burden of Sarcopenia Risk, Sex Differences, and Clinical Correlates
by Joan M. Nolla, Lidia Valencia-Muntalà, Laura Berbel-Arcobé, Diego Benavent, Paola Vidal-Montal, Martí Aguilar-Coll, Montserrat Roig-Kim, Javier Narváez and Carmen Gómez-Vaquero
J. Clin. Med. 2025, 14(21), 7751; https://doi.org/10.3390/jcm14217751 - 31 Oct 2025
Cited by 2 | Viewed by 442
Abstract
Background/Objectives: Sarcopenia is now recognized as a frequent and disabling accompaniment of rheumatoid arthritis (RA), although structured screening approaches are still rarely applied in everyday practice. The SARC-F questionnaire offers a simple, validated, patient-reported tool for sarcopenia screening, but its performance in RA [...] Read more.
Background/Objectives: Sarcopenia is now recognized as a frequent and disabling accompaniment of rheumatoid arthritis (RA), although structured screening approaches are still rarely applied in everyday practice. The SARC-F questionnaire offers a simple, validated, patient-reported tool for sarcopenia screening, but its performance in RA remains largely unexplored. We aimed to evaluate the burden of sarcopenia risk, defined by abnormal SARC-F scores (≥4), and its clinical correlates in RA compared with age- and sex-matched controls. Methods: We conducted an observational case–control study including 275 RA patients (69.5% women) aged >50 years and 300 matched controls. Clinical, laboratory, and patient-reported outcomes were recorded. Sarcopenia risk was assessed using SARC-F (cutoff ≥ 4). RA patients also underwent grip strength and gait speed testing. Multivariable regression analyses were used to identify independent correlates of abnormal SARC-F results. Results: A SARC-F score ≥ 4 was observed in 26.9% of RA patients. Compared with controls, the burden was significantly higher in women with RA (34.0% vs. 24.7%, p < 0.05) but not in men (10.7% vs. 15.0%). Within the RA cohort, abnormal SARC-F was independently associated with female sex (OR 3.14, 95% CI 1.24–7.95) and higher RAPID3 scores (OR 1.25, 95% CI 1.18–1.33). More than half of RA patients exhibited low grip strength, with partial overlap with SARC-F findings. Conclusions: The SARC-F questionnaire revealed a notable burden of sarcopenia risk in RA, particularly among women. Combined with simple grip strength testing, it offers a feasible, low-cost approach to case finding, directly applicable in routine rheumatology practice. Incorporating this strategy may enhance recognition and management of sarcopenia in RA. Full article
(This article belongs to the Section Immunology & Rheumatology)
12 pages, 505 KB  
Article
Validation of Sarcopenic Obesity Screening Tools: A Cross-Sectional Analysis Based on ESPEN and EASO Criteria
by Seongmin Choi, Miji Kim, Yunsoo Soh and Chang Won Won
Medicina 2025, 61(11), 1909; https://doi.org/10.3390/medicina61111909 - 24 Oct 2025
Viewed by 868
Abstract
Background and Objectives: Sarcopenic obesity, characterized by sarcopenia and obesity, is associated with adverse outcomes. The recent consensus from the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) proposed a diagnostic algorithm [...] Read more.
Background and Objectives: Sarcopenic obesity, characterized by sarcopenia and obesity, is associated with adverse outcomes. The recent consensus from the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) proposed a diagnostic algorithm (screening, diagnosis, and staging) for sarcopenic obesity. However, the effectiveness of recommended screening tools for sarcopenic obesity remains unclear. This study aimed to assess the performance of SARC-F questionnaire (Strength, walking Assistance, Rise, Climb, and Falls), calf circumference (CC), and SARC-CalF (SARC-F combined with CC), combined with obesity indicators, as screening tools for sarcopenic obesity. Materials and Methods: This cross-sectional study analyzed 2020 community-dwelling older adults from the Korean Frailty and Aging Cohort Study. Sarcopenic obesity was defined according to ESPEN and EASO criteria. Screening tools included SARC-F, CC, and SARC-CalF in combination with high body mass index (BMI; ≥25 kg/m2) or high waist circumference (WC; men, ≥90 cm; women, ≥85 cm). The diagnostic performance was evaluated using sensitivity, specificity, and predictive value. Results: SARC-F (≥4) with high BMI or WC demonstrated low sensitivity (men, 5.68%; women, 17.82%) but high specificity (men, 99.03%; women, 94.35%) and negative predictive value (NPV) (men, 91.68%; women, 91.09%). Lowering the SARC-F cutoff improved sensitivity but reduced specificity. CC combined with a high BMI or WC showed modest sensitivity (men, 34.09%; women, 34.65%) but moderate specificity (men, 59.48%; women, 59.91%). SARC-CalF (≥11) combined with high BMI or WC showed slightly higher sensitivity (men, 13.64%; women, 19.80%) but lower specificity (men, 95.04%; women, 86.93%) than SARC-F. Conclusions: SARC-F combined with obesity indicators may serve as a case-finding tool with high specificity and NPV, supporting its usefulness in ruling out sarcopenic obesity in the clinical setting. Meanwhile, CC was not an effective screening tool, and SARC-CalF did not substantially improve sensitivity or accuracy compared with SARC-F. Full article
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14 pages, 303 KB  
Article
Clinical-Functional Vulnerability of Older Adults in Primary Care in a Brazilian Municipality: Associated Factors
by Cleomar Ana de Souza Valentim, André Silva Valentim, Maria da Luz Rosário de Sousa and Marília Jesus Batista
Int. J. Environ. Res. Public Health 2025, 22(10), 1583; https://doi.org/10.3390/ijerph22101583 - 18 Oct 2025
Viewed by 798
Abstract
Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, [...] Read more.
Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, Brazil, in 2023. Sociodemographic data, health behaviors, and data on oral health (number of teeth; chewing: good/fair/poor), cognitive function (10-CS), nutritional status (MNA), health literacy (HLS-14), sarcopenia (SARC-F+CC) and frailty (IVCF-20) were collected. Descriptive and bivariate analyses between the outcome (CFV) and the independent variables were performed using the chi-squared test and binary logistic regression models (p < 0.05). Results: A total of 211 older adults participated in this study; 72% were female and the mean age was 70.41 years (±7.45). Regarding CFV, a high risk was identified in 9.5% of the participants (n = 19), a moderate risk in 34.6% (n = 73), and a low risk in 55.9% (n = 118). After adjusting the regression model, the following variables were associated with CFV: lower income (OR = 1.90; 95%CI: 1.02–3.55), poor (OR = 5.18; 95%CI: 2.13–12.63) and fair (OR = 2.36; 95%CI: 1.10–5.05) chewing, risk of malnutrition or malnourished (OR = 2.36; 95%CI: 1.23–5.52), and low literacy (OR = 1.86; 95%CI: 1.09–3.45). Conclusion: Socioeconomic factors, nutritional status (underweight or malnourished), poor or fair chewing, and low health literacy were associated with CFV among older people. Strengthening primary health care through targeted interventions may help prevent frailty or delay its progression. Understanding the predictors of frailty can guide health professionals, managers, and researchers in designing preventive and health promotion strategies, as well as public policies within Primary Health Care. Full article
(This article belongs to the Section Health Care Sciences)
14 pages, 633 KB  
Article
Prevalence of Dysphagia and Its Health Implications Among Elderly Residents in Long-Term Care Facilities in the Liguria Region (Italy): An Observational Cohort Study
by Elena Formisano, Enrico Di Cino, Elena Nicosia, Andrea Pasta, Gianfranco Paccione, Alessandro Antioco Sukkar, Livia Pisciotta and Samir Giuseppe Sukkar
Nutrients 2025, 17(20), 3268; https://doi.org/10.3390/nu17203268 - 17 Oct 2025
Viewed by 1410
Abstract
Background/Objectives: Dysphagia is a common condition among older adults, associated with significant health risks. This prospective, open-label observational cohort study aimed to determine the prevalence of dysphagia and its impact on nutritional status and clinical outcomes in elderly residents of six long-term [...] Read more.
Background/Objectives: Dysphagia is a common condition among older adults, associated with significant health risks. This prospective, open-label observational cohort study aimed to determine the prevalence of dysphagia and its impact on nutritional status and clinical outcomes in elderly residents of six long-term care facilities. Methods: Patients aged ≥ 65 years were screened using the 3 oz Water Swallow Test (WST); those with dysphagia were followed for 6 months. Nutritional status was evaluated with the Mini Nutritional Assessment short-form (MNA-SF), the Global Leadership Initiative on Malnutrition (GLIM), and the SARC-F questionnaire. Anthropometric and body composition measurements were also obtained. Results: Among 656 patients screened, 188 (28.6%) had dysphagia (median age 90 years; 89.9% females). Mild dysphagia was present in 34.0%, while 66.0% had moderate-to-severe dysphagia. At baseline, patients with moderate-to-severe dysphagia had significantly lower BMI (18.4 vs. 20.6 kg/m2, p = 0.014), smaller calf circumference (24.0 vs. 28.0 cm, p = 0.005), and higher SARC-F score (8 vs. 7, p = 0.028). Bioimpedance analysis showed lower fat mass (6.7 vs. 12.9 kg, p < 0.001) and fat mass% (14.7 vs. 25.4%, p < 0.001), and higher FFM% (85.3 vs. 74.6%, p < 0.001). At 6 months, BMI, calf circumference, handgrip strength, fat mass, and fat mass% resulted significantly lower in patients with moderate-to-severe dysphagia. A total of 23 participants (12.2%) died during follow-up, with a higher mortality rate in the moderate-to-severe group (HR 2.58, 95% CI 1.20–7.59, p = 0.044); aspiration pneumonia was the leading cause (21.7%). Conclusions: Dysphagia significantly affects nutritional status and survival in elderly residents of long-term care facilities. Early personalized nutritional intervention is pivotal to improve outcomes. Full article
(This article belongs to the Section Geriatric Nutrition)
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16 pages, 2258 KB  
Review
From Emergency Department to Operating Room: The Role of Early Prehabilitation and Perioperative Care in Emergency Laparotomy: A Scoping Review and Practical Proposal
by Francisco Javier García-Sánchez, Fernando Roque-Rojas and Natalia Mudarra-García
J. Clin. Med. 2025, 14(19), 6922; https://doi.org/10.3390/jcm14196922 - 30 Sep 2025
Cited by 1 | Viewed by 1461
Abstract
Background: Emergency laparotomy (EL) carries high morbidity and mortality relative to elective abdominal surgery. While Enhanced Recovery After Surgery (ERAS) principles improve outcomes in elective care, their translation to emergencies is inconsistent. The emergency department (ED) provides a window for rapid risk stratification [...] Read more.
Background: Emergency laparotomy (EL) carries high morbidity and mortality relative to elective abdominal surgery. While Enhanced Recovery After Surgery (ERAS) principles improve outcomes in elective care, their translation to emergencies is inconsistent. The emergency department (ED) provides a window for rapid risk stratification and pre-optimization, provided that interventions do not delay definitive surgery. Methods: We conducted a PRISMA-ScR–conformant scoping review to map ED-initiated, ERAS-aligned strategies for EL. PubMed, Scopus, and Cochrane were searched in February 2025. Eligible sources comprised ERAS guidelines, systematic reviews, cohort studies, consensus statements, and programmatic reports. Evidence was charted across five a priori domains: (i) ERAS standards, (ii) comparative effectiveness, (iii) ED-feasible pre-optimization, (iv) risk stratification (Emergency Surgery Score [ESS], frailty, sarcopenia), and (v) oncological emergencies. Results: Thirty-four sources met inclusion. ERAS guidelines codify rapid assessment, multimodal intraoperative care, and early postoperative rehabilitation under a strict no-delay rule. Meta-analysis and cohort data suggest ERAS-aligned pathways reduce complications and length of stay, though heterogeneity persists. ED-feasible measures include multimodal analgesia, goal-directed fluids, early safe nutrition, respiratory preparation, and anemia/micronutrient optimization (IV iron, vitamin B12, folate, vitamin D). Sarcopenia, frailty, and ESS consistently predicted adverse outcomes, supporting targeted bundle activation. Evidence from oncological emergencies indicates feasibility under no-delay governance. Conclusions: A minimal, ED-initiated, ERAS-aligned bundle is feasible, guideline-concordant, and may shorten hospitalization and reduce complications in EL. We propose a practical framework that links rapid risk stratification, opportunistic pre-optimization, and explicit continuity into intra- and postoperative care; future studies should test fidelity, costs, and outcome impact in pragmatic emergency pathways. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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12 pages, 853 KB  
Article
Predictive Value of C-Reactive Protein/Albumin Ratio (CAR) for Malnutrition and Sarcopenia in Acute Ischemic Stroke Patients
by Hasan Dogan, Sugra Simsek, Ahmet Hakan Bayram, Aydan Topal, Mehlika Berra Pamuk, Ozkan Ozmuk, Nedim Ongun and Cetin Kursad Akpinar
J. Clin. Med. 2025, 14(19), 6804; https://doi.org/10.3390/jcm14196804 - 26 Sep 2025
Viewed by 728
Abstract
Background/Objective: Malnutrition and sarcopenia are common complications after ischemic stroke and have a negative impact on prognosis. The C-reactive protein/albumin ratio (CAR) reflects both inflammation and nutritional status, but its predictive role in this setting has not been widely studied. This study aimed [...] Read more.
Background/Objective: Malnutrition and sarcopenia are common complications after ischemic stroke and have a negative impact on prognosis. The C-reactive protein/albumin ratio (CAR) reflects both inflammation and nutritional status, but its predictive role in this setting has not been widely studied. This study aimed to investigate the predictive value of CAR (C-reactive protein/albumin ratio) for malnutrition risk and probable sarcopenia in patients with ischemic stroke. Methods: In this prospective observational study, 197 patients with acute ischemic stroke were evaluated. Patients with chronic renal or hepatic failure, malignancy, active infection, and hand disability preventing grip strength measurement were excluded. Demographic data (age, sex), vascular risk factors, the NIHSS score, and laboratory parameters were recorded. The nutritional status of patients was assessed using the Nutritional Risk Screening-2002 (NRS-2002), and sarcopenia risk was evaluated with the SARC-F questionnaire. Handgrip strength was measured in patients with high SARC-F scores to define probable sarcopenia. CAR was calculated from serum CRP and albumin levels. Logistic regression was applied to identify independent predictors, and receiver operating characteristic (ROC) analyses were performed to determine the discriminatory ability and cut-off values of CAR. The nutritional status of patients admitted to the neurology clinic with acute ischemic stroke was assessed using the Nutritional Risk Screening-2002 (NRS-2002), and sarcopenia risk was evaluated with the SARC-F questionnaire. Handgrip strength was measured in patients with high SARC-F scores to define probable sarcopenia. CAR was calculated from serum CRP and albumin levels. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: Malnutrition risk was identified in 32.5% of patients, and probable sarcopenia was identified in 19.3% of patients. ROC analysis showed that CAR had acceptable discriminatory power for both conditions. In multivariate analysis, CAR was consistently identified as an independent predictor of malnutrition risk and possible sarcopenia. ROC analysis for malnutrition risk showed an AUC of 0.750 (cut-off: 0.306; sensitivity 68.8%; specificity 75.2%). In regression analysis, CAR (OR = 2.13; 95% CI: 1.39–3.26; p < 0.001), age (OR = 1.05; 95% CI: 1.02–1.09; p = 0.003), and NIHSS (OR = 1.11; 95% CI: 1.01–1.23; p = 0.026) were independent predictors. For probable sarcopenia, ROC analysis revealed an AUC of 0.814 (cut-off: 0.320; sensitivity 81.6%; specificity 71.7%). Multivariate analysis identified CAR (OR = 1.73; 95% CI: 1.19–2.52; p = 0.004), age (OR = 1.11; 95% CI: 1.05–1.18; p < 0.001), and NIHSS (OR = 1.19; 95% CI: 1.05–1.35; p = 0.007) as independent predictors. Conclusions: CAR was identified as an independent predictor of both malnutrition risk and probable sarcopenia in ischemic stroke patients. CAR may serve as a reliable biomarker for early nutritional and functional risk stratification in clinical practice. Full article
(This article belongs to the Section Clinical Neurology)
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12 pages, 278 KB  
Review
Diabetes and Sarcopenia: Unraveling the Metabolic Crossroads of Muscle Loss and Glycemic Dysregulation
by Jose Jorge Ortez Toro
Endocrines 2025, 6(3), 47; https://doi.org/10.3390/endocrines6030047 - 18 Sep 2025
Viewed by 2952
Abstract
The intersection of type 2 diabetes mellitus (T2DM) and sarcopenia, often termed diabetic sarcopenia, represents a critical yet underrecognized comorbidity that significantly impacts the quality of life and functional capacity of older adults. This paper explores the complex interplay between T2DM and sarcopenia, [...] Read more.
The intersection of type 2 diabetes mellitus (T2DM) and sarcopenia, often termed diabetic sarcopenia, represents a critical yet underrecognized comorbidity that significantly impacts the quality of life and functional capacity of older adults. This paper explores the complex interplay between T2DM and sarcopenia, focusing on the prevalence, risk factors, and underlying mechanisms driving muscle mass and strength decline in this population. Drawing from recent clinical studies, we highlight a prevalence of sarcopenia ranging from 15.36% to 30.2% among elderly T2DM patients, with notable gender disparities (41.3% in men versus 20.1% in women) and regional variations. Key risk factors identified include poor glycemic control (HbA1c ≥8%), longer diabetes duration (>5 years), low body mass index (BMI), and reduced levels of 25-hydroxyvitamin D and insulin-like growth factor-1 (IGF-1). We also recommend a practical screening algorithm for diabetic sarcopenia, integrating tools like the SARC-F questionnaire, dynamometry, and BMI-adjusted calf circumference to facilitate early diagnosis and staging in clinical settings. The review underscores the need for a multidisciplinary approach—encompassing pharmacological optimization, nutritional interventions with high-protein diets, and tailored physical exercise—to mitigate muscle loss and improve metabolic outcomes. Future research directions should focus on validating diagnostic protocols and diagnosis techniques and further exploring specific therapies to effectively address this dual burden. Full article
(This article belongs to the Section Obesity, Diabetes Mellitus and Metabolic Syndrome)
15 pages, 534 KB  
Article
Combined Fried Frailty Scale and Mini Nutritional Assessment Identifies Cardiovascular Patients with Reduced Protein/Albumin Plasma Levels: A Cross-Sectional Study
by Julia Cieśla, Marcin Schulz, Michał Krawiec, Michał Janik, Paweł Wojciechowski, Iga Dajnowska, Dominika Szablewska, Jakub Bartoszek, Brygida Przywara-Chowaniec and Andrzej Tomasik
Nutrients 2025, 17(17), 2786; https://doi.org/10.3390/nu17172786 - 27 Aug 2025
Viewed by 1176
Abstract
Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to [...] Read more.
Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to assess the malnutrition and sarcopenia scale in patients with frailty syndrome and the viability of evaluating the concentrations of the following potential biomarkers: albumin, total protein, and fibrinogen. Methods: A total of 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. The following fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume-one second (FEV1). Results: A total of 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%) according to Fried frailty criteria. Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the prefrail and robust groups (p < 0.05). A total of 38% of frail patients were at risk of sarcopenia, and 52% were at risk of malnutrition. Frail patients had lower PEF and FEV1 values, with decreases in respiratory parameters correlating with fat-free body mass and muscle strength. Conclusions: Frail patients are at substantial risk of malnutrition and sarcopenia. The MNA and SARC-F scales, combined with routine screening of elderly patients with frailty, may effectively identify patients with the highest risk. Full article
(This article belongs to the Special Issue Nutritional Assessment in Epidemiological Studies)
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