Search Results (412)

Sex steroid hormones play a pivotal role in maintaining systemic homeostasis throughout life. Their age-related decline is closely associated with the onset of frailty, including sarcopenia and dementia. Here, this article provides a narrative review of the existing literature about the multifaceted roles of sex steroid hormones, particularly estrogens and androgens, in aging and age-related diseases. Sex steroid action is mediated by nuclear receptors such as estrogen receptor alpha (ERα) and androgen receptor (AR). Transcriptional activation through these receptors is orchestrated by epigenetic mechanisms, including histone modifications and chromatin remodeling. Beyond their reproductive functions, sex hormones also influence systemic physiology, metabolism, immune responses, and neuroplasticity. Clinical studies on hormone-deprivation therapies for prostate and breast cancers, as well as animal models, have revealed the key contributions of AR and ER activity to muscle integrity, bone density, and cognitive function. The sexual dimorphism in cognitive decline, especially in postmenopausal women, suggests the therapeutic potential of hormone supplementation and receptor-targeted strategies. Thus, AR- and ER-associated genes are considered promising targets for preventing frailty, sarcopenia, osteoporosis, and dementia. This review summarizes the current knowledge on sex hormone signaling in aging, with an emphasis on translational implications and future research directions. Full article

Background/Objectives: The global population is ageing rapidly, with projections indicating that there will be over two billion individuals aged ≥60 years by 2050. Sarcopenia and frailty are major age-related syndromes associated with loss of muscle mass, reduced strength, and increased vulnerability, for which adequate protein and amino acid intake are key preventive factors. However, nationally representative data on dietary amino acid intakes and sources among older adults are lacking, particularly in Europe. Methods: This study aimed to address this gap by updating the Irish Food Composition Database (IFCD) (2011) with amino acid composition data and estimating amino acid intakes and dietary sources in older adults in Ireland (≥65 years) using data from the National Adult Nutrition Survey (2008–2010; n = 226). Results: Mean total amino acid intake was 76.2 g/day (1.0 g/kg body weight/day). Intakes of all essential amino acids were above the US Institute of Medicine (IOM) recommendations, with no significant differences observed between sexes or age groups (65–74 y, 75+ y). ‘Meat and meat dishes’ were the principal contributors to amino acid intake (28–47%), followed by ‘breads and rolls’, ‘milk and yoghurt’, and ‘fish and fish dishes’. Conclusions: This study provides the first nationally representative estimates of amino acid intakes in older adults in Europe, establishing a baseline for future dietary surveillance and informing protein quality assessment amid dietary transitions toward plant-based foods. Full article

Background: Bariatric surgery effectively treats severe obesity, but postoperative weight loss includes reductions in both fat mass (FM) and fat-free mass (FFM). Excessive FFM loss may increase the risk of sarcopenia, frailty, and long-term weight regain, yet its magnitude and determinants are not fully established. Methods: We conducted a retrospective analysis of a prospectively collected cohort of 179 patients who underwent laparoscopic or robotic Roux-en-Y gastric bypass between January 2020 and December 2022. Anthropometric parameters and body composition (bioelectrical impedance analysis) were measured preoperatively and at 6 and 12 months. The proportion of FFM loss relative to total weight loss (%FFML/WL) was calculated, and excessive FFM loss was defined using published cut-offs (≥25%, ≥30%, and ≥35%). Predictors of FFM preservation were assessed through stepwise regression. Results: Baseline BMI was 44.1 ± 4.6 kg/m², FM 54.6 ± 10.7 kg, and FFM 61.1 ± 11.9 kg. At 6 and 12 months, BMI decreased to 31.0 ± 4.2 and 28.8 ± 4.4 kg/m², respectively; FM decreased to 35.6 ± 11.0 and 22.0 ± 10.0 kg; and FFM to 54.7 ± 9.5 and 50.1 ± 7.0 kg (all p < 0.001). Most FFM loss occurred within the first 6 months (mean − 6.4 kg). Median %FFML/WL was 26.4% at 6 months and 28.7% at 12 months. Excessive FFM loss affected 41–46% of patients (≥25%), 27–31% (≥30%), and 14% (≥35%). In multivariable analysis, FFM at 6 months was the only independent predictor of FFM at 12 months (p < 0.001). Conclusions: Bariatric surgery leads to substantial FM and FFM reductions, with nearly half of patients exceeding established %FFML/WL alert thresholds. Early postoperative body composition monitoring may help identify individuals at higher risk of FFM depletion and guide preventive strategies such as adequate protein intake and resistance training. Full article

Sarcopenia and physical frailty are interconnected geriatric syndromes that frequently coexist in older adults, sharing common pathophysiological pathways. However, their early detection in community settings is limited by resource constraints and by the lack of simplified, scalable diagnostic tools. This cross-sectional study aimed to estimate the prevalence and overlap of sarcopenia and frailty in a real-world public health screening programme and to evaluate the diagnostic performance of a pragmatic two-step algorithm. In September 2025, a total of 256 consecutive community-dwelling adults aged ≥65 years underwent standardized assessment using the SARC-F questionnaire, handgrip strength dynamometry, and selective bioelectrical impedance analysis (BIA). Sarcopenia was defined according to 2019 EWGSOP2 criteria, and frailty according to the Fried phenotype. Confirmed sarcopenia was identified in 37 participants (14.5%, 95% CI 10.7–19.1%) and frailty in 31 (12.1%, 95% CI 8.6–16.7%), with substantial overlap (77.4% of frail individuals also had sarcopenia; Cohen’s κ = 0.62). The two-step algorithm (Step 1: SARC-F ≥ 4; Step 2: handgrip strength and BIA only in screen-positive participants) demonstrated excellent accuracy for confirmed sarcopenia (AUC 0.913, 95% CI 0.871–0.955), with sensitivity 91.9%, specificity 81.3%, and a 53.9% reduction in BIA use. Factors independently associated with confirmed sarcopenia included older age, BMI < 22 kg/m², physical inactivity, and higher SARC-F score. A simple, function-centered two-step approach enables efficient and scalable identification of sarcopenia and frailty in community settings, supporting early preventive strategies to preserve physical function. Full article

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

Skeletal muscle atrophy underlies sarcopenia, frailty, and muscular dystrophies, but the molecular mechanisms linking oxidative stress to muscle degeneration remain incompletely understood. We previously identified protein complex formation between transient receptor potential canonical 3 (TRPC3) and NADPH oxidase 2 (Nox2) as a key driver of anthracycline-induced myocardial atrophy. Here, we investigated whether this complex also contributes to skeletal muscle wasting. In skeletal muscle from sciatic nerve transection model mice and Duchenne muscular dystrophy (mdx) mice, TRPC3-Nox2 complex formation was enhanced. TRPC3 deletion significantly attenuated denervation-induced soleus atrophy and reduced reactive oxygen species (ROS) production. TRPC3-Nox2 complex formation was upregulated in the soleus muscle (SM) of mdx mice. Pharmacological disruption of the TRPC3-Nox2 interaction improved muscle size and strength and reduced plasma creatine kinase in mdx mice. A recombinant adeno-associated virus (AAV) encoding a TRPC3 C-terminal peptide was used to suppress TRPC3-Nox2 complex formation in vivo. AAV-mediated expression of TRPC3 C-terminal peptide mitigated muscle wasting (CSA) in mdx mice, while muscle strength and plasma CK were not significantly improved. Thus, TRPC3-Nox2 complex formation may be a pivotal driver of oxidative stress-mediated skeletal muscle atrophy. Targeting this protein–protein interaction represents a promising therapeutic strategy for Duchenne muscular dystrophy (DMD) and other intractable muscle-wasting disorders. Full article

Introduction: Functionality, anthropometric measurements (BMI, arm circumference), and handgrip strength (HGS) are crucial for assessing the health of older adults, as HGS is a strong predictor of frailty and independence, correlating with muscle mass loss (sarcopenia) and the risk of falls. Background/Objectives: To analyze the relationship between functional capacity, anthropometric measurements, and handgrip strength in community-dwelling older adults. Methods: A descriptive, exploratory, cross-sectional study with a quantitative approach was conducted with 225 older adults monitored at two Family Health Units, using the Barthel Scale, Lawton and Brody Scale, anthropometric measurements (body mass index, waist, calf, and brachial circumferences), and dynamometry as instruments. Spearman’s test was used for correlations, with interpretation by shared variance and comparison of magnitudes by Steiger r-to-z method. A higher frequency of females (65.8%) was observed, in the age range between 60 and 68 years (51.1%), independent in Basic Activities of Daily Living (76.9%) and dependent in Instrumental Activities of Daily Living (99.1%). The analysis revealed that waist circumference showed a significant correlation with waist-to-hip ratio (ρ-value 0.604; p-value < 0.01) and body mass index (ρ-value = 0.696; p-value < 0.01). These associations showed shared variances of 36.5% (waist circumference and waist-to-hip ratio) and 48.4% (waist circumference and body mass index). Waist-to-hip ratio showed a significant positive correlation with waist-to-hip ratio (ρ-value = 0.256; p-value < 0.01) and body mass index (ρ-value = 0.198; p-value < 0.01). However, these relationships showed lower shared variances at 6.5% with waist-to-hip ratio and 3.9% with BMI. The Lawton scale showed a statistically significant negative correlation with hand grip strength (ρ-value = −0.176; p-value < 0.01). Conclusions: There is a significant relationship between functional capacity, anthropometric measurements, and hand grip strength in community-dwelling older adults, reflecting the interaction between physical performance, body composition, and autonomy. Full article

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and newer incretin-based co-agonists have transformed obesity and type 2 diabetes (T2D) management, achieving unprecedented weight loss and cardiometabolic benefits. However, their effects on body composition, particularly lean and skeletal muscle mass, remain incompletely defined. In this current review, we examined the influence of GLP-1 RAs and incretin hormone agonists on lean tissue, integrating physiological, clinical, and mechanistic perspectives. We first outlined the physiology of incretin hormones, with emphasis on their metabolic roles and potential relevance to muscle health. We then discussed sarcopenia and sarcopenic obesity as conditions of rising clinical concern, given their overlap with obesity and metabolic disease. Evidence from preclinical studies and randomized clinical trials indicates that while GLP-1-based therapies predominantly reduce adipose tissue, including visceral and ectopic depots, but they also produce absolute reductions in lean mass, generally representing 20–30% of total weight loss. The extent to which these changes translate into impaired muscle function or increased vulnerability to frailty remains unclear. Preservation of lean and skeletal muscle mass is a critical yet underexplored aspect of incretin-based weight loss. Current studies are constrained by methodological heterogeneity, small sample sizes, and limited assessment of functional outcomes. Data on dual and triple agonists are emerging but remain limited. Future research should integrate standardized body-composition measures, mechanistic exploration, and adjunctive interventions such as resistance training or protein optimization. Full article

Background and Objectives: Chronic kidney disease is characterized by the progressive loss of functioning nephrons due to structural and functional alterations in the kidneys. It is clinically defined through the presence of a glomerular filtration rate below 60 mL/min/1.73 m² or persistent kidney damage lasting at least three months. Patients undergoing haemodialysis frequently present with sarcopenia and frailty. The aim of this study was to evaluate the effects of intradialytic exercise on sarcopenia and frailty in individuals with chronic kidney disease. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines. Electronic searches were executed in PubMed, PEDro, Scopus, and Dialnet. Eligible studies included adults (≥18 years) on haemodialysis who engaged in exercise interventions compared with passive control groups. Exclusion criteria included any conditions conflicting with the inclusion criteria, systematic reviews, study protocols, and articles not meeting the PICO framework or contradictory to the inclusion criteria. Outcomes of interest were sarcopenia and frailty, assessed through measures of physical function and muscle strength. Methodological quality was appraised using the PEDro scale, and risk of bias was evaluated with the Cochrane Risk of Bias tool. Results: Fifteen studies met the inclusion criteria. Most interventions consisted of aerobic training, resistance training, or combined exercise programs. Across studies, exercise interventions consistently improved physical function and muscle strength, although no significant effects on body composition were observed. Conclusions: This systematic review provides evidence that intradialytic exercise may produce clinically relevant improvements in sarcopenia by enhancing muscle strength and functional performance, as measured by tests such as the sitting-to-standing test. These results suggest that intradialytic exercise could be beneficial for patients with chronic kidney disease. Full article

Background/Objectives: Sarcopenia and frailty are prevalent and independently prognostic in cirrhosis. Few studies have evaluated both together to ascertain their interaction and phenotypic differences. None have studied their relationship with resting energy expenditure (REE). We simultaneously examined sarcopenia, frailty and REE in a cohort of patients with cirrhosis and portal hypertension—a novel approach. Methods: We retrospectively studied consecutive patients with cirrhosis and portal hypertension, prospectively recruited between 2015 and 2018 to undergo sarcopenia (transversal psoas muscle thickness [TPMT]/height), frailty (Fried Frailty Index [FFI]), and REE assessments via indirect calorimetry. The primary outcome was transplant-free survival (TFS). Results: Ninety-seven patients were recruited with sarcopenia and frailty present in 26% and 40%, respectively. Patients with sarcopenia or frailty alone were phenotypically similar except those with sarcopenia had lower median body mass index (BMI) (23 vs. 28 kg/m², p = 0.032) and were more likely to be hypermetabolic (60% vs. 0%, p = 0.017). Median TFS was lower in patients with sarcopenia (3.6 months) or frailty (4.5 months), compared to those with neither (10.3 months), while patients with both sarcopenia and frailty exhibited the worst TFS (1.8 months, log-rank p = 0.001). Independent predictors of death or liver transplant were sarcopenia, hepatic encephalopathy, and a higher model for end-stage liver disease score. Conclusions: In patients with cirrhosis and portal hypertension, sarcopenia and physical frailty are related but have differences in BMI and REE. The deleterious impact of sarcopenia and frailty on TFS are additive. Sarcopenia remains an independent predictor of TFS after adjusting for frailty. Full article

Sarcopenia is a progressive, age-related loss of skeletal muscle mass, strength, and function, strongly associated with frailty, disability, and chronic disease. Its pathogenesis involves chronic low-grade inflammation, hormonal imbalance, and impaired anabolic signaling, making biomarkers essential for diagnosis, prognosis, and intervention monitoring. This review systematically analyzes randomized controlled trials (RCTs) evaluating the impact of physical exercise on biomarkers relevant to sarcopenia. Exercise modulates both pro-inflammatory markers (e.g., IL-6, TNF-α, CRP) and anti-inflammatory cytokines (e.g., IL-10, IL-15), while also affecting growth factors like IGF-1, myostatin, and follistatin. These changes support muscle anabolism, reduce catabolic signaling, and improve physical performance. In addition, we highlight a growing class of emerging exerkines, including irisin, apelin, beta-aminoisobutyric acid (BAIBA), decorin, brain-derived neurotrophic factor (BDNF), and meteorin-like factor (Metrnl). These molecules exhibit promising roles in mitochondrial health, lipid metabolism, muscle regeneration, and immune modulation, key processes in combating inflamm-aging and sarcopenic decline. Despite encouraging findings, biomarker responses remain heterogeneous across studies, limiting translational application. The integration of biomarker profiling with exercise prescription holds the potential to personalize interventions and guide precision medicine approaches in sarcopenia management. Future large-scale, standardized trials are needed to validate these biomarkers and optimize exercise protocols for aging populations. Full article

Background: Institutionalized older adults often experience cognitive and functional decline and altered body composition (BC), making nutritional assessment difficult. Bioelectrical impedance analysis (BIA) offers a simple and non-invasive method to evaluate BC; classic and specific bioelectrical impedance vector analysis do not require predictive models or assumptions about hydration status. Objective: This study aimed to evaluate the utility of BIA, classic bioelectrical impedance vector analysis (BIVA), and specific BIVA (BIVA-Sp) in detecting nutritional and other related disorders in institutionalized psychogeriatric patients. Methods: A cross-sectional study was conducted in 95 institutionalized older adults (52 men, 43 women; mean age: 80 years). Clinical and functional data, including frailty, dependency, handgrip strength, and anthropometry, were collected. BC was assessed using BIA. Nutritional diagnoses included malnutrition (GLIM criteria), sarcopenia (EWGSOP2), adiposity, and sarcopenic obesity (SOGLI criteria). Mean impedance vectors and 95% confidence ellipses were generated for BIVA and BIVA-Sp. Individual vectors were compared with reference data from healthy older adults. Statistical analyses compared clinical variables and impedance vector distributions between groups. Results: Classic BIVA differentiated patients with sarcopenia and sarcopenic obesity, while BIVA-Sp identified vector shifts associated with adiposity and sarcopenic obesity. Neither BIVA nor BIVA-Sp discriminated patients based on body mass index or malnutrition status. Conclusions: The application of BIVA in institutionalized psychogeriatric patients allows for easier, faster, and more effective detection of changes in BC and hydration status compared with conventional methods. This enables individualized monitoring and facilitates interventions that may reduce complications, functional decline, and hospitalizations, thereby improving their quality of life. Full article

Background: Frailty is a major barrier to healthy ageing, yet early identification strategies remain limited. The serum creatinine-to-cystatin C ratio (sarcopenia index, SI) has emerged as a cost-effective biomarker of muscle mass and function, while physical activity (PA) is a key protective factor. However, their combined role in predicting frailty is unclear. This study aimed to investigate the independent and joint associations of SI and PA with incident frailty in middle-aged and older adults. Methods: We analyzed 5307 participants aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018). SI was calculated from serum creatinine and cystatin C levels, and PA was assessed using standardized questionnaires. Frailty was defined using a 32-item Frailty Index (FI ≥ 0.25). Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of SI and PA with incident frailty, adjusting for sociodemographic and health-related factors. Effect modification by PA was formally tested. Results: Over the follow-up period, 1483 participants developed frailty (27.9%). Higher SI was inversely associated with frailty in a dose–response manner: compared with the lowest quartile, HRs (95% CIs) were 0.84 (0.73–0.97) for Q2, 0.83 (0.72–0.96) for Q3, and 0.69 (0.59–0.82) for Q4 (p-trend < 0.001). Each 10-unit increase in SI corresponded to a 6% lower frailty risk (HR = 0.94, 95% CI: 0.91–0.97). PA significantly modified this relationship (interaction p < 0.05), with the strongest protective effect of SI observed among individuals with low PA, and attenuation at higher PA levels. Conclusions: SI is independently associated with a lower risk of incident frailty, particularly among less physically active individuals. These findings support the potential use of SI as a feasible biomarker for early frailty risk stratification and highlight the importance of integrating biomarker-based screening with lifestyle interventions to prevent frailty. Full article

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

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