Muscle quality as a complementary prognostic tool in conjunction with sarcopenia assessment in younger and older individuals (original) (raw)

Low Relative Skeletal Muscle Mass (Sarcopenia) in Older Persons Is Associated with Functional Impairment and Physical Disability

Journal of the American Geriatrics Society, 2000

To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcopenia is related to functional impairment and physical disability in older persons. DESIGN: Cross-sectional survey. SETTING: Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III). PARTICIPANTS: Fourteen thousand eight hundred eighteen adult NHANES III participants aged 18 and older.

Associations Between Muscle Mass, Muscle Morphology and Bone Health in Older Men With Sarcopenia: A Cross-sectional Study

2020

Background: The aim of this study was to explore the association between muscle mass, morphology, bone mineral density, and physical function in community-dwelling older men with sarcopenia. Methods: A total of 151 men, 60 years or older were included in this study. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Low bone mineral density was diagnosed if T-score was equal to or below-1.0 SD of mean young men reference range. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People (EWGSOP) criteria: low muscle mass and low muscle strength or low physical performance. Physical performance was evaluated by short physical performance battery. Microbiopsy of musculus vastus lateralis was performed with disposable muscle microbiopsy system. The perimeter and cross-section area of muscle bers were calculated using image analysis software in whole slide images; type of ber and their distribution were evaluated as well. Relationship between variables were examined using Spearman's and Pearson's correlations. The level of signi cance (p-value) of < 0.05 was considered as statistically signi cant. Results: Mean age of the subjects was 72.9 ± 8.02 years. Sarcopenia was diagnosed in 45 (29.8%) men. In the sarcopenia group, 25 muscle biopsies were examined. The average muscle ber length was 217.47 ± 25.22 microm and average ber cross-sectional area was 2446 ± 608.87 microm 2. In 9 sarcopenic men with T-scores equal or below-2.5, the muscle ber area had a signi cant correlation with balance test (r = 0.73, p = 0.025). Multiple signi cant correlations were found between bone mineral density, lean mass, appendicular lean mass, arm and leg lean mass, gait speed, balance test and handgrip strength. Conclusions: In men with sarcopenia, low lean muscle mass was associated with low femoral neck and hip BMD, and lower muscle strength. In sarcopenic men with osteoporosis, lower muscle ber area was associated with lower scores of balance test. Trial registration: study protocol has been approved by Lithuanian regional biomedical research ethics committee (No. 158200-03-208-75). Background In 1989, Rosenberg described age-related loss of lean body mass as sarcopenia [1]. Although, there is no one unifying de nition of sarcopenia, all current ones include low muscle mass and function, be it either muscle strength or physical performance, or both [2]. Depending on the de nition used, the prevalence of sarcopenia varies between 10-40% [3]. Sarcopenia is associated with such negative outcomes as falls, increased hospitalization, functional decline and death [4, 5]. One of the hallmark components of sarcopenia is muscle mass. Muscle consists of different types of ber (type I and type II). With ageing, the number and size of bers, especially type II, decreases [6, 7]. Furthermore, age related changes lead to ber atrophy [8]. This in turn may lead to muscle atrophy and reduced muscle mass. Bone mineral density (BMD) is used to assess bone health. Furthermore, BMD is a component of body composition measurements [9]. Low BMD is also a risk factor for osteoporosis and fractures [10]. It is known that there are associations between fat mass, lean muscle mass and BMD [11]. Moreover, these associations continue to persist in longitudinal studies [12, 13]. A loss of muscle or bone tissue, affects musculoskeletal system. It was believed that bone and muscle interact only on biomechanical level, meaning that force produced by muscles impacts bone strength and density [14]. Also, a relationship between bone health, muscle strength and physical performance exists [12]. However, a new theory is now emerging that links bone and muscle transformations at biochemical level [15]. Despite that there are only a few studies, which looked at association between muscle changes and bone health. Therefore, the aim of this study was to explore associations between muscle mass, morphology, bone mineral density and physical functions in community-dwelling elderly males with sarcopenia. Methods Criteria for participation in this cross-sectional study include men who have attended the National Osteoporosis Center in Vilnius, Lithuania. Inclusion criteria were: age 60 years and older, voluntary consent to participate in the study. Exclusion criteria were: an objection to any procedure, large dose of radiation received over the past 12 months, malignant tumours of various localizations, mental disorders, muscle diseases (hereditary and in ammatory), current/past use of any medications likely to affect muscle, bone and fat metabolism. This study protocol has been approved by Lithuanian regional biomedical research ethics committee (No. 158200-03-208-75). All subjects gave their written informed consent prior to enrolment.

An anthropometric prediction equation for appendicular skeletal muscle mass in combination with a measure of muscle function to screen for sarcopenia in primary and aged care

Journal of the American Medical Directors Association, 2015

Sarcopenia is the presence of low muscle mass and poor physical function. We have developed an anthropometric prediction equation (PE). We compared the accuracy of our previously developed anthropometric prediction equation (PE) to dual absorptiometry x-ray (DXA) in predicting low muscle mass and sarcopenia. Cross-sectional study design. Community dwelling. Men and women aged 65 years and older. Gender-specific low muscle mass cutoffs were identified using the lowest 20% of the skeletal muscle index (SMI) where muscle mass was determined using PE in 611 men and 375 women aged 65 years and older. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PE derived low muscle mass were compared with DXA-derived low muscle mass. The cohort was randomized into a development and validation group to identify various cutoffs for low muscle mass via the PE method and test its performance against the DXA method. The PE cutoff for low muscle mass was...

Sarcopenia in the Context of Skeletal Muscle Function Deficit (SMFD)

Frailty and Sarcopenia - Onset, Development and Clinical Challenges, 2017

Evidence shows that not only changes in skeletal muscle mass but changes in strength and other factors underpinning muscle quality play a role in muscle function decline and impaired mobility associated with aging. Changes in both strength and quality may precede loss of muscle mass. Skeletal muscle function deficit (SMFD) is a terminology that embraces this evolving conceptualization of sarcopenia and age-related muscle dysfunctions. This chapter provides a discussion on sarcopenia in the context of SMFD, including operational definitions and methodological challenges associated with their establishment; integration of muscle quality into SMFD; efforts to identify diagnostic cutoff values for low muscle mass and weakness and their predictive validity to mobility disability; need for standardized muscle quality assessment; clinical and public health relevance and research opportunities. Changes in muscle composition, based on excessive levels of inter-and intramuscular or intramyocellular fat are striking features increasingly addressed in the literature, found to affect muscle metabolism and peak force generation. Methods to easily and rapidly assess muscle composition in multiple clinical settings and with minimal patient burden are needed. Further characterization of SMFD should emphasize integration of muscle quality and factors behind changes in quality, as well as associated clinical and research implications.

Diagnostic criteria for sarcopenia and physical performance

AGE, 2014

Relative and absolute muscle mass and muscle strength are used as diagnostic criteria for sarcopenia. We aimed to assess which diagnostic criteria are most associated with physical performance in 180 young (18-30 years) and 281 healthy old participants (69-81 years) of the European study MYOAGE. Diagnostic criteria included relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height squared and total lean mass), knee extension torque, and handgrip strength. Physical performance comprised walking speed, Timed Up and Go test (TUG), and in a subgroup physical fitness. Diagnostic criteria for sarcopenia and physical performance were standardized, and the associations were analyzed using linear regression models stratified by age category, with adjustments for age, gender, and country. In old participants, relative muscle mass was associated with faster walking speed, faster TUG, and higher physical fitness (all p<0.001). Absolute muscle mass was not associated with physical AGE (2014) 36:275-285

Cut-off points for muscle mass — not grip strength or gait speed — determine variations in sarcopenia prevalence

The journal of nutrition, health & aging, 2016

Objectives: The European Working Group on Sarcopenia in Older People (EWGSOP) has proposed different methods and cutoff points for the three parameters that define sarcopenia: muscle mass, muscle strength and physical performance. Although this facilitates clinical practice, it limits comparability between studies and leads to wide differences in published prevalence rates. The aim of this study was to assess how changes in cutoff points for muscle mass, gait speed and grip strength affected sarcopenia prevalence according to EWGSOP criteria. Methods: Cross-sectional analysis of elderly individuals recruited from outpatient clinics (n=298) and nursing homes (n=276). We measured muscle mass, grip strength and gait speed and assessed how changes in cutoff points changed sarcopenia prevalence in both populations. Results: An increase from 5.45 kg/m 2 to 6.68 kg/m 2 in the muscle mass index for female outpatients and nursing-home residents increased sarcopenia prevalence from 4% to 23% and from 9% to 47%, respectively; for men, for an increase from 7.25 kg/m 2 to 8.87 kg/m 2 , the corresponding increases were from 1% to 22% and from 6% to 41%, respectively. Changes in gait speed and grip strength had a limited impact on sarcopenia prevalence. Conclusion: The cutoff points used for muscle mass affect the reported prevalence rates for sarcopenia and, in turn, affect comparability between studies. The main factors influencing the magnitude of the change are muscle mass index distribution in the population and the absolute value of the cutoff points: the same difference between two references (e.g., 7.5 kg/m 2 to 7.75 kg/m 2 or 7.75 kg/m 2 to 8 kg/m 2) may produce different changes in prevalence. Changes in cutoff points for gait speed and grip strength had a limited impact on sarcopenia prevalence and on study comparability.

Sarcopenia: a predictor of mortality and the need for early diagnosis and intervention

Aging Clinical and Experimental Research, 2014

The term sarcopenia refers to the loss of muscle mass that occurs with aging. Sarcopenia is defined by the European Working Group on Sarcopenia in Older People (EWGSOP) as low muscle mass and low muscle function (strength and performance). Its prevalence varies depending on the definition used for it, but estimates propose a loss of approximately 8 % per decade until the age of 70 years; afterwards, the loss increases and ranges from 13 to 24 % per decade. Irrespective of how sarcopenia is defined, both low muscle mass and poor muscle strength are highly prevalent and important risk factors for disability and increased mortality in individuals as they age. In this review, we address age-related muscle loss and the risk factors of mortality, emphasizing the need for early diagnosis and intervention.

Sarcopenia parameters in active older adults – an eight-year longitudinal study

BMC Public Health

Backgroud Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population. Methods The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters we...

Sarcopenic Characteristics of Active Older Adults: a Cross-Sectional Exploration

Sports Medicine - Open, 2021

Background: Ageing is associated with a decline in skeletal muscle mass and function (strength and power), known as sarcopenia. Inadequate dietary protein and inactivity have been shown to accelerate sarcopenia outcomes, occurring at different rates in males and females. Regardless, active older adults who often exceed the exercise guidelines still show signs of sarcopenia. This study aimed to explore the link between age, physical activity, protein intake, and biological sex with skeletal muscle mass, strength, power, and physical capacity/ performance in active older adults. Fifty-four active older adults were recruited from this trial and grouped according to age (middle aged: 50-59 years, and older age: ≥ 60 years), exercise volume (low: ≥ 90-149 min/week, moderate: ≥ 150-299 min/week, and high: ≥ 300 min/week), protein intake (low: < 0.8 g/kg body mass (BM), moderate: ≥ 0.8-1.19g /kg BM, and high: ≥ 1.2 g/kg BM), and biological sex (males and females). Skeletal muscle and fat mass (dual X-ray absorptiometry), strength (1-repetition maximum using leg press, chest press, lateral pull down, and hand grip), power (counter movement jump), and general fitness (cardiorespiratory capacity and gait speed) were assessed. Data were grouped based on variables, and a general linear model (ANCOVA) or an independent t test was used to determine between group differences. Results: Fifty three of the total participants' data were analysed. The middle-aged group had 18%, 11%, and 10% higher leg press, chest press, and lateral pull down, respectively, compared to the older-aged group (p < .05). There were no significant differences between different levels of training volume and any of the outcomes. Higher protein intakes were associated with significantly less body fat mass (p = .005) and a trend towards a higher leg press (p = .053) and higher relative power (W/kg) (p = .056) compared with the moderate and low protein intake groups. Significant differences based on biological sex were observed for all outcomes except for gait speed (p = .611) and cardiorespiratory fitness (p = .147). Conclusions: Contributions of age, physical activity, daily protein intake, and biological sex can explain the individual variation in outcomes related to changes in body composition, strength, power, and/or cardiorespiratory fitness in a cohort of active older adults.