BackgroundHand grip strength (HGS) is used for the diagnosis of sarcopenia and frailty. Several factors have been shown to influence HGS values during measurement. Therefore, variations in the protocols used to assess HGS, as part of the diagnosis of sarcopenia and frailty, may lead to the identification of different individuals with low HGS, introducing bias. The aim of this systematic review is to gather all the relevant studies that measured HGS to diagnose sarcopenia and frailty and to identify the differences between the protocols used.MethodsA systematic review was carried out following the recommendations of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed and Web of Science were systematically searched, until August 16, 2016. The evidence regarding HGS measurement protocols used to diagnose sarcopenia and frailty was summarised and the most recent protocols regarding the procedure were compared.ResultsFrom the described search 4393 articles were identified. Seventy-two studies were included in this systematic review, in which 37 referred to sarcopenia articles, 33 to frailty and two evaluated both conditions. Most studies presented limited information regarding the protocols used.ConclusionsThe majority of the studies included did not describe a complete procedure of HGS measurement. The high heterogeneity between the protocols used, in sarcopenia and frailty studies, create an enormous difficulty in drawing comparative conclusions among them.
This condition is very prevalent in Portuguese older adults, one fifth are frail whereas half are pre-frail. Weakness identified by low handgrip strength is the most prevalent criterion in pre-frail and frail Portuguese older adults.
BackgroundVitamin D deficiency is common in older adults and has been linked with frailty and obesity, but it remains to be studied whether frail obese older adults are at higher risk of vitamin D deficiency. Therefore, the aim of this study is to explore the association between frailty, obesity indices and serum 25(OH)D concentrations.Methods1447 individuals with 65 years or older, participating in a cross-sectional study (Nutrition UP 65) were included. Frailty, according to Fried et al., body mass index (BMI), waist circumference (WC), body roundness index (BRI) and body shape index (ABSI) were evaluated. A stepwise multinomial logistic regression was carried out to quantify the association between 25(OH)D quartiles and independent variables.ResultsMedian 25(OH)D levels were lower in individuals presenting both frailty and obesity (p<0.001). In the multivariate analysis, pre-frailty (OR: 2.65; 95% CI: 1.63–4.33) and frailty (OR: 3.77; 95% CI: 2.08–6.83) were associated with increased odds of lower 25(OH)D serum levels (first quartile). Regarding obesity indices, the highest categories of BMI (OR: 1.74; 95% CI: 1.06–2.86), WC (OR: 3.46; 95% CI: 1.95–6.15), BRI (OR: 4.35; 95% CI: 2.60–7.29) and ABSI (OR: 3.17 95% CI: 1.86–5.38) were directly associated with lower 25(OH)D serum levels (first quartile).ConclusionsA positive association between frailty or obesity and lower vitamin D levels was found. Moreover, besides BMI and WC, other indicators of body adiposity, such as BRI and ABSI, were associated with lower 25(OH)D serum concentrations.
Aim The aim of this study was to describe sarcopenia frequency, to identify the factors associated with sarcopenia and undernutrition, and to evaluate their coexistence. Methods A total of 1500 Portuguese older adults aged ≥65 years from the Nutrition UP 65 study were evaluated using a cross‐sectional analysis. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP)2 guidelines (2018), using anthropometric measures. Undernutrition status was evaluated by Mini‐Nutritional Assessment‐Short Form. Results Sarcopenia frequency was 4.4% (n = 66). Sarcopenia coexists with undernutrition or undernutrition risk in 1.5% of this sample. In the multivariate analysis, sarcopenia was directly associated with age >75 years (odds ratio (OR): 2.14; 95% confidence interval (CI): 1.19–3.84), undernutrition or undernutrition risk (OR: 1.86; 95% CI: 1.01–3.43) and inversely associated with male gender (OR: 0.52; 95% CI: 0.29–0.97), overweight (OR: 0.24; 95% CI: 0.13–0.42) or obesity (OR: 0.02; 95% CI: 0.01–0.09) and moderate alcohol consumption (OR: 0.47; 95% CI: 0.24–0.90). Undernutrition or undernutrition risk was associated with a poor or very poor self‐perception of health status (OR: 3.53; 95% CI: 2.32–5.37), a low physical activity level (OR: 1.74; 95% CI: 1.23–2.47), sarcopenia (OR: 1.85; 95% CI: 1.02–3.36), and being overweight (OR: 0.40; 95% CI: 0.27–0.59) or obese (OR: 0.43; 95% CI: 0.28–0.65). Conclusions The majority of the older adults presented low muscle strength (probable sarcopenia), but only a small number had concomitantly low muscle quantity or quality (sarcopenia). Coexistence between these conditions is low which reinforces the need to assess them both individually during geriatric assessment.
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