SummarySarcopenia is an age-related process of skeletal muscle loss associated with declining physical performance, highly prevalent among older subjects, with a negative prognostic effect on falls, disability and mortality risk. Modern approaches to sarcopenia case finding and diagnosis are based on physical performance measures, while assessment of muscle mass represents the second diagnostic step. Muscle mass can be quantified at different levels of body composition, with a complexity increasing from atomic detection to anatomic measure. In the choice of measuring method, different factors have to be taken into account, including validity, simplicity, cost and specific purpose (clinical versus research). Some methods, such as MRI and CT, have high validity but are complex and costly. Bioelectrical impedance analysis is inexpensive and easy to perform in most settings, being the preferred method for clinical practice. Dual energy X-ray absorptiometry has intermediate cost and complexity with good reproducibility, and is more reliable for research setting. Other methods, such as administration of tritium (D3)-marked creatine and measurement of urinary D3-creatinine, are still in a preclinical phase of development. For all methods the issue of normative data does exist and needs to be solved, in order to reliably identify homogeneous populations with sarcopenia, to be targeted in clinical practice and intervention studies.

Based on critical appraisal, the Gait Assessment and Intervention Tool shows a good level of quality, and its use in stroke rehabilitation is recommended. Rigorous studies are needed for the other tools in order to establish their usefulness.

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Cardiovascular complications in patients undergoing non-cardiac surgery are associated with longer hospital stays and higher in-hospital mortality. The aim of this study was to assess the incidence of in-hospital myocardial infarction and/or myocardial injury in patients undergoing hip fracture surgery and their association with mortality. Moreover, we evaluated the prognostic value of troponin increase stratified on the basis of peak troponin value. The electronic records of 1970 consecutive hip fracture patients were reviewed. Patients <70 years, those with myocardial infarction <30 days, and those with sepsis or active cancer were excluded from the study. Troponin and ECG were obtained at admission and then at 12, 24, and 48 h after surgery. Echocardiography was made before and within 48 h after surgery. Myocardial injury was defined by peak troponin I levels > 99th percentile. A total of 1854 patients were included. An elevated troponin concentration was observed in 754 (40.7%) patients in the study population. Evidence of myocardial ischemia, fulfilling diagnosis of myocardial infarction, was found in 433 (57%). ECG and echo abnormalities were more frequent in patients with higher troponin values; however, mortality did not differ between patients with and without evidence of ischemia. Peak troponin was between 0.1 and 1 µg/L in 593 (30.3%). A total of 191 (10%) had peak troponin I ≥ 1 µg/L, and 98 died in hospital (5%). Mortality was significantly higher in both groups with troponin increase (HR = 1.37, 95% CI 1.1–1.7, p < 0.001 for peak troponin I between 0.1 and 1 µg/L; HR = 2.28, 95% CI 1.72–3.02, p < 0.0001 for peak troponin ≥1 µg/L) in comparison to patients without myocardial injury. Male gender, history of coronary heart disease, heart failure, and chronic kidney disease were also associated with in-hospital mortality. Myocardial injury/infarction is associated with increased mortality after hip fracture surgery. Elevated troponin values, but not ischemic changes, are related to early worse outcome.