This study compares the effects of two resistance training programs in peripheral and respiratory musculature on muscle mass and strength and physical performance and identifies the appropriate muscle mass parameter for assessing the intervention effects. Thirty-seven institutionalized older Spanish adults with sarcopenia were analyzed: control group (n = 17), respiratory muscle training group (n = 9), and peripheral muscle training group (n = 11). Measured outcomes were appendicular skeletal muscle mass (ASM/height, ASM/weight, and ASM/BMI), isometric knee extension, arm flexion and handgrip strength, maximal inspiratory and expiratory pressures, and gait speed pre- and postintervention. Trained groups participated in a 12-week program and improved in maximum static inspiratory pressure, maximum static expiratory pressure, knee extension, and arm flexion (p < .05), whereas nonsignificant changes were found in gait speed and ASM indexes pre- and postintervention in the three groups. In conclusion, resistance training improved skeletal muscle strength in the studied population, and any ASM index was found to be appropriate for detecting changes after physical interventions.

Background: Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. Methods: A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson’s Comorbidity Index (ACCI), number of medications, hospital stays and falls. Results: Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke’s R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). Conclusion: BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.

No abstract

The main purpose of this paper is to evaluate the innovative nursing home voucher scheme that was introduced by the Valencia Autonomous Region of Spain in the early s to implement targets laid down by the national plan for the development of older people's services. The article begins with a review of the evolution of Spanish social services, and especially the nursing home sector, and then summarises the genesis, objectives and characteristics of the voucher scheme. The main part of the paper reports a performance analysis and economic evaluation of the programme. On the basis of detailed information over four years, it is concluded that nursing home vouchers have contributed to the increased supply of publicly-financed rooms, have promoted equality of access to the service, and have increased user choice. It is also shown, however, that while vouchers can lead to an increase in the quality of inputs, they increase utilisation and expenditure. In the absence of the monitoring or reporting data that would be required, it is not possible to determine whether the scheme has increased efficiency, in the sense of improving the quality of life of frail older people at reasonable and containable cost.

Information on public services for older people is often limited to institutional care and Home Help/ Home Care, be it for individuals in surveys, statistics for a specific country or for international comparisons. Yet, these two major services in many countries are supplemented -or substituted -by other, minor services. The latter include services such as transportation services, meals-on-wheels, alarm systems, and day care. In this study the authors use various data sources to provide information on all or most of these types of support for Denmark, Norway, Sweden, Germany, England, Spain, and Israel, concluding with a closer scrutiny of Swedish service profiles. When all types of support are considered, service coverage in these countries is approximately 50-100% higher than for the two major types alone. Data suggest some degree of targeting, at least in countries with higher coverage rates for services. Coverage is estimated as a percentage of a specific age group which uses a service. In countries with lower coverage rates, users may demand or get what is available, with little differentiation between client needs. When user rates are high, there is also a greater overlap between family care and public services. In countries with lower coverage rates, family care and public services are more often substituted for each other. It is suggested that a range of services, major and minor, may suit the varying needs of older people more effectively than the choice between nothing, Home Help or institutional care, but minor services also may be used as an inexpensive substitute for full support.