Incidence, reversibility, risk factors and the protective effect of high body mass index against sarcopenia in community‐dwelling older Chinese adults

Abstract

Aim:We examined the incidence and the reversibility of sarcopenia and their associated factors over a 4-year period using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Methods:A total of 4000 community-dwelling older adults aged ≥65 years were evaluated for which detailed information regarding demographics, socioeconomic, medical history, lifestyle, and clinical factors were documented at baseline, 2 years, and 4 years later. Sarcopenia was defined according to the EWGSOP algorithm. Incident sarcopenia and its reversibility were documented at each follow-up year, and related to possible factors. Results:At baseline, of the 4000 participants, 361 (9.0%) had sarcopenia. Between baseline and 2-year follow-up, 6.0% of the participants without sarcopenia at baseline had developed sarcopenia, and 18.8% of the initially sarcopenic participants had reverted to normal. Between baseline and 4-year follow-up, the corresponding figures were 6.3% and 14.1%, respectively. The average annual incidence over 4 years was 3.1%. After multivariate adjustments, older age, female sex, presence of chronic obstructive pulmonary disease, presence of stroke, higher physical activity levels, presence of instrumental activities of daily living impairments, and lower body mass index were associated with incident sarcopenia, whereas younger age, female sex, higher body mass index and absence of instrumental activities of daily living impairments, but not physical activity, were associated with its reversibility. Protein and vitamin D intake were not significantly associated with sarcopenia incidence or its reversibility. Conclusion:Sarcopenia incidence increases with age, but is potentially reversible in a Chinese elderly population. High body mass index is protective against sarcopenia incidence and its reversibility. Increasing physical activity and maintaining a healthy weight could be beneficial in the prevention of sarcopenia. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 15-28.

The Pleiotropic Effect of Physical Exercise on Mitochondrial Dynamics in Aging Skeletal Muscle

“…Moreover a recent 4-year follow-up study on Chinese elderly people confirmed that the accomplishment of sarcopenia reversibility is associated with several lifestylerelated factors. In particular a high BMI resulted protective against sarcopenia occurrence; however, the increment of physical activity and the maintenance of a healthy weight was beneficial in the prevention of sarcopenia as well [72]. Further studies in different populations and with a longer follow-up are necessary to better investigate to what extent lifestyle behaviours might contribute to sarcopenia reversibility.…”

Management of Sarcopenia to Improve Quality of Life in Geriatric Populations

“…46,47 Lifestyle behaviors such as physical inactivity, smoking, and poor diet are also important risk factors of sarcopenia. [48][49][50][51] Genetic factors also play a role in the etiology of sarcopenia. [52][53][54] Similar to osteopenia that predicts risk of fracture, sarcopenia is a predictor of falls, 55 fracture, 56 disability, [57][58][59] and mortality, 26,60 Sarcopenia also plays a predominant role in the development of frailty, 61 which is predictive of adverse events such as hospitalization, morbidity, disability, and mortality.…”

“…There is evidence suggesting that individuals who have knowledge of sarcopenia or a low value of muscle mass/strength were associated with fear of falls; their perception of health may be altered due to concerns that their conditions may predispose them to fracture, 56,98 which impact negatively upon quality of life. 97,99 Furthermore, those with sarcopenia were more likely to report having chronic diseases such as chronic obstructive pulmonary disease, stroke, and chronic kidney disease, 51,92,100 which have been associated with poor quality of life. 101,102 As mentioned earlier, sarcopenia and obesity often coexist and that a loss of muscle mass could be related to impaired metabolism (such as insulin resistance and metabolic syndrome), 68,70 both of which may have negative effects on quality of life.…”

“…101,102 As mentioned earlier, sarcopenia and obesity often coexist and that a loss of muscle mass could be related to impaired metabolism (such as insulin resistance and metabolic syndrome), 68,70 both of which may have negative effects on quality of life. 103,104 Sarcopenia is also significantly associated with ADL/instrumental activities of daily living (IADL) impairments, 51,105,106 which have been demonstrated to be strong predisposing factors of poor quality of life. 107 There is also evidence that ADL impairments are associated depression, loneliness, and social isolation, 108,109 which are also risk factors of poor quality of life.…”

“…Considerable evidence suggests that sarcopenia is a reversible cause of adverse outcomes; 51 therefore, by targeting sarcopenia and its components, therapeutic and preventive interventions have the potential to improve physical function, maintain independence, and improve quality of life.…”