Sarcopenia and physical independence in older adults: the independent and synergic role of muscle mass and muscle function

Santos, Leandro dos; Cyrino, Edílson Serpeloni; Antunes, Melissa; Santos, Diana A.; Sardinha, Luís B.

doi:10.1002/jcsm.12160

Cited by 207 publications

(171 citation statements)

References 42 publications

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“…Our results clearly show the differences between older adults with sarcopenia and non‐sarcopenia in the performance in gait speed and the level of dependence. As shown in previous studies, our findings confirm that sarcopenia results in lower gait speed and independence in daily living . Consequently, the promotion of physical activity in older adults is key to maintain the muscle mass to prevent the deterioration of gait speed.…”

Section: Discussionsupporting

confidence: 90%

“…In Colombia, recent results from SABE Bogota study estimated that sarcopenia affects 11.5% of the older population . Sarcopenia is related to several functional comorbidities including mobility disorders, risk of falls and fractures, and a loss of physical independence in activities of daily living (ADL) . It seems that sarcopenia depends on several coadjuvant factors such as inflammatory processes related to aging, nutritional status, intramuscular fat, and genetics, in addition to the reduction of physical activity, which is a crucial precursor of sarcopenia .…”

Section: Introductionmentioning

confidence: 99%

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Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Pérez-Sousa

Venegas-Sanabria

Chavarro-Carvajal

et al. 2019

J cachexia sarcopenia muscle

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Background Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. Methods A cross‐sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to ‘SABE Survey 2015’. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). Results Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and non‐sarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non‐sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (β = −0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect (−0.009 to −0.004). Conclusions The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Pérez-Sousa

Venegas-Sanabria

Chavarro-Carvajal

et al. 2019

J cachexia sarcopenia muscle

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“…36 The prevalence of sarcopenia in Asia ranges from 4.1% to 11.5% of the general older population. 38 In acute care wards, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80) after adjustment for age, sex, and other confounders. 38 In acute care wards, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80) after adjustment for age, sex, and other confounders.…”

Section: Chronic Heart Failure and Muscle Maintenancementioning

confidence: 89%

Skeletal muscle wasting in chronic heart failure

2018

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Patients suffering from chronic heart failure (CHF) show an increased prevalence (~20% in elderly CHF patients) of loss of muscle mass and muscle function (i.e. sarcopenia) compared with healthy elderly people. Sarcopenia, which can also occur in obese patients, is considered a strong predictor of frailty, disability, and mortality in older persons and is present in 5–13% of elderly persons aged 60–70 years and up to 50% of all octogenarians. In a CHF study, sarcopenia was associated with lower strength, reduced peak oxygen consumption (peak VO2, 1173 ± 433 vs. 1622 ± 456 mL/min), and lower exercise time (7.7 ± 3.8 vs. 10.22 ± 3.0 min, both P < 0.001). Unfortunately, there are only very limited therapy options. Currently, the main intervention remains resistance exercise. Specialized nutritional support may aid the effects of resistance training. Testosterone has significant positive effects on muscle mass and function, and low endogenous testosterone has been described as an independent risk factor in CHF in a study with 618 men (hazard ratio 0.929, P = 0.042). However, the use of testosterone is controversial because of possible side effects. Selective androgen receptor modulators have been developed to overcome these side effects but are not yet available on the market. Further investigational drugs include growth hormone, insulin‐like growth factor 1, and several compounds that target the myostatin pathway. The continuing development of new treatment strategies and compounds for sarcopenia, muscle wasting regardless of CHF, and cardiac cachexia makes this a stimulating research area.

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“…Cross‐sectional analysis among 3493 non‐institutionalized older adults found that low muscle mass and low muscle function are independent risk factors for losing physical independence in later life. However, individuals with both low muscle mass and low muscle function presented the highest risk for losing physical independence . In addition, a prospective study suggested that muscle strength rather than muscle mass at baseline was associated with increased falls risk score and fracture incidence at 10 years follow‐up in community‐dwelling older adults …”

Section: Discussionmentioning

confidence: 99%

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Yeung

Reijnierse

Pham

et al. 2019

J cachexia sarcopenia muscle

643

463

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Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta‐analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty‐six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non‐sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty‐three studies (45 926 individuals) were included in the meta‐analysis. Sarcopenic individuals had a significant higher risk of falls (cross‐sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2 = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2 = 37%) and fractures (cross‐sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2 = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2 = 0%) compared with non‐sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.

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Sarcopenia and physical independence in older adults: the independent and synergic role of muscle mass and muscle function

Cited by 207 publications

References 42 publications

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Skeletal muscle wasting in chronic heart failure

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

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