The incidence of sarcopenia among hospitalized older patients: results from the Glisten study

Martone, Anna Maria; Bianchi, Lara; Abete, Pasquale; Bellelli, Giuseppe; Bo, Mario; Cherubini, Antonio; Corica, Francesco; Bari, Mauro Di; Maggio, Marcello; Manca, Giovanna Maria; Marzetti, Emanuele; Rizzo, Maria Rosaria; Rossi, Andrea P.; Volpato, Stefano; Landi, Francesco

doi:10.1002/jcsm.12224

Cited by 164 publications

(148 citation statements)

References 40 publications

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“…We could not include a positive control group for hospitalized patients that show atrophy of skeletal muscles other than from aspiration pneumonia. A previous study reported the incidence of sarcopenia among hospitalized aged patients . Because the methods to evaluate the muscles were completely different, we could not compare the degree of muscle atrophy with the previous study or other diseases.…”

Section: Discussionmentioning

confidence: 83%

Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems

Komatsu

Okazaki

Ebihara

et al. 2018

J cachexia sarcopenia muscle

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BackgroundRepetition of the onset of aspiration pneumonia in aged patients is common and causes chronic inflammation. The inflammation induces proinflammatory cytokine production and atrophy in the muscles. The proinflammatory cytokines induce muscle proteolysis by activating calpains and caspase‐3, followed by further degradation by the ubiquitin‐proteasome system. Autophagy is another pathway of muscle atrophy. However, little is known about the relationship between aspiration pneumonia and muscle. For swallowing muscles, it is not clear whether they produce cytokines. The main objective of this study was to determine whether aspiration pneumonia induces muscle atrophy in the respiratory (the diaphragm), skeletal (the tibialis anterior, TA), and swallowing (the tongue) systems, and their possible mechanisms.MethodsWe employed a mouse aspiration pneumonia model and computed tomography (CT) scans of aged pneumonia patients. To induce aspiration pneumonia, mice were inoculated with low dose pepsin and lipopolysaccharide solution intra‐nasally 5 days a week. The diaphragm, TA, and tongue were isolated, and total RNA, proteins, and frozen sections were stored. Quantitative real‐time polymerase chain reaction determined the expression levels of proinflammatory cytokines, muscle E3 ubiquitin ligases, and autophagy related genes. Western blot analysis determined the activation of the muscle proteolysis pathway. Frozen sections determined the presence of muscle atrophy. CT scans were used to evaluate the muscle atrophy in aged aspiration pneumonia patients.ResultsThe aspiration challenge enhanced the expression levels of proinflammatory cytokines in the diaphragm, TA, and tongue. Among muscle proteolysis pathways, the aspiration challenge activated caspase‐3 in all the three muscles examined, whereas calpains were activated in the diaphragm and the TA but not in the tongue. Activation of the ubiquitin‐proteasome system was detected in all the three muscles examined. The aspiration challenge activated autophagy in the TA and the tongue, whereas weak or little activation was detected in the diaphragm. The aspiration challenge resulted in a greater proportion of smaller myofibers than in controls in the diaphragm, TA, and tongue, suggesting muscle atrophy. CT scans clearly showed that aspiration pneumonia was followed by muscle atrophy in aged patients.ConclusionsAspiration pneumonia induced muscle atrophy in the respiratory, skeletal, and swallowing systems in a preclinical animal model and in human patients. Diaphragmatic atrophy may weaken the force of cough to expectorate sputum or mis‐swallowed contents. Skeletal muscle atrophy may cause secondary sarcopenia. The atrophy of swallowing muscles may weaken the swallowing function. Thus, muscle atrophy could become a new therapeutic target of aspiration pneumonia.

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Section: Discussionmentioning

confidence: 83%

Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems

Komatsu

Okazaki

Ebihara

et al. 2018

J cachexia sarcopenia muscle

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“…The authors acknowledge that a wide range of techniques have previously been used to describe changes in body composition and muscle size in clinical populations . BIA, however, is necessary as an alternative to more stringent measures of body composition in MD where mobility is limited .…”

Section: Discussionmentioning

confidence: 99%

Relationships between muscle size, strength, and physical activity in adults with muscular dystrophy

Jacques

Onambélé-Pearson

Reeves

et al. 2018

J cachexia sarcopenia muscle

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BackgroundMuscular dystrophy (MD) is characterized by progressive muscle wasting and weakness, yet few comparisons to non‐MD controls (CTRL) of muscle strength and size in this adult population exist. Physical activity (PA) is promoted to maintain health and muscle strength within MD; however, PA reporting in adults with MD is limited to recall data, and its impact on muscle strength is seldom explored.MethodsThis study included 76 participants: 16 non‐MD (CTRL, mean age 35.4), 15 Duchenne MD (DMD, mean age 24.2), 18 Becker's MD (BMD, mean age 42.4), 13 limb‐girdle MD (LGMD, mean age 43.1), and 14 facioscapulohumeral MD (mean age 47.7). Body fat (%) and lean body mass (LBM) were measured using bioelectrical‐impedance. Gastrocnemius medialis (GM) anatomical cross‐sectional area (ACSA) was determined using B‐mode ultrasound. Isometric maximal voluntary contraction (MVC) was assessed during plantar flexion (PFMVC) and knee extension (KEMVC). PA was measured for seven continuous days using triaxial accelerometry and was expressed as daily average minutes being physically active (TPAmins) or average daily percentage of waking hours being sedentary (sedentary behaviour). Additionally, 10 m walk time was assessed.ResultsMuscular dystrophy groups had 34–46% higher body fat (%) than CTRL. DMD showed differences in LBM with 21–28% less LBM than all other groups. PFMVC and KEMVC were 36–75% and 24–92% lower, respectively, in MD groups than CTRL. GM ACSA was 47% and 39% larger in BMD and LGMD, respectively, compared with CTRL. PFMVC was associated with GM ACSA in DMD (P = 0.026, R = 0.429) and CTRL (P = 0.015, R = 0.553). MD groups were 14–38% more sedentary than CTRL groups, while DMD were more sedentary than BMD (14%), LGMD (8%), and facioscapulohumeral MD (14%). Sedentary behaviour was associated with LBM in DMD participants (P = 0.021, R = −0.446). TPAmins was associated with KEMVC (P = 0.020, R = 0.540) in BMD participants, while TPAmins was also the best predictor of 10 m walk time (P < 0.001, R 2 = 0.540) in ambulant MD, revealed by multiple linear regression.ConclusionsQuantified muscle weakness and impaired 10 m walking time is reported in adults with MD. Muscle weakness and 10 m walk time were associated with lower levels of TPA in adults with MD. Higher levels of sedentary behaviour were associated with reduced LBM in DMD. These findings suggest a need for investigations into patterns of PA behaviour, and relevant interventions to reduce sedentary behaviour and encourage PA in adults with MD regardless of impairment severity.

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“…This is one among the many different definitions of sarcopenia that have been suggested; however, no international consensus has been arrived at in this question. 19 Yang et al conducted a prospective observational study in acute care wards in teaching hospitals in Western China and obtained the survival status and readmission information after 12, 24, and 36 months after the baseline investigation. Whilst the total sample included 719 participants, incidence data were available for 302 participants with an incidence rate for sarcopenia of 3.7 cases per 100 personyears at risk.…”

Section: Prevalence and Incidence Of Sarcopenia In Elderly Populationsmentioning

confidence: 99%

Muscle wasting and sarcopenia in heart failure: a brief overview of the current literature

Haehling

2018

ESC Heart Failure

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The incidence of sarcopenia among hospitalized older patients: results from the Glisten study

Cited by 164 publications

References 40 publications

Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems

Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems

Relationships between muscle size, strength, and physical activity in adults with muscular dystrophy

Muscle wasting and sarcopenia in heart failure: a brief overview of the current literature

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