The Relationship between Sarcopenia and Respiratory Muscle Weakness in Community-Dwelling Older Adults

Abstract

An association between respiratory muscle weakness and sarcopenia may provide a clue to the mechanism of sarcopenia development. We aimed to clarify this relationship among community-dwelling older adults. In total, 117 community-dwelling older adults were assessed and classified into 4 groups: robust, respiratory muscle weakness, sarcopenia, and respiratory sarcopenia. The respiratory sarcopenia group (12%) had a significantly higher percentage of males and had lower BMI, skeletal muscle index, skeletal muscle mass, phase angle, and oral function than the robust group (32.5%). All physical functions were significantly lower. The respiratory muscle weakness group (54.7%) had a significantly lower BMI and slower walking speed, compared with the robust group. The sarcopenia group (0.8%) was excluded from the analysis. The percent maximum inspiratory pressure was significantly lower in both the respiratory muscle weakness and respiratory sarcopenia groups, compared with the robust group. Almost all participants with sarcopenia showed respiratory muscle weakness. In addition, approximately 50% had respiratory muscle weakness, even in the absence of systemic sarcopenia, suggesting that respiratory muscle weakness may be the precursor of sarcopenia. The values indicating physical function and skeletal muscle mass in the respiratory muscle weakness group were between those in the robust and the respiratory sarcopenia groups.

Comparison of Characteristics of Definition Criteria for Respiratory Sarcopenia—The Otassya Study

“…According to a previous study on the relationship between sarcopenia and respiratory muscle strength, there was low respiratory muscle strength in sarcopenia [ 23 ]. Furthermore, when sarcopenia was set as an independent variable, the AUCs of MIP (men: 0.793, women: 0.734) and MEP (men: 0.739, women: 0.715) were moderate, indicating a significant relationship between sarcopenia and respiratory muscle strength [ 22 ].…”

Patterns of Changes in Respiratory Muscle Strength over 1 Year in Non-Sarcopenia, Sarcopenia, and Severe Sarcopenia

“…Therefore, experts have yet to reach a consensus on its definition, and the validity and reliability of the diagnostic criteria have not yet been evaluated in detail. Furthermore, most of the studies on respiratory sarcopenia to date have consisted of cross-sectional designs [ 9 , 10 , 11 , 12 , 13 , 14 ], and the patient characteristics that predict a decline in respiratory muscle strength have not been identified. This study is the first to report changes in respiratory muscle strength over time according to the severity of sarcopenia.…”

“…Morisawa et al noted lower respiratory muscle strength in approximately 50% of patients without whole-body sarcopenia, suggesting that lower respiratory muscle strength may be a precursor to sarcopenia [ 14 ]. The underlying physiology of this disease may be explained by the notion of respiratory muscle-induced metaboreflex.…”

“…Older adults with sarcopenia are reported to have a thin diaphragm [ 13 ]. Furthermore, there is a difference in physical function and muscle strength between people with lower respiratory muscle strength associated with sarcopenia and those with lower respiratory muscle strength alone [ 14 ]. However, no previous studies have investigated the changes in this relationship over time because previous studies on respiratory sarcopenia have primarily used cross-sectional study designs.…”

Repetitive transcranial magnetic stimulation combined with respiratory muscle training for pulmonary rehabilitation after ischemic stroke—A randomized, case-control study

“…Studies have proved that the respiratory muscle strength of the affected side also decreases after stroke ( Ramos et al, 2020 ). The weakness of respiratory muscle shows low endurance during exercise and independent walking ability ( Morisawa et al, 2021 ). Respiratory muscle weakness in stroke patients is usually manifested as pulmonary infection, respiratory failure, atelectasis or sleep disorders ( Jung et al, 2014 ; Liaw et al, 2020 ; Bruce et al, 2022 ).…”