Treatment of sarcopenia: the road to the future

Morley, John E.

doi:10.1002/jcsm.12386

Cited by 58 publications

(58 citation statements)

References 69 publications

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“…This coherence might be an advantage for the development of therapeutic approaches and design of trials that could benefit both diseases. 38,39 Data from our research group indicate that GLIM criteria are also strong predictors of the onset of sarcopenia, as they were associated with an approximately four-fold higher risk of developing sarcopenia and severe sarcopenia during a 4-year follow-up. 40 Surprisingly, no association was found between malnutrition and institutionalization, hospitalization, falls, and fractures.…”

Section: Discussionmentioning

confidence: 97%

Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study

Sánchez-Rodríguez

Locquet

Reginster

et al. 2020

J cachexia sarcopenia muscle

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Background The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently launched by consensus of the major nutrition societies. GLIM criteria are partly constructed on the previous definition of malnutrition developed by the European Society of Clinical Nutrition and Metabolism (ESPEN). We aimed to assess malnutrition according to the ESPEN and GLIM criteria at baseline and to determine the corresponding risk of mortality during a 4-year follow-up in community-dwelling older adults from the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study. The relationship between malnutrition and incidence of 4-year adverse health consequences (institutionalization, hospitalization, falls, and fractures) was assessed. Methods This prospective population-based cohort was part of SarcoPhAge, which included 534 older adults in Belgium, followed up from 2013 to 2019. Community-dwelling healthy volunteers ≥65 years old were recruited. Mortality and adverse health consequences were collected annually by interview or phone call. Baseline malnutrition was defined according to the GLIM and ESPEN criteria. Agreement between the two definitions was reported by Cohen's kappa coefficient. Adjusted Cox regression and Kaplan-Meier survival curves were performed for malnutrition. Logistic regression was used for the other outcomes. Results From 534 subjects in SarcoPhAge, the records for 411 participants (73.2 ± 6.05 years old; 55.7% women) had all the variables needed to apply the GLIM criteria. Prevalence of baseline malnutrition was 23.4% for GLIM and 7% for ESPEN criteria (k = 0.30, low agreement). The adjusted Cox regression showed a significant increased mortality risk according to malnutrition status as defined by the GLIM [adjusted hazard ratio = 4.41 (95% confidence interval: 2.17-8.97)] and ESPEN [adjusted hazard ratio = 2.76 (95% confidence interval: 1.16-6.58)] criteria. Survival curves differed significantly between malnourished and non-malnourished groups, regardless of the definition used (log rank P < 0.001 for both). No association was found between baseline malnutrition according to these two criteria and 4-year risk of institutionalization, hospitalization, falls, or fractures (all P > 0.05). Conclusions Malnutrition according to the GLIM criteria was associated with a 4.4-fold higher mortality risk, double that of the ESPEN criteria, during a 4-year follow-up. No association was found between malnutrition according to these two criteria and incidence of other health adverse consequences. GLIM criteria anticipate mortality and might guide interventions, with important implications for clinical practice and research.

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Section: Discussionmentioning

confidence: 97%

Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study

Sánchez-Rodríguez

Locquet

Reginster

et al. 2020

J cachexia sarcopenia muscle

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“…Accordingly, adaptations of bone and muscle tissue to reduced or increased loading conditions coincide . Because of the obvious beneficial effects of physical activity on muscle and bone health, physical activity is recommended for the prevention and treatment of osteoporosis and sarcopenia . However, hormonal changes seem to be the major contributors to the changes in muscle and bone tissue in women undergoing the menopausal transition, whereas the level of physical activity seems to play a lesser role during this phase of life.…”

Section: Introductionmentioning

confidence: 99%

Muscle and bone mass in middle‐aged women: role of menopausal status and physical activity

Sipilä

Törmäkangas

Sillanpää

et al. 2020

J cachexia sarcopenia muscle

130

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Background Women experience drastic hormonal changes during midlife due to the menopausal transition. Menopausal hormonal changes are known to lead to bone loss and potentially also to loss of lean mass. The loss of muscle and bone tissue coincide due to the functional relationship and interaction between these tissues. If and how physical activity counteracts deterioration in muscle and bone during the menopausal transition remains partly unresolved. This study investigated differences between premenopausal, early perimenopausal, late perimenopausal, and postmenopausal women in appendicular lean mass (ALM), appendicular lean mass index (ALMI), femoral neck bone mineral density (BMD) and T score. Furthermore, we investigated the simultaneous associations of ALM and BMD with physical activity in the above‐mentioned menopausal groups. Methods Data from the Estrogen Regulation of Muscle Apoptosis study were utilized. In total, 1393 women aged 47–55 years were assigned to premenopausal, early perimenopausal, late perimenopausal, and postmenopausal groups based on follicle‐stimulating hormone concentration and bleeding diaries. Of them, 897 were scanned for ALM and femoral neck BMD by dual‐energy X‐ray absorptiometry and ALMI (ALM/height2) and neck T scores calculated. Current level of leisure‐time physical activity was estimated by a validated self‐report questionnaire and categorized as sedentary, low, medium, and high. Results Appendicular lean mass, appendicular lean mass index, femoral neck bone mineral density, and and T score showed a significant linear declining trend across all four menopausal groups. Compared with the postmenopausal women, the premenopausal women showed greater ALM (18.2, SD 2.2 vs. 17.8, SD 2.1, P < 0.001), ALMI (6.73, SD 0.64 vs. 6.52, SD 0.62, P < 0.001), neck BMD (0.969, SD 0.117 vs. 0.925, SD 0.108, P < 0.001), and T score (−0.093, SD 0.977 vs −0.459, SD 0.902, P < 0.001). After adjusting for potential confounding pathways, a higher level of physical activity was associated with greater ALM among the premenopausal [β = 0.171; confidence interval (CI) 95% 0.063–0.280], late perimenopausal (β = 0.289; CI 95% 0.174–0.403), and postmenopausal (β=0.278; CI 95% 0.179–0.376) women. The positive association between femoral neck BMD and level of physical activity was significant only among the late perimenopausal women (β = 0.227; CI 95% 0.097–0.356). Conclusions Skeletal muscle and bone losses were associated with the menopausal transition. A higher level of physical activity during the different menopausal phases was beneficial, especially for skeletal muscle. Menopause‐related hormonal changes predispose women to sarcopenia and osteoporosis and further to mobility disability and fall‐related fractures in later life. New strategies are needed to promote physical activity among middle‐aged women. Longitudinal studies are needed to confirm these results.

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“…At present, the only candidate with robust evidence for treating sarcopenia in older adults is exercise 6 – 8 . Unfortunately, the best approach to exercise sarcopenic patients has not yet been established 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of resistance and balance exercise for sarcopenic patients aged 80–99 years

Liang

Wang

Jiang

et al. 2020

Sci Rep

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We compared a mixed exercise program (i.e., balance exercise plus resistance exercise) with resistance exercise in a single-blind, randomized controlled trial in a post-acute care unit. In total, 60 sarcopenic patients were randomly assigned to an intervention group (12-week mixed exercise) and a control group (12-week resistance exercise). The primary outcomes were the change of the Barthel Index and the number of fallers. The intervention group showed a mean increase of 9.5 points on the Barthel Index (95% confidence interval (CI) 3.9–15.1), while the control group showed a mean increase of 6.3 points (95% CI 2.3–10.4). The mixed exercise program provided a significant benefit over resistance exercise (adjusted mean difference of the change of Barthel Index: 6.8 points; 95% CI 1.4–12.1). The number of fallers was 13.3% and 23.3% in the intervention and control groups, respectively, but the difference was not significant (risk ratio (RR) 0.89, 95% CI 0.69–1.13, p = 0.506). In conclusion, compared with resistance exercise, the mixed exercise program appears to further improve the activities of daily living and physical performance in our study population. Under the monitoring of experienced physiotherapists, both exercise programs are feasible and safe for this population.

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Treatment of sarcopenia: the road to the future

Cited by 58 publications

References 69 publications

Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study

Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study

Muscle and bone mass in middle‐aged women: role of menopausal status and physical activity

A randomized controlled trial of resistance and balance exercise for sarcopenic patients aged 80–99 years

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