This research was to explore the effectiveness, safety, and adherence of home-based strength and balance exercises for fall prevention among the self-reliant individuals of advanced age and analyzed the beneficial components.

This randomized controlled single-blind study included 124 individuals aged 80 years and over(mean age 84.4±3.2 years). The test group (n=63) performed strength and balance exercises facilitated by sports video training (≥ 3 sessions a week, ≥ 30 minutes per session), while the control group (n=61) maintained their daily routines. We conducted a comprehensive geriatric assessment (self-care ability, muscle strength, mobility, cognition, and psychological status) at baseline and 12 months later and dynamic posture mapping for balance and gait.

The test group had a decreased risk of falls compared to the control group (25.4%vs.44.3%, respectively; RR = 0.747; 95% CI: 0.551-0.975; p = 0.027). There was no statistically significant difference in the fall rate between the two groups (0.48 falls per person-year vs. 0.67 falls per person-year, respectively; IRR: 0.708; 95% CI: 0.394-1.275; p = 0.251). The composite equilibrium score (SOTcom) for vestibular and integrated balance on the Sensory Organization Test (SOT) increased in the test group, while SOTcom decreased in the control group. In the test group, there was a significant improvement in the indexes pertaining to response time, movement speed, directional control, and endpoint offset in some directions. Adherence was better in the test group, with 54.0% exercised ≥ 3 times per week and 28.6% exercised 1-2 times per week on average.

Home-based strength and balance exercises improved balance and reduced the risk of falls among the individuals of advanced age. The video-guided, remotely monitored regimen demonstrated effectiveness, safety, and compliance, although scope for improvement remains.

The global rise in type 2 diabetes mellitus (T2DM) poses challenges, particularly with the increasing burden of sarcopenia and poor glycemic control. Phase angle (PhA) is a promising biomarker for early detection and management of these conditions. This study aimed to evaluate PhA as an independent predictor of sarcopenia and glycemic control.

This cross-sectional study included older adults with T2DM hospitalized for diabetes education between April 2021 and March 2023. Measurements included PhA, muscle mass, body fat mass, grip strength, knee extension strength, physical function (Short Physical Performance Battery and 6-min walk distance), and glycemic control (fasting blood glucose and hemoglobin A1c [HbA1c]). Sarcopenia was defined as low muscle mass and physical function. Analyses included Pearson correlations, receiver operating characteristic curve analysis, and multivariate logistic regression.

PhA was moderately correlated with muscle mass (r = 0.42, p < 0.001), grip strength (r = 0.43, p < 0.001), and body mass index (r = 0.27, p = 0.001), and inversely correlated with HbA1c (r = - 0.34, p < 0.001) and age (r = - 0.26, p = 0.003). PhA showed a strong predictive ability for sarcopenia (AUC = 0.83, 95% CI: 0.76-0.90, p < 0.001). Logistic regression indicated PhA as an independent predictor of sarcopenia (OR = 0.105, 95% CI: 0.031-0.353, p < 0.001) and glycemic control (OR = 0.380, 95% CI: 0.201-0.719, p = 0.003).

PhA is a non-invasive, practical tool for predicting sarcopenia and monitoring glycemic control. Routine integration of PhA could identify high-risk patients and guide interventions. Future research should validate its application in diverse settings.

The online version contains supplementary material available at 10.1007/s40200-025-01590-z.

Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia.

654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors.

The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors.

Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms.

Sarcopenia is the disease characterized by muscle loss, and leading to functional decline and increased mortality, especially affects the elderly. Gait abnormalities are common perform the dysfunction but are understudied quantitatively.

Sixty-two participants (20 sarcopenia, 42 healthy) were recruited for gait analysis. The clinically characterized data including anthropometric data, muscle mass, handgrip strength were measured. The spatiotemporal and the kinematic parameters during gait were also captured through the motion capture.

Sarcopenia patients exhibited significantly reduced stride length (1.12 ± 0.13 m vs. 1.20 ± 0.10 m, p = 0.006) and gait speed (0.96 ± 0.14 m/s vs. 1.10 ± 0.12 m/s, p < 0.001), alongside increased stride time (1.17 ± 0.08 s vs. 1.10 ± 0.08 s, p = 0.005) compared to healthy controls. Joint kinematics revealed significant differences in hip flexion-extension range (40.66° ± 5.44° vs. 41.69° ± 6.12°, p < 0.05) and knee adduction-abduction range (10.51° ± 3.53° vs. 13.85° ± 5.28°, p < 0.05) during gait stance phase.

The reduced stride length and speed, along with wider step width, highlight the functional decline impacted by sarcopenia. The gait patterns were also influenced with patients adopting conservative strategies for stability. Joint angle differences suggest limitations in sagittal and coronal plane movements, affecting balance and joint biomechanics. This quantitative study demonstrates the functional impact of sarcopenia on gait, emphasizing the need for comprehensive assessment and tailored interventions to improve mobility and quality of life in elderly populations.

Sarcopenia usually manifests as a decrease in muscle mass and strength, seriously affecting the quality of life and independent living ability of elderly people. Moreover, sarcopenia is associated with various adverse outcomes such as mortality, postoperative infections, and severe complications, as well as affecting the balance and plantar pressure of the elderly.

What are the characteristics of balance ability and plantar pressure in sarcopenia population across different standing postures?

A plantar pressure measurement system was used to measure the COP parameters and plantar pressure of 70 individuals in four standing postures: Feet 10 cm apart (FA), Feet together (FT), Feet Semi Tandem (FST), and Feet Full Tandem (FFT). The plantar area was divided into ten regions based on the anatomical structure of the foot. An independent samples t-test was conducted for significance testing, and developed sarcopenia screening models based on binary logistic regression.

Research has found that there are significant differences in the center of plantar pressure (COP) speed, 95 % elliptical region, COP length, and short axis length between populations with and without sarcopenia in the FST stance. The analysis of plantar pressure showed that the main differences between the two groups were located in the metatarsal and heel regions, and the accuracy of the binary logistic regression model constructed based on the FFT stance plantar pressure data without weight-adjusted for screening sarcopenia was as high as 94.3 %, which was superior to other standing postures.

The difference in balance ability between sarcopenia population and non-sarcopenia population is reflected in standing posture with a relatively narrower base of support on the plantar surface (FST), and FFT stance plantar pressure can be used as a new method for screening sarcopenia.

To compare the diagnostic accuracy of possible sarcopenia identification pathways, as suggested by Asian Working Group for Sarcopenia (AWGS) in 2019, by gender among Korean community-dwelling older adults.

Cross-sectional analysis of data from 2,129 community-dwelling adults (70-84 years, 50.4% men) enrolled in Korean Frailty and Aging Cohort Study.

Based on AWGS 2019 guideline, possible sarcopenia was defined by low handgrip strength (HGS) or slow five-times chair stand test (5CST) time, referred to as "assessments." "Case-findings" (low calf circumference [CC], SARC-F ≥4, or SARC-CalF ≥11) were recommended for screening 'possible sarcopenia' before assessment. For the six 'possible sarcopenia' pathways (combining three case-finding and two assessment tools), area under the curve (AUC) and F1 score are compared.

For case-finding in men, CC demonstrated the highest AUC (0.657) and F1 score (0.504) for predicting sarcopenia compared with SARC-F and SARC-CalF (p <0.001, =0.001). Among men with low CC, ΔAUC between HGS and 5CST was not significant as assessment (p=0.079) (AUCs: 0.763 vs. 0.707; F1 scores: 0.713 vs. 0.650). For case-finding in women, SARC-CalF demonstrated the highest AUC (0.631) and F1 score (0.389) compared with CC and SARC-F (p=0.012, <0.001). Subsequently, ΔAUC between HGS and 5CST was not significant in women (p=0.069) (AUCs: 0.566 vs. 0.636; F1 scores: 0.387 vs. 0.514).

Based on AWGS 2019 guideline, CC in men and SARC-CalF in women was the best case-finding tool for community-dwelling older adults. After the best case-finding in each gender, two assessment pathways demonstrated insignificant difference in both genders.

For case-finding of possible sarcopenia, using calf circumference in older men and using SARC-CalF in older women demonstrated the highest diagnostic accuracy for predicting sarcopenia. After the best case-finding in each gender, two assessment pathways (handgrip strength and five-times chair stand test) of possible sarcopenia demonstrated insignificant difference in both genders.

Evidence of an association between sarcopenic obesity (SO) and the risk of long-term atrial fibrillation (AF) is lacking, and the underlying involvement of insulin resistance (IR) and inflammation is not clear.

This community-based prospective cohort study evaluated sarcopenia, obesity, and baseline clinical characteristics in 4321 non-diabetic older adults between 2007 and 2011. Sarcopenia was identified using skeletal muscle mass/body weight (SMM/BW), appendicular lean mass (ALM)/BW, and handgrip strength (HGS), and obesity was identified by fat mass (FM)/BW. The association of sarcopenia and obesity with AF risk was determined by Kaplan-Meier analysis and a Cox proportional hazards model. Interaction analysis, a restricted cubic splines model, mediation analysis, and a Fine-Gray competing-risk model were also used.

Over an average of 10.9 years of follow-up, 546 (11.98 per 1000 person-years) participants developed AF. Low SMM/BW, low ALM/BW, low HGS, high FM/BW, sarcopenia and obesity, were significantly associated with an increased AF risk. There was a significant synergistic relationship between sarcopenia and obesity in the increased AF risk [hazard ratio (HR): 2.029, 95 % confidence interval (CI): 1.639-2.512]. Compared with participants without sarcopenia and obesity, AF risk was the highest in those with SO (HR: 2.669, 95 % CI: 2.110-3.377], followed by sarcopenia alone (HR: 1.980, 95%CI: 1.453-2.699) and obesity (HR: 1.839, 95%CI: 1.475-2.292). Mediation analysis found that estimated glucose disposal rate (a surrogate marker of IR), high-sensitivity C-reactive protein, and galectin-3 were mediating factors in the increased AF risk caused by SO, accounting for 34.87 %, 27.56 %, and 21.05 % of the total effect, respectively.

SO significantly increased AF risk in these non-diabetic older individuals. Sarcopenia and obesity not only acted alone but also exhibit had a synergistic relationship to increase AF risk. IR and inflammation mediated the increased AF risk associated with SO.

Sarcopenia and diabetes are prevalent diseases among middle-aged and elderly population. This study aimed to investigate the bidirectional association between sarcopenia and diabetes.

This study comprised two longitudinal analyses. In cohort 1, the association between baseline diabetes and the risk of new-onset sarcopenia was assessed. In cohort 2, the association between baseline sarcopenia and the risk of new-onset diabetes was examined. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (95 % CI). Cross-lagged panel analysis was used to further validate their bidirectional associations.

Significant bidirectional associations were observed between sarcopenia and diabetes in both cross-sectional and longitudinal analyses (P < 0.05). After four years of follow-up, low handgrip strength (OR: 2.31, 95 % CI: 1.74-3.08) and appendicular skeletal muscle mass index (ASM/Ht2) (OR: 1.25, 95 % CI: 1.20-1.30) were associated with an increased risk of diabetes. Conversely, elevated fasting plasma glucose (FPG) (OR: 1.52, 95 % CI: 1.17-1.96) and glycated hemoglobin A1c (HbA1c) (OR: 1.35, 95 % CI: 1.05-1.73) were associated with a higher risk of sarcopenia. Cross-lagged analysis further confirmed their bidirectional longitudinal association.

This study identified significant longitudinal bidirectional association between sarcopenia and diabetes, highlighting that each condition serves as a risk factor for the other. Clinically, early assessments of handgrip strength and ASM/Ht2 may aid in diabetes prevention, while monitoring FPG and HbA1c could help reduce the risk of sarcopenia.

Findings regarding dietary protein and frailty are inconsistent. This inconsistency may be attributed to variations in energy intake adequacy. We hypothesized that the prevalence of frailty in older adults with sufficient energy intake is inversely associated with the intake of total, animal, and plant proteins; however, in those with deficient energy intake, this association may not be observed.

This cross-sectional study included data of 5,768 adults aged ≥65 years from the Korea National Health and Nutrition Examination Survey 2014-2018. Frailty was assessed using a modified Cardiovascular Health Study frailty index. Protein intake was measured via a 24-h recall and analyzed using multivariable logistic regression.

In older adults with sufficient energy intake, frailty was inversely associated with the intake of total (odds ratio [OR], 0.67; 95% confidence interval [CI], 0.46-0.97; p = 0.032), animal (OR, 0.59; 95% CI, 0.43-0.82; p = 0.001), and plant proteins (OR, 0.68; 95% CI, 0.50-0.92; p = 0.043). In those with deficient energy intake, total and animal protein intake showed no significant associations with frailty, whereas plant protein intake was inversely associated with frailty.

Adequate energy intake appears essential for the protective effects of total and animal protein against frailty. Higher plant protein intake appears to confer benefits regardless of energy intake, highlighting its potential role in frailty prevention.

To assess the interaction of dynapenic abdominal obesity (DAO) and sleep duration on the risk of functional disability among middle-aged and older Chinese individuals.

Data were extracted from the China Health and Retirement Longitudinal Study conducted in 2011, 2013, 2015, 2018, and 2020. A total of 6,343 participants were enrolled in this retrospective cohort study. Sleep duration was obtained through face-to-face interviews. Dynapenia (D) and abdominal obesity (AO) were defined by handgrip strength and waist circumference, respectively. Functional disability was assessed according to activities of daily living scales. Cox proportional hazard models analyzed the interactions of DAO and sleep duration on functional disability.

Over a mean follow-up of 10 years, 3,879 (61.2%) participants reported functional disability. Individuals with short sleep duration and D/AO (appropriate but short: RR = 1.42, 95% CI = 1.10-1.82, too short sleep: RR = 1.54, 95% CI = 1.16-2.06), long sleep duration and D/AO (appropriate but long: RR = 1.61, 95% CI = 1.11-2.33; too long: RR = 1.63, 95% CI = 1.15-2.32), were more likely to develop functional disability than those with normal sleep duration and ND/NAO in the fully adjusted model. The multiplicative interaction between the short sleep group and D/NAO or ND/AO were both significant. Middle-aged individuals and females were more susceptible to the effects of short sleep and DAO, while elderly individuals and males were more susceptible to the effects of long sleep and DAO.

Short and long sleep durations combined with DAO increase the risk of functional disability. Managing waist circumference and improving grip strength in middle-aged and older adults with abnormal sleep durations may help prevent functional disability.

Sarcopenia is a clinical syndrome characterized by the loss of muscle mass quantity and quality. Our objective was to establish the prevalence of low muscle reserve, risk of sarcopenia (RIS) and probable sarcopenia (PS) and their associations with survival at two years in hospitalized patients with cancer.

This was a post hoc analysis of the Nutri-Score and Malnutrition Screening Tool (MST) operational characteristics. Adjusted calf circumference (CC) was used as an indicator of muscle reserve. The RIS was determined using cut-off points of the CC. PS was defined as low hand grip strength (HGS) according to Working Groups on Sarcopenia also the presence of RIS with PS was analysed. A 2-year survival model was constructed.

A total of 137 patients were included: 54 % were women, with a mean age of 54.7 ± 15.4 years; 61 % had some degree of malnutrition; 48 % had low muscle reserve; 42 % had RIS; 28 % and 38 % had PS and 25 % had RIS with PS. Severe muscle reserve deficit (Hazard Ratio (HR) = 2.71, 95 % Interval Confidence (95 % CI) 1.37-5.37), RIS (HR = 2.94 95 % 1.66-5.21), PS (HR = 1.85 95 % 1.06-3.22) and (HR = 1.94 95 % 1.09-3.41) by two different consensus and RIS with PS (HR = 2.36 95 % CI 1.33-4.19) were associated with survival.

Severe muscle reserve deficit, RIS and PS are associated with decreased survival in hospitalized patients with oncological disease.

Phase angle is a promising tool for diagnosing sarcopenia. This study aimed to summarize its diagnostic performance by performing a systematic review and meta-analysis.

We conducted a systematic search of PubMed, Web of Science, Embase, and Scopus. The Quality Assessment of Diagnostic Accuracy Studies, Version 2, was used to evaluate the quality of the studies. A bivariate random effects model was employed for data synthesis, and diagnostic performance was reported in terms of pooled sensitivity, specificity, and the area under the summary receiver operating characteristic curve (AUC). Additionally, meta-regression, subgroup analyses, and sensitivity analyses were performed.

A total of 15 studies were included in this meta-analysis, involving 4,063 participants. The overall risk of bias in the included studies was high. The meta-analysis revealed that the pooled sensitivity and specificity across all studies were 0.74 [95 % confidence interval (CI): 0.71-0.78] and 0.75 (95 % CI: 0.70-0.79), respectively, with an AUC of 0.79 (95 % CI: 0.76-0.83). Meta-regression indicated that study design, country, population, sex-specificity, and age may influence the diagnostic performance of phase angle. The optimal diagnostic performance was observed in the cut-off interval of 4.20 to 4.50°.

The phase angle demonstrated moderate diagnostic performance for sarcopenia, and the possible cut-off interval is 4.20 to 4.50 °. However, large-scale, multicenter prospective studies are necessary to assess its clinical applicability at specific cut-off values.

Frailty transition is common, and increased physical activity can prevent it. An objective assessment of physical activity could eliminate bias and provide more precise information on the association between frailty transitions and physical activity.

This study aimed to examine the association between objective physical activity and frailty transition in community-dwelling prefrail Japanese older adults.

This is a retrospective cohort study based on the National Institute for Longevity Science-Longitudinal Study of Aging data.

A total of 387 community-dwelling older adults with prefrailty were enrolled (mean age 72.0 years).

Frailty was assessed using modified components of the Cardiovascular Health Study criteria, and frailty statuses were reassessed two years later. The frailty transitions were categorized into three groups: deterioration, persistence, and reversal. Participants wore a uniaxial accelerometer to assess the physical activities. Differences in baseline characteristics according to frailty transitions were assessed. To compare the baseline objective physical activities based on frailty transition, a general linear model and a logistic regression model were used.

Among the 387 participants, 40 (10.3%) deteriorated to frailty, 97 (25.0%) reversed to robust, and the majority (n = 250, 64.6%) remained prefrail after a 2-year follow-up. Using the general linear model, after adjusting for other factors, total energy expenditure (TEE) in the reversal group was significantly higher than that in the deterioration and persistence groups. No differences in TEE were observed between the persistence and deterioration groups. No significant differences existed in the numbers of daily steps, exercise energy expenditure (EEE) and physical activity with different intensity among these three groups. The logistic model also showed a significant association between TEE and the reversal of frailty.

Frailty transitions were common in the Japanese prefrail population. This study showed that a higher TEE was positively associated with frailty reversal in prefrail older adults. Promoting proactive programs for older adults to increase physical activity could help them stay healthy and prevent frailty deterioration.

To undertake a systematic review and meta-analysis to examine the evidence base for the effects of β-hydroxy-β-methylbutyrate (HMB) supplementation in patients with sarcopenia.

Systematic review and meta-analysis.

The literature was searched via the PubMed, MEDLINE, Web of Science, EMBASE, CINAHL, Scopus, WANFANG, CNKI and VIP databases, through 23rd February 2024. The inclusion criteria were: randomized controlled trials (RCTs); patients diagnosed with sarcopenia defined according to well-accepted clinical consensus; HMB as an intervention; outcomes on muscle mass and/or muscle strength and/or physical performance. Data extraction was completed by independent pairs of reviewers. Meta-analyses of continuous outcomes were performed on the extracted data. Standard mean difference (SMD) with 95 % confidence intervals (CIs) between treatment and control group were used to express intervention effect estimates of HMB for each study. Risk of bias was assessed according to Version 2 of the Cochrane tool for assessing risk of bias in randomized trials (ROB 2).

Of 196 records retrieved and screened, five RCTs met the eligibility criteria for qualitative and quantitative analysis, yielding 154, 359 and 359 participants for muscle mass, muscle strength, and physical performance, respectively. For the overall risk of bias, no studies were graded as "high risk of bias", one (20.0 %) as "some concerns", and four (80.0 %) as "low risk of bias" according to the ROB 2. The overall meta-analysis revealed a beneficial effect on muscle mass and strength, as demonstrated by a higher skeletal muscle mass index (SMD = 0.32; 95 % CI: [0.00,0.64]; Z value =1.98; P = 0.048), along with an elevated handgrip strength (SMD = 0.65; 95 % CI: [0.05, 1.25]; Z value = 2.12; P = 0.034) in the HMB intervention groups compared with the control groups. However, there was no evidence of a benefit on physical performance, assessed by gait speed (SMD = 0.19; 95 % CI: [-0.14, 0.53]; Z value = 1.14; P = 0.255).

Overall, although limited and requiring interpretation with utmost caution, current evidence indicates that HMB supplementation is beneficial for improving muscle mass and strength, but there is no evidence of a benefit on physical performance in patients with sarcopenia. In future, more well-designed HMB intervention trials should be conducted that include populations diagnosed with sarcopenia according to well-accepted clinical consensus.

Measuring urinary titin levels is expected to be useful in screening for muscle damage or injury in various diseases. We evaluated whether urinary titin levels were elevated in individuals with type 2 diabetes mellitus (T2DM) and how urinary titin levels were associated with the diagnosis of sarcopenia in T2DM.

We performed a cross-sectional analysis of 114 controls and 515 patients with T2DM. Multivariate-adjusted models were used to determine the odds ratios (OR) of urinary titin cutoff values for diagnosing sarcopenia.

Urinary titin levels were higher in the T2DM group than in the non-diabetes group after propensity score matching (median [IQR] 3.2 [2.3, 4.6] vs. 4.4 [2.7, 6.9] pmol/mg·creatinine). T2DM was associated with high titin levels after correction for comorbidities (odds ratio 2.46, 95% confidence interval (CI) 1.29-4.70, P = 0.006) but not after correction for sarcopenia-associated factors. Urinary titin levels above the cutoff value showed an odd ratio of 6.61 (age- and body mass index-adjusted, 1.26-34.6, P = 0.021) for the diagnosis of sarcopenia in men with T2DM aged ≥ 75 years.

Results indicated that T2DM was associated with a high-titin state and that the urinary titin cutoff value could be useful for identifying candidates at high risk for sarcopenia, such as elderly men.

Data regarding the association between cachexia and clinical outcomes in hepatopancreatobiliary (HPB) malignancies are limited. This retrospective study sought to investigate the prognostic significance of preoperative cachexia in patients undergoing major HPB surgery for malignancies.

Data from patients, who underwent major open surgery for HPB malignancies between March 2014 and December 2018, were retrospectively reviewed. Cachexia was evaluated a few days before surgery, and defined according to modified Asian Working Group for Cachexia criteria: low body mass index (<21 kg/m2) and decreased handgrip strength (<28 kg [males] and <18 kg [females]) or elevated C-reactive protein level (>0.5 mg/dL). The primary endpoint was postoperative overall survival (OS); secondary endpoints included disease-free survival (DFS) and postoperative complications.

Of 332 patients (228 male; mean age, 68.8 ± 10.3 years), 93 (28 %) had preoperative cachexia. There were 154 (46 %) deaths and 181 (55 %) combined events (death or recurrence) during a five-year follow-up (mean, 3.3 ± 1.7 years), with no significant differences in major postoperative complications between the 2 groups (P = 0.329). After adjusting for covariates, cachexia (n = 93) exhibited significant associations with shorter OS (adjusted hazard ratio [HR] 1.65 [95 % confidence interval (CI) 1.18-2.30]; P = 0.004) and DFS (adjusted HR 1.39 [95 % CI 1.01-1.91; P = 0.043) compared with non-cachexia (n = 239). Cachexia significantly shortened OS only in a subset with pathological stage ≤ II disease (adjusted HR 2.45 [95 % CI 1.27-4.74]; P = 0.008) but not otherwise (P for interaction, 0.040).

Preoperative cachexia did not affect short-term surgical complications but significantly deteriorated postoperative prognosis in patients who underwent surgery for HPB malignancies.

The existing diagnostic criteria for cancer cachexia do not meet clinical needs. We aimed to establish novel comprehensive evaluation scales for cachexia specific to patients with solid tumours.

This study included 12 651 patients (males: 6793 [53.7%]; females: 5858 [46.3%]; medium age: 58 [interquartile range:50/66] years; medium follow-up duration: 24.16 [13.32/44.84] months; 4271 [33.8%] patients died; mean survival: 55.53 [95% confidence interval, 54.87/56.10] months; 3344 [26.4%], 4184 [33.1%] and 5123 [40.5%] patients with Stage I-II, III and IV tumour, respectively; derivation set: 10022, validation set: 2629 patients) with 14 types of solid tumours, including lung, gastric, liver, breast, oesophageal, cervical, bladder, pancreatic, prostate, ovarian, colorectal cancer, nasopharyngeal and endometrial carcinoma and cholangiocarcinoma, from an open and ongoing multicentre cohort study in China. Risk factors for cachexia, including tumour characteristics and nutritional parameters, were examined to develop diagnostic scales using Cox proportional hazards models and Kaplan-Meier analysis.

Ten nutrition items (body mass index, weight loss, intake reduction, physical activity function, fatigue, handgrip strength, anorexia, albumin level, albumin/globulin ratio and neutrophil/lymphocyte ratio) with different weighted scores were identified to construct a nutrition-weighted scoring scale (NWSS) for nutrition risk. Tumour type and tumour burden status (tumour-node-metastasis stage and radical or non-radical tumour) were determined to construct a disease-weighted scoring scale (DWSS) for disease risk. A lumped scale (5 × 5 matrix) established using a five-grade classification of nutrition and disease risk was used to determine a five-grade classification of comprehensive cachexia risk: A, no cachexia risk (reference; lowest disease and nutrition risks); B, cachexia risk (hazard ratio [HR] = 4.517 [4.033/5.058]); C, pre-cachexia (HR = 9.755 [8.73/10.901], medium survival = 21.21 months); D, cachexia (HR = 16.901 [14.995/19.049], medium survival = 11.61 months); and E, refractory cachexia (HR = 31.879 [28.244/35.981], medium survival = 4.83 months, highest disease and nutrition risks) (p < 0.001). Patients in Categories A-D benefited from nutrition therapy and anti-tumour treatments to varying degrees. Patients in Category E were clinically refractory to nutrition therapy without prolonged survival compared with patients without nutrition therapy (medium survival, pre-hospitalization nutrition therapy vs. hospitalization nutrition therapy vs. without nutrition therapy, 2.89 [1.91/3.88] vs. 4.04 [3.21/4.88] vs. 5.89 [4.73/7.04] months, p = 0.015) and anti-tumour treatments without prolonged survival compared with patients receiving palliative care (medium survival, radical anti-tumour treatments vs. adjuvant anti-tumour treatments vs. palliative anti-tumour treatments vs. and palliative care, 6.48 [4.42/8.53] vs. 6.48 [3.23/9.73] vs. 4.83 [4.22/5.44] vs. 2.70 [1.09/4.30] months, p = 0.263).

We systematically developed a novel definition and grading diagnostic criteria for tumour-type-specific comprehensive cancer cachexia risk.

Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites - body chart, pain phenotype - PainDETECT, severity and disability - BPI, pain catastrophizing - PCS, and kinesiophobia - Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60; 22.34); Asymptomatic = 21.75 (20.89; 22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41; 3.37); Asymptomatic=0.50 (0.32; 0.68)) and lower hand grip strength (Pain=24.01 (21.74; 26.29); Asymptomatic=27.98 (25.80; 30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26; 35.79); Asymptomatic=34.55 (33.86; 35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition. PERSPECTIVE: This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.

Sarcopenia and physical frailty are age-related syndromes characterized by progressive loss of muscle mass and function, significantly impacting mortality and quality of life in older adults. This systematic review evaluated the effectiveness of protein supplementation interventions for these conditions.

We systematically searched Medline, CENTRAL, and Ichushi Web from January 2000 to March 2023, with additional manual searching extended to March 2024. Randomized controlled trials investigating protein supplementation, alone or combined with exercise, in adults aged ≥65 years with sarcopenia or physical frailty were included. The primary outcomes were changes in muscle mass, strength, and physical performance.

The systematic literature search identified 1,506 records through database searching (Medline: 357, CENTRAL: 275, Ichushi Web: 639) and 235 additional records through hand searching. Finally, 13 randomized controlled trials (n=1,057) met the inclusion criteria. Combined protein and exercise interventions demonstrated significant improvements in skeletal muscle index (MD = 0.89 kg/m², 95 % CI: 0.45 to 1.33) and handgrip strength (MD: +2.64 kg, 95 % CI: +0.75 to +4.53) compared to exercise alone. Protein supplementation alone showed modest benefits in muscle strength but limited effects on physical performance. No serious adverse events were reported.

While protein supplementation combined with exercise shows promising effects on muscle mass and strength in older adults with sarcopenia or physical frailty, the evidence quality was consistently rated as very low. Further high-quality trials are needed to establish optimal supplementation strategies.

PROSPERO: CRD42023408529.

This study aimed to compare sarcopenia prevalence in older adults using nine diagnostic criteria from different regions to assess how these guidelines influence prevalence rates within the same population. Additionally, we analyzed variations across subgroups to identify factors contributing to prevalence differences.

A total of 1760 participants aged 65-99 were enrolled. Bioelectrical impedance analysis was used to assess muscle mass, while muscle strength and physical performance were evaluated using grip strength, gait speed, and the repeated chair stands test. Sarcopenia prevalence was determined based on definitions provided by ESPEN (European Society for Clinical Nutrition and Metabolism), EWGSOP (European Working Group on Sarcopenia in Older People), IWGS (International Working Group on Sarcopenia), SCWD (Society for Sarcopenia, Cachexia, and Wasting Disorders), AWGS (Asian Working Group for Sarcopenia), FNIH (Foundation for the National Institutes of Health), and SDOC (Sarcopenia Definitions and Outcomes Consortium). Additionally, prevalence rates were assessed across subgroups based on age, sex, and BMI categories.

Sarcopenia prevalence varied from 4.8 % (n = 79), based on the FNIH criteria, to 16.1 % (n = 261), according to the EWGSOP criteria. Among females, higher prevalence rates were observed using the ESPEN, AWGS, and EWGSOP2 criteria, while the FNIH criteria indicated a higher prevalence in males. Prevalence increased with age, especially in those aged 85 and older. Lower BMI was associated with higher sarcopenia prevalence according to most criteria, except the FNIH and ESPEN.

The notable variability in sarcopenia prevalence across different diagnostic criteria highlights the need for population-specific guidelines. Refining diagnostic criteria to address demographic variations could enhance the accuracy and applicability of sarcopenia assessments. Future studies should aim to further tailor diagnostic approaches and interventions to meet the needs of diverse populations.

Muscle quality, represented by myosteatosis, is recognized as an important factor in sarcopenia. In this study, we aimed to determine the associations between myosteatosis, muscle strength and physical performance among the elderly South Korean population.

We included 1440 participants (mean age 62.7 ± 6.2 years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid-thigh imaging, the total muscle area (TMA), normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA) and inter-intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4-m gait speed, a 30-s sit-to-stand test and 2-min walking test.

Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (p for trend < 0.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non-diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise.

Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.

The aim of this study was to investigate the differences in gait kinematics and kinetics among pre-frail, frail, and non-frail older adults during routine walking tasks. A total of 106 older adult participants were classified into frail, pre-frail, and non-frail groups based on the Fried frailty scale. Kinematic and kinetic data were acquired via a three-dimensional gait analysis system. Multivariate analysis of covariance (MANCOVA) was employed to assess the differences in gait kinematics and kinetics among the groups, followed by Bonferroni post-hoc tests. MANCOVA revealed significant differences in peak ankle plantar flexion, ankle range of motion (ROM), knee heel strike angle, and hip toe-off angle among the groups on the right side (P < 0.002). On the left side, significant differences were found in peak ankle plantar flexion, ankle ROM, and hip toe-off angle (P < 0.002). However, no significant differences in gait kinetics were observed among the three groups (P > 0.002). There is a weak correlation between gait kinematic parameters and dynamic postural stability. Compared with non-frail individuals, frail older adults reduced peak ankle plantar flexion, ankle ROM, and knee heel strike angle during walking. In contrast, the hip toe-off angle was found to be increased in the frail group.

Physical-functional fitness (PFF) assessments have become crucial tools for identifying physical frailty syndrome (PFS) in older adults, helping guide preventive and interventional strategies.

This study aimed to evaluate the predictive value of performance-based PFF tests for detecting PFS among community-dwelling older adults in Tehran, Iran. Additionally, it sought to compare PFF variables between PFS groups to assess the applicability of these tests as practical screening tools in clinical and community settings.

Data were collected from 161 participants (91 males, 56.5%; 70 females, 43.5%), including sociodemographic, anthropometric, medical history, PFF, and PFS assessments.

Frail participants exhibited significantly lower scores in various PFF tests, including the Tinetti balance, walking, and total score components, physical activity levels (PAL), mean hand grip strength (MGS), 30-s arm curl (30 s-AC), 30 s-chair stand (30 s-CS), Standing Stork Balance (SSB), and back stretch (BST) tests (p < 0.001). Frail individuals also had lower levels of education, shorter stature, and higher BMI compared to non-frail/pre-frail participants, highlighting broader vulnerabilities. Logistic regression analyses showed that all PFF tests, including Tinetti balance and walking components, MGS, 30 s-AC, 30 s-CS, were significant protective factors against FS. However, ROC curve analysis revealed optimal cutoff points for PFS identification, with PAL and MGS demonstrating the highest sensitivity and specificity for predicting PFS. The all components of Tinetti scale also proved to be strong predictors of FS.

Our findings demonstrate that, regardless of age, sex, education level, stature, and fall incidence, PFF assessments remain critical for identifying older adults at risk for PFS. The study highlights the predictive strength of key variables, such as PAL, MGS, and the Tinetti-POMA components, offering novel insights into the role of these tests in improving PFS screening accuracy. These results underscore the importance of integrating PFF assessments into routine clinical and community-based health evaluations, enabling early detection and timely interventions to promote healthier aging trajectories.

With an aging population, the prevalence of lumbar spinal diseases necessitating surgical intervention is increasing. Handgrip strength (HGS) has emerged as a simple measure of muscle function that may correlate with surgical outcomes. However, the role of HGS concerning postoperative recovery following transforaminal lumbar interbody fusion (TLIF) is not well-studied, highlighting a gap in the literature regarding its potential as a prognostic tool.

This prospective observational study included 89 patients who underwent TLIF performed by a single surgeon. Patients were categorized into normal and low HGS groups based on preoperative HGS measurements. Demographics, baseline HGS, and surgical details were recorded, and outcomes were assessed using the JOA, EQ-5D-3L, and Barthel Index at 3, 6, and 12 months postoperatively. Generalized Estimating Equations were used to examine associations between baseline parameters and outcomes over time.

All patients were followed for at least one year, except for 15 (15.6%) who were lost to follow-up before the one-year mark. Patients with lower preoperative HGS were associated with significantly poorer postoperative functional outcomes. Specifically, a one-unit decrease in HGS was associated with a 2.551-point decrease in the JOA score (p = 0.008), a 0.142-point decrease in the EQ-5D-3L score (p = 0.007), and a 5.784-point decrease in the Barthel Index (p = 0.036). Additionally, male sex, higher body mass index, and lower Charlson comorbidity index were associated with better postoperative outcomes.

Low preoperative handgrip strength is associated with poorer functional, quality of life, and independence outcomes up to 12 months after TLIF surgery. Assessing HGS preoperatively may provide clinicians with valuable information for identifying patients at risk of suboptimal recovery. Future research could explore intervention strategies to improve preoperative muscle function and potentially enhance recovery outcomes for patients undergoing TLIF.

Sarcopenia predicts worse postoperative outcomes and lower survival rates in patients with colorectal cancer (CRC). There is a scarcity of studies on the most effective assessment tools for detecting sarcopenia in preoperative elderly patients with CRC. Our objective was to compare the diagnostic accuracy of various tools such as calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), SARC-F plus CC (SARC-CalF), the short version of mini sarcopenia risk assessment (MSRA-5), the full version of mini sarcopenia risk assessment (MSRA-7), and Ishii score chart in screening sarcopenia in preoperative elderly patients with CRC.

During the period of April 2021 to September 2023, we conducted a cross-sectional study involving consecutive elderly patients who were undergoing colorectal surgery. Sarcopenia was defined using the diagnostic criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) and the 2019 Asian Working Group for Sarcopenia (AWGS2019). The screening tools' performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses, based on the criteria proposed by EWGSOP2 and AWGS2019.

We enrolled 482 patients with an average age of 71.86 ± 5.60 years. According to the EWGSOP2 and AWGS2019 diagnostic standards, the incidence of sarcopenia was 19.5% and 21.6% respectively. The sensitivity of SARC-F, SARC-CalF, MSRA-5, MSRA-7, and Ishii score chart ranged from 51.92 to 56.38%, 84.62-85.11%, 86.54-88.30%, 65.96-67.31%, and 73.08-74.47% respectively, while the specificity ranged from 84.92 to 85.05%, 70.36-71.69%, 36.86-37.04%, 60.57-61.64%, and 77.32-78.31% respectively. Regardless of the sarcopenia diagnostic criteria used, the AUCs of Ishii score chart (0.87 to 0.88) and SARC-CalF (0.89 to 0.90) were significantly larger than those of other tools (P<0.05). There was no significant difference in AUCs among SARC-F, SARC-CalF, and Ishii score chart in females.

Among the five sarcopenia screening tools, Ishii score chart and SARC-CalF had the largest overall diagnostic accuracy for sarcopenia in preoperative elderly patients with CRC.

This study aimed to compare the impact of sarcopenia on gait recovery using the Sarcopenia Special Interest Group of the International Society of Physical and Rehabilitation Medicine (ISarcoPRM) and the Asian Working Group for Sarcopenia 2019 (AWGS2019) algorithms in older orthopaedic patients.

A prospective observational study.

A total of 153 orthopaedic patients (78.4% women; average age 79.3 ± 6.7 years) were included during hospitalization.

Sarcopenia was defined using the ISarcoPRM and AWGS2019 algorithms on admission. Functional ambulation categories assessed gait independence before admission and on discharge. The impact of sarcopenia on worsened gait independence on discharge was evaluated using multivariate logistic regression analysis.

Sarcopenia based on the ISarcoPRM algorithm (prevalence=56.2%) was significantly associated with worsened gait independence (odds ratio: 3.94, 95% confidence interval: 1.51-10.25, p = 0.005), unlike sarcopenia based on AWGS2019 (prevalence=36.6%).

Sarcopenia assessed using the ISarcoPRM algorithm was associated with worsened gait independence on discharge in older orthopaedic patients.

Ischemic stroke is a common chronic disease worldwide and is correlated with a high disability rate. Sarcopenia is considered a key factor in the disablement process. Limited evidence of sarcopenia in acute ischemic stroke is available. The aim of this study was to investigate the effect of sarcopenia on the prognosis of patients with acute ischemic stroke.

A prospective cohort study was conducted and included patients who were diagnosed with acute ischemic stroke between August 2020 and May 2021. A modified Poisson regression was applied to determine the relative risk (RR) for the change in modified Rankin Scale (mRS) score and allow adjustment for confounders. The modified Poisson regression was used to identify associations between sarcopenia, and multiple linear regression analyses were used to assess the effect of sarcopenia on the Barthel Index (BI) and stroke-specific quality of life (SSQOL). The generalized linear mixed model was used to investigate the effect of sarcopenia on prognosis at 1, 3 and 6 months. Cox regression proportional risk model was used to analyze the effect of sarcopenia on readmission in patients with acute ischemic stroke.

The prevalence of sarcopenia was 39.83% among the 118 enrolled acute ischemic stroke patients (aged 64.98 ± 11.053 years; 72.88% males). Modified Poisson regression showed that a poor prognostic outcome occurred in sarcopenia patients (relative risk [RR] = 3.021, 95% CI: 1.621-5.633; P = 0.001). Even after adjusting for confounders, sarcopenia still was a risk predictor of the increase of mRS (RR = 2.149, 95% CI: 1.045-4.420; P = 0.038). And sarcopenia was positively correlated with BI and SSQOL with or without adjustment for confounding factors (P < 0.01). Patients with sarcopenia in mild acute ischemic stroke exhibit worse prognoses compared to those without sarcopenia. (t = 3.128, P = 0.002). Cox regression risk ratio model showed that sarcopenia was a predictor of readmission within 6 months after mild ischemic stroke (hazard ratio [HR] = 3.361, 95% CI: 1.277-8.848; P = 0.014). Sarcopenia remained an independent risk factor for mild acute ischemic stroke readmission after adjusting for confounders.

Sarcopenia has a high prevalence in mild acute ischemic stroke patients. Sarcopenia is an independent risk factor for poor outcomes following mild acute ischemic stroke and contributes to high rates of readmission. These findings may be useful for selecting therapeutic strategies for mild acute ischemic stroke patients with sarcopenia.

The link between serum insulin level and low muscle mass among older adults is not yet fully understood. This study seeks to investigate this association using data from a nationally representative large-scale survey.

The study utilized data from two waves of the China Health and Nutrition Survey (CHNS) conducted in 2009 and 2015. Subjects meeting the inclusion criteria were classified according to the Asia Working Group for Sarcopenia 2019 criteria. The study employed ordinary least squares (OLS) regression models to analyze the cross-sectional association between appendicular skeletal muscle mass (ASM) and serum insulin level. Additionally, based on the median insulin level in the population without low muscle mass in 2009, these individuals were divided into high insulin and low insulin groups. Logistic regression models were utilized to examine the longitudinal association between low muscle mass and serum insulin level.

In 2009, a cross-sectional association study enrolled a total of 2329 participants aged over 60 years, with 53.1% women and a median age of 68.00 years. The prevalence of low muscle mass in the study population was 30.83%, with females accounting for 60.03%. In the adjusted OLS regression model based on blood biomarker, serum insulin level was positively associated with ASM (β = 0.075, 95% confidence interval (95% CI): 0.034-0.117, P < 0.01). A total of 944 individuals from the 2009 population without low muscle mass were divided into high insulin and low insulin groups based on the median insulin level, and were followed up until 2015. It was found that there was a significant difference in the incidence of low muscle mass between the two groups. (12.44% vs. 7.45%, P = 0.01). The adjusted logistic regression models indicated that higher serum insulin levels were associated with a reduced incidence of low muscle mass (Hazard ratio = 0.958, 95% CI: 0.925-0.989, P = 0.01).

Adequate serum insulin level could potentially serve as a protective factor in preserving healthy muscle mass among Chinese adults aged 60 and above.

Not applicable.

This study aimed to analyze the predictive value of different physical performances including short physical performance battery (SPPB), time-up and go test (TUGT), gait speed (GS), five times sit-to-stand test (FTSST) and handgrip strength (HGS) on the incidence of falls among community-dwelling older adults and to propose the cut-off values for predicting the incidence of falls.

This 3-year longitudinal observational study continuously recruited community-dwelling older adults in 2018, assessing baseline physical performances and recording fall incidence (at least one fall) after 3 years.

Of the 215 older adults (mean age, 84.0 ± 4.4 years; 123 [57.2%] females) included in this study, 98 (45.6%) fell. After adjusting for age, sex, and comorbidity, decreased SPPB score (odds ratio [OR] = 0.84, 95% confidence interval [CI], 0.75-0.94), increased TUGT time (OR = 1.07, 95% CI, 1.03-1.12), and lower GS (OR = 0.11, 95% CI, 0.03-0.37) were significantly associated with higher risk of fall and had similar predictive values, while the FTSST and HGS were not. To predict the incidence of falls, the areas under the curve for SPPB, TUGT, and GS were 0.71 (95% CI: 0.65-0.77), 0.73 (95% CI: 0.67-0.79), and 0.71 (95% CI: 0.64-0.77), whereas the cut-offs were 7 points, 14.8 s, and 0.75 m/s, according to the Youden index, respectively.

As physical performance indicators, SPPB, TUGT, and GS may be more effective in assessing fall risk, and the threshold values proposed in this study can be used as a reference for stratified fall risk management among community-dwelling older residents.

The association between possible sarcopenia, sarcopenia and sarcopenic obesity on multimorbidity risk remains poorly investigating. We aimed to evaluate the associations between possible sarcopenia, sarcopenia and sarcopenic obesity on multimorbidity prevalence and incidence among middle-aged and older Chinese population.

A total of 13,036 participants from the China Health and Retirement Longitudinal Study 2011 were included in cross-sectional analyses. 5771 participants were including in longitudinal analyses and were followed up in 2018. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Obesity was defined according to body mass index.

In cross-sectional analyses, possible sarcopenia, sarcopenia and sarcopenic obesity were significantly associated with higher multimorbidity prevalence. During the 7 years of follow-up, 2295(39.77%) participants with new-onset multimorbidity were identified. Compared with participants without sarcopenia or obesity, a greater increase in the risk of multimorbidity incidence was found among participants with obesity only (OR = 1.39, 1.21-1.59), sarcopenia only (OR = 1.45, 1.35-1.58) and sarcopenic obesity (OR = 2.42, 2.03-2.89). Both pre-sarcopenia, sarcopenia and sarcopenic obesity were positively related to an increased number of morbidities.

Pre-sarcopenia, sarcopenia and sarcopenic obesity were associated with higher multimorbidity prevalence and incidence. Our findings provide important implications for screening and preventing possible sarcopenia, sarcopenia and obesity, which may be beneficial in reducing chronic disease burden.

Predicting all-cause readmission in patients with heart failure (HF) is crucial. This study investigated the independent risk factors for short-term readmission and assessed the potential mediators involved in this process.

We evaluated data from 2,254 patients with HF admitted to our institution between January 2019 and December 2020. Logistic regression analysis was used to examine the association between sarcopenia index (SI), neutrophil-to-lymphocyte ratio (NLR), hemoglobin-to-red cell distribution width ratio (HRR), and all-cause 30-d readmission. A restricted cubic spline regression model with three knots assessed potential non-linear relationships between confounders and readmission risk. A mediation analysis was performed to evaluate the direct and indirect effects, as well as the proportion of mediation.

The mean age of the participants was 72 ± 12 years, with 1,324 males (58.7%). The all-cause 30-d readmission rate was 7.1%. HRR was independently associated with 30-d readmission among the evaluated biomarkers, whereas SI and NLR showed no significant correlation. A non-linear relationship was found between HRR and readmission risk, with an inflection point at 0.94. Patients with HRR < 0.94 exhibited a significantly higher risk of readmission, whereas no significant association was found for HRR ≥ 0.94. Mediation analysis revealed that N-terminal pro-B-type natriuretic peptide (NT-proBNP) partially mediated this relationship, which accounted for 13.6% of the effect.

HRR is an independent predictor of all-cause 30-d readmission in patients with a non-linear relationship observed. An inverse association was found for HRR < 0.94, whereas no significant association was found for HRR ≥ 0.94. Additionally, NT-proBNP was identified as a partial mediator of this relationship.

Although studies had shown that Insulin resistance (IR) was correlated with the occurrence of sarcopenia, there were still many controversial conclusions. Therefore, we conducted a more comprehensive study on the relationship between the estimated glucose disposal rate (eGDR), an alternative indicator of IR, and the risk of sarcopenia, muscle mass, and muscle strength to clarify their interactions.

The Study included individuals from The China Health and Retirement Longitudinal Study (CHARLS) who had complete eGDR data at baseline and did not develop low muscle mass and low muscle strength. The individuals were divided into four subgroups based on the quartile (Q) of the eGDR. The lowest quartile (Q1) of the eGDR was used as a reference. Logistic regression and linear regression were used to evaluate the relationship between eGDR and sarcopenia (low muscle mass, low muscle strength, possible sarcopenia, and sarcopenia) and sarcopenia related features (ASM/Ht2, grip, and RMS), respectively. In addition, we further evaluated the nonlinear relationship using smooth curve fitting and threshold effect analysis.

The results showed that after adjusting for confounders, eGDR was negatively associated with the risk of sarcopenia and positively associated with sarcopenia related characteristics. In addition, men showed a more significant reduction in the likelihood of low muscle mass compared to women. But as eGDR levels rise, women gain more ASM/Ht2. Further nonlinear analysis revealed an inverse correlation between eGDR and ASM/Ht2 at the inflection point of 15.3893. Besides that, eGDR was positively correlated with grip (7.1862) and RMS (11.1042) before the inflection point.

The study found that higher levels of eGDR were associated with a lower risk of developing sarcopenia. However, the effects of eGDR on muscle mass and muscle strength need to be considered comprehensively. For muscle mass, it is recommended to maintain eGDR below 15.3893, and for muscle strength, it is recommended to maintain eGDR below 7.1862, with more potential benefits for early warning of sarcopenia.

Although the effect of social relationships on sarcopenia has been explored, the underlying pathways remains to be elucidated. This study aimed to examine whether loneliness and social isolation influenced new-onset sarcopenia through depressive symptoms and cognitive function.

A total of 5003 participants aged ≥60years from 2011 (Wave 1), 2013 (Wave 2) and 2015 (Wave 3) of China Health and Retirement Longitudinal Study (CHARLS) were included. Of these, 49.1 % were females, and mean age was 67.1 years at Wave 1. Generalized linear model and Cox proportional hazard regression model were carried out to test the associations among loneliness (Wave 1), social isolation (Wave 1), depressive symptoms (Wave 2), cognitive function (Wave 2), and new-onset sarcopenia (Wave 3). A four-way decomposition was applied with depressive symptoms and cognitive function as mediators to explore their mediation and interaction effects on social relationships and sarcopenia.

Loneliness (HR = 1.309, 95%CI = 1.073-1.596) and social isolation (HR = 1.115, 95%CI = 1.013-1.228) were associated with new-onset sarcopenia. Depressive symptoms (coefficient = 0.036, 95%CI = 0.030-0.042, attributable ratio = 23.5 %) and cognitive function (coefficient = 0.015, 95%CI = 0.010-0.019, attributable ratio = 9.8 %) mediated the association between loneliness and new-onset sarcopenia, while only cognitive function (coefficient = 0.015, 95%CI = 0.013-0.018, attributable ratio = 9.8 %) mediated the association between social isolation and sarcopenia.

Although various confounding factors were adjusted for, we cannot rule out the possibility of residual confounders.

The pathways through which social relationships impact sarcopenia vary by the attributes of social relationships. Healthcare providers may address the mental and cognitive health issues to prevent and manage sarcopenia among lonely and socially isolated older adults.

Sex differences in sarcopenia prevalence and recovery patterns among post-stroke patients remain poorly understood. This study aimed to investigate sex differences in sarcopenia prevalence, improvement rates, and changes in muscle-related indices among post-stroke patients in rehabilitation settings.

A retrospective cohort study was conducted at a post-acute rehabilitation hospital. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. The primary outcomes were sarcopenia status and muscle-related indices (handgrip strength and skeletal muscle mass index) at discharge. Propensity score-adjusted logistic regression analysis was performed to examine the association between sex and non-sarcopenia at discharge.

A total of 598 patients (274 women) with a mean age of 71.6 years were analyzed. Women showed higher sarcopenia prevalence at admission compared to men (47.4% vs 34.2%, p = 0.001). After adjusting for confounders, male sex was positively associated with non-sarcopenia at discharge (OR 1.046, 95% CI 1.009-1.104, p < 0.001) and greater improvements in handgrip strength (B = 1.93, p = 0.031) and skeletal muscle mass index (B = 0.322, p = 0.019).

This study revealed significant sex differences in sarcopenia among post-stroke rehabilitation patients. While women showed higher sarcopenia prevalence at admission, men demonstrated better improvements in muscle-related outcomes.

The relationship between sarcopenic obesity and masticatory function is poorly understood. This study aims to explore this association in community-dwelling individuals aged 75 years or older.

This study analyzed data from 236 community-dwelling adults aged 75 years or older. Masticatory function was assessed using spectrophotometric measurement of gum color differences before and after chewing color-changeable gum (ΔE*ab). Participants were categorized into tertiles of masticatory function based on their ΔE*ab values. The tertiles were defined as low, intermediate, and high. Sarcopenic obesity was assessed using the Consensus statement of the Japanese Working Group on Sarcopenic Obesity. Bayesian multinomial logistic regression was employed to examine the relationship between masticatory function and sarcopenic obesity.

The prevalence rates for obesity, sarcopenia, and sarcopenic obesity were 15.3%, 24.2%, and 9.7%, respectively. After adjusting for covariates, participants with high masticatory function had a significantly lower posterior estimate of sarcopenic obesity (posterior estimate: -1.83 [95% credible interval: -3.66, -0.22]) and sarcopenia (posterior estimate: -1.97 [95% credible interval: -3.37, -0.72]) compared with participants with low masticatory function. However, no significant associations were observed between masticatory function and obesity.

These findings suggest that high masticatory function is associated with a significantly lower prevalence of sarcopenic obesity in older adults.