Journal of frailty, sarcopenia and falls最新文献

Objective: To compare body composition, muscle performance, and muscle quality across age and sex groups.

Methods: A cross-sectional analytical study was conducted in healthy-self-referred adults stratified in age groups: 18-35, 50-64, and ≥65 years. Evaluations included BMI (kg/m²), DXA-derived body composition (ALM, kg; body-fat, %), handgrip-dynamometry, and isokinetic knee-extensor testing concentric/eccentric low/high angular velocities. MQIs were calculated as force normalized to LM. Group comparisons, effect sizes, and correlation analyses were performed. Statistical significance was set at p < 0.05.

Results: A total of 152 adults were analyzed. Body composition showed significant age-related differences, with increased body-fat percentage from young to middle adulthood and reduced ALM in older adults, while BMI showed limited discriminatory capacity. Handgrip-strength declined significantly only in the oldest group and showed small effect sizes after normalization by body-weight. In contrast, isokinetic knee extensor strength (particularly high-velocity concentric-torque) demonstrated pronounced age-related declines with moderate-to-large effect sizes. Eccentric/concentric torque ratios increased with age, indicating relative preservation of eccentric strength. Handgrip-based MQIs showed no age-group discrimination, whereas isokinetic-derived MQIs did.

Conclusion: Muscle aging is characterized by early adiposity increase and later deterioration of lower-limb, velocity-dependent muscle performance, better captured by isokinetic-based measures than by BMI or handgrip-derived indices.

Objectives: Sarcopenia and low muscle mass are distinct clinical conditions associated with adverse outcomes after colorectal cancer (CRC) surgery. Due to limited effective screening methods, we evaluated the diagnostic performance of four tools for these conditions in preoperative patients with CRC.

Methods: This cross-sectional study included patients aged ≥65 years with stage I-III CRC scheduled for elective surgery. Sarcopenia and low appendicular skeletal muscle mass (ASM) were diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Diagnostic performance of calf circumference (CC), SARC-F, SARC-CalF, and the Ishii score was evaluated.

Results: Ninety-eight patients (48.0% females, mean age 77.4 ± 6.2 years) were included. Prevalences of low ASM and sarcopenia were 56.1% and 41.8%, respectively. For low ASM, CC demonstrated the highest accuracy (AUC 0.907, sensitivity 80.0%, specificity 86.0%), significantly outperforming SARC-F and SARC-CalF (AUCs 0.617 and 0.854; p<0.005), and comparable to the Ishii score (AUC 0.895). For sarcopenia, the Ishii score exhibited the highest accuracy (AUC 0.957, sensitivity 100%, specificity 75.4%), significantly surpassing CC, SARC-F, and SARC-CalF (AUCs 0.875, 0.704, and 0.865; p<0.001).

Conclusions: The Ishii score demonstrated superior diagnostic performance for sarcopenia, underscoring the importance of muscle strength assessment for effective screening.

Nowadays, adipose tissue is recognized as a dynamic endocrine organ that profoundly affects metabolic, reproductive and skeletal physiology. Apart from its role in energy storage, adipocytes secrete cytokines and bioactive proteins, known as adipokines, that contribute to the regulation of the hypothalamic-pituitary-gonadal axis, gonadal steroidogenesis and bone remodeling. Reciprocal signaling between adipose tissue, bone and the reproductive system forms a complex endocrine network linking energy balance to fertility and bone homeostasis. Key mediators, including leptin, adiponectin, resistin, visfatin and bone marrow adipose tissue, interact with osteoblast-derived proteins, such as osteocalcin, to modulate steroidogenesis and metabolic function. Vitamin D, stored in adipose tissue and acting through its receptor, further integrates these pathways by coordinating calcium metabolism, reproduction and skeletal integrity. This review aims to present mechanistic and clinical evidence demonstrating how metabolic signals derived from adipose depots communicate with gonadal and skeletal tissues through overlapping endocrine, paracrine and autocrine networks. Attention is paid to depot-specific effects, bidirectional feedback between adipose tissue and bone signaling, as well as in emerging implications for infertility, osteoporosis and metabolic bone disease. Finally, we discuss critical knowledge gaps and research priorities, to elucidate novel therapeutic approaches for reproductive and skeletal disorders.

Objectives: This study aimed to determine baseline physical indicators and their cutoff values associated with improvement in sarcopenia (IS) in older individuals undergoing rehabilitation.

Methods: We retrospectively reviewed 343 older individuals with sarcopenia (median age = 81 years) admitted to a rehabilitation hospital between January 2020 and September 2023 after discharge from acute care hospitals. Sarcopenia was diagnosed using the 2019 Asian Working Group for Sarcopenia criteria; IS was defined as no longer meeting the diagnostic criteria at discharge. Baseline assessments included handgrip strength (HGS), gait speed (GS), skeletal muscle mass index (SMI), and the Short Physical Performance Battery. We used sex-wise multivariate logistic regression analyses to identify factors associated with IS and receiver operating characteristic curve analyses to determine cutoff values.

Results: IS was seen in 16 males (17%) and 46 females (18%). Associated indicators were GS (p = 0.019; cutoff: 0.78 m/s) and SMI (p = 0.004; cutoff: 6.7 kg/m²) in males, and HGS (p < 0.001; cutoff: 15.0 kg) and SMI (p < 0.001; cutoff: 5.1 kg/m²) in females.

Conclusions: Baseline SMI, plus GS in males and HGS in females, was associated with IS. These cutoff values may help to characterize individuals with different likelihoods of diagnostic improvement.

This systematic review examines whether adding cognitive training to a multicomponent balance rehabilitation protocol provides additional benefits for older people with balance disorders who have no or mild cognitive impairment. A comprehensive search of electronic databases was conducted to identify eligible studies. The target population consists of community-dwelling older people at risk of falling and/or with a persistent history of imbalance, with an absence of or mild cognitive impairment. The GRADE system was used to assess the risk of bias. Sixteen RCTs were identified as eligible, integrating at least balance and cognitive training as modules of a multicomponent rehabilitation protocol. Strengthening exercises, endurance training, and advanced technology were also included. In almost all studies (except one), balance exercises were provided simultaneously with cognitive exercises. The recommended exercise dosage consisted of 40-60 minutes per session, performed 2-3 per week over a period of 12 weeks. Μotor-cognitive training improved standing posture, gait speed, functional mobility, domains of cognitive function, and motor-cognitive performance. Duration of interventions was correlated with the level of clinical improvement. Specific methodological issues may limit the overall reliability and generalizability of the findings. Cognitive training provided additional benefits for posture, gait speed, functional mobility, and dual-task performance in older people with balance disorders by optimizing the allocation of attentional demands.

Objectives: Fibromyalgia is a chronic condition characterised by persistent pain, fatigue, and poor sleep, with major impacts on quality of life, psychological wellbeing, and disability. Physical activity is a cornerstone of management, and the National Institute for Health and Care Excellence recommends supervised programmes tailored to individual needs. Yet, people with fibromyalgia frequently face barriers to physical activity, and few studies have explored experiences of group-based interventions. This study examined the perspectives of adults with fibromyalgia on group-based physical activity to identify challenges and inform future practice.

Methods: Two focus groups were conducted with participants (n=8) recruited from Musculoskeletal and Pain Management Services in NHS Ayrshire and Arran. Discussions were audio-recorded, transcribed, and thematically analysed by three independent researchers.

Results: An overarching theme was a lack of understanding of the impact of fibromyalgia and a desire for validation. This was evident across all discussions. Two further themes were identified: the challenges of engaging in physical activity, and priorities for intervention design and delivery. Participants emphasised the need for practitioners who recognise the fluctuating nature of fibromyalgia and who demonstrate empathy, openness, and collaboration.

Conclusions: Findings highlight the importance of practitioner understanding and patient-centred design in developing acceptable group-based physical activity interventions for people with fibromyalgia.

Objectives: To assess the risk of sarcopenia, anxiety, and depression among healthcare professionals working in disability care facilities (DCF), and to investigate the contributing occupational and personal factors.

Methods: A cross-sectional study was conducted among 138 healthcare professionals. Demographic and occupational factors, including work schedule, health issues, and medication, were recorded. Participants were assessed for sarcopenia using the SARC-F questionnaire and handgrip strength measurements. Anxiety and depression were evaluated using the validated Greek version of the Hospital Anxiety and Depression Scale (HADS).

Results: Based on SARC-F scores (≥4), 43.48% of healthcare professionals exhibited a risk of sarcopenia (p<0.001), while 9.42% had probable sarcopenia according to handgrip strength. BMI and gender differed significantly between the groups (p<0.05). The probable sarcopenia group had the highest BMI and the highest percentage of males. The HADS score indicated medium levels of anxiety (6.27±2.39) and depression (6.92±2.65) in healthcare professionals with sarcopenia, without significant differences between the groups.

Conclusions: According to the findings of this study, the prevalence of sarcopenia risk was high among Greek healthcare professionals working in DCF, while the levels of anxiety and depression were moderate. Male gender and ΒΜΙ appear to influence rise/establishment of sarcopenia spectrum in these individuals.

Objectives: Functional asymmetry is a hallmark of aging-related motor decline, contributing to impaired gait, balance deficits, and increased fall risk. This study aimed to evaluate the effects of a single session of Neuro Postural Optimization (NPO), a non-invasive neuromodulation protocol based on Radio Electric Asymmetric Conveyer (REAC) technology, on central neurophysiological balance and functional symmetry in older adults.

Methods: Eighteen participants (mean age: 72.4 ± 6.1 years) underwent a standardized REAC-NPO session. Assessments were performed immediately before and after treatment using the Timed Up and Go (TUG) test, the Gait Speed test, the Five Times Sit-to-Stand (FTSTS), and Handgrip dynamometry.

Results: Statistically significant improvements were found in TUG (p=0.026), Gait Speed (p=0.041), and FTSTS (p=0.003). No significant change was observed in handgrip strength (p=0.530), supporting a central rather than peripheral mechanism of action. Functional dysmetria, a reproducible and quantifiable indicator of maladaptive central motor control, was completely corrected in all participants immediately after the REAC-NPO session.

Conclusions: A single REAC-NPO session can restore functional symmetry and improve mobility-related outcomes in older adults. The immediate and complete correction of functional dysmetria supports the potential role of REAC-NPO in fall prevention strategies and functional recovery programs for aging populations.

Objectives: The objective of this study was to quantify the impact of shifting time away from sedentary behavior to physical activity on frailty in older adults.

Methods: Participants from the All of Us Research Program with Fitbit data were included in the analysis. Fitbit data was used to measure time spent in sleep, sedentary behavior, light-intensity physical activity, and moderate-to-vigorous physical activity. Frailty was assessed using a 33-item frailty index. A compositional isotemporal substitution model was created to assess the estimated effects of substituting 30 minutes of sedentary behavior with an equal amount of time in physical activity on frailty.

Results: Reductions in frailty index were seen by shifting 30 minutes from sedentary behavior to light activity (-0.003 [95% CI: -0.004, -0.002]) and moderate-to-vigorous activity (-0.016 [-0.017, -0.014]). Lower odds of frailty were also seen from shifting time from sedentary behavior to light activity or moderate-to-vigorous activity. Associations between physical activity and frailty were generally more pronounced in those participants who were frail or pre-frail than in those who were robust.

Conclusions: Shifting time from sedentary behavior to physical activity is associated with lower odds of frailty, and shifting time to higher intensity activities may have a greater benefit to frailty.