Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. Development of a simple screening test for sarcopenia in older adults. Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Interleukin-6 levels in relation to psychosocial factors: Studies on serum, saliva, and in vitro production by blood mononuclear cells Epidemiology of sarcopenia among the elderly in New Mexico. Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life. Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food Hormone replacement therapy and interrelation between serum interleukin-6 and body mass index in postmenopausal women: a population-based study. Nutritional status, body composition, and quality of life in community-dwelling sarcopenic and non-sarcopenic older adults: A case-control study. Serum IL-6 level and the development of disability in older persons. Interleukin-6 and risk of cognitive decline: MacArthur Studies of Successful Aging Sarcopenia in Advanced Serous Ovarian Cancer Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Similar effects of leucine rich and regular dairy products on muscle mass and functions of older polymyalgia rheumatica patients: A randomized crossover trial Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain) Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia.
The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging , also called sarcopenia . The aim of this prospect i ve study was to investigate whether low serum 25-hydroxyvitamin D ( 25-OHD ) and high serum PTH concentration were associated with sarcopenia . In men and women aged 65 yr and older , participants of the Longitudinal Aging Study Amsterdam , grip strength ( n = 1008 ) and appendicular skeletal muscle mass ( n = 331 , using dual-energy x-ray absorptiometry ) were measured in 1995 - 1996 and after a 3-yr follow-up . Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort , translating into a loss of grip strength greater than 40 % or a loss of muscle mass greater than 3 % . After adjustment for physical activity level , season of data collection , serum creatinine concentration , chronic disease , smoking , and body mass index , persons with low ( < 25 nmol/liter ) baseline 25-OHD levels were 2.57 ( 95 % confidence interval 1.40 - 4.70 , based on grip strength ) and 2.14 ( 0.73 - 6.33 , based on muscle mass ) times more likely to experience sarcopenia , compared with those with high ( > 50 nmol/liter ) levels . High PTH levels ( > or=4.0 pmol/liter ) were associated with an increased risk of sarcopenia , compared with low PTH ( < 3.0 pmol/liter ) : odds ratio = 1.71 ( 1.07 - 2.73 ) based on grip strength , odds ratio = 2.35 ( 1.05 - 5.28 ) based on muscle mass . The associations were similar in men and women . The results of this prospect i ve , population -based study show that lower  25-OHD  and higher  PTH levels increase the risk of sarcopenia in older men and women AIM To develop a simple screening test to identify older adults at high risk for sarcopenia . METHODS We studied 1971 functionally independent , community-dwelling adults aged 65 years or older r and omly selected from the resident register of Kashiwa city , Chiba , Japan . Data collection was carried out between September and November 2012 . Sarcopenia was defined based on low muscle mass measured by bioimpedance analysis and either low muscle strength characterized by h and grip or low physical performance characterized by slow gait speed . RESULTS The prevalence of sarcopenia was 14.2 % in men and 22.1 % in women . After the variable selection procedure , the final model to estimate the probability of sarcopenia included three variables : age , grip strength and calf circumference . The area under the receiver operating characteristic curve , a measure of discrimination , of the final model was 0.939 with 95 % confidence interval ( CI ) of 0.918 - 0.958 for men , and 0.909 with 95 % CI of 0.887 - 0.931 for women . We created a score chart for each sex based on the final model . When the sum of sensitivity and specificity was maximized , sensitivity , specificity , and positive and negative predictive values for sarcopenia were 84.9 % , 88.2 % , 54.4 % , and 97.2 % for men , 75.5 % , 92.0 % , 72.8 % , and 93.0 % for women , respectively . CONCLUSIONS The presence of sarcopenia could be detected using three easily obtainable variables with high accuracy . The screening test we developed could help identify functionally independent older adults with sarcopenia who are good c and i date s for intervention OBJECTIVES To test whether accelerated sarcopenia in older persons with high interleukin (IL)-6 serum levels plays a role in the prospect i ve association between inflammation and disability found in many studies . DESIGN Cohort study of older women with moderate to severe disability . PARTICIPANTS Six hundred twenty older women from the Women 's Health and Aging Study in whom information on baseline IL-6 serum level was available . MEASUREMENTS Self-report of functional status , objective measures of walking performance , and knee extensor strength were assessed at baseline and over six semiannual follow-up visits . Potential confounders were baseline age , race , body mass index , smoking , depression , and medical conditions . RESULTS At baseline , women with high IL-6 were more often disabled and had lower walking speed . After adjusting for confounders , women in the highest IL-6 tertile ( IL-6>3.10 pg/mL ) were at higher risk of developing incident mobility disability ( risk ratio ( RR ) = 1.50 , 95 % confidence interval ( CI ) = 1.01 - 2.27 ) , disability in activities of daily living ( RR = 1.41 , 95 % CI = 1.01 - 1.98 ) , and severe limitation in walking ( RR = 1.61 , 95 % CI = 1.09 - 2.38 ) and experienced steeper declines in walking speed ( P < .001 ) than women in the lowest IL-6 tertile ( IL-6 < or = 1.78 pg/mL ) . Decline in knee extensor strength was also steeper , but differences across IL-6 tertiles were not significant . After adjusting for change over time in knee extensor strength , the association between high IL-6 and accelerated decline of physical function was no longer statistically significant . CONCLUSIONS Older women with high IL-6 serum levels have a higher risk of developing physical disability and experience a steeper decline in walking ability than those with lower levels , which are partially explained by a parallel decline in muscle strength BACKGROUND AND OBJECTIVES Reduced muscle mass and strength are prevalent conditions in dialysis patients . However , muscle strength and muscle mass are not congruent ; muscle strength can diminish even though muscle mass is maintained or increased . This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination ( i.e. , concurrent loss of muscle mass and strength/mobility , here defined as sarcopenia ) . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS This study included 330 incident dialysis patients ( 203 men , mean age 53±13 years , and mean GFR 7±2 ml/min per 1.73 m(2 ) ) recruited between 1994 and 2010 and followed prospect ively for up to 5 years . Low muscle mass ( by dual-energy x-ray absorptiometry appendicular mass index ) and low muscle strength ( by h and grip ) were defined against young reference population s according to the European Working Group on Sarcopenia in Older People . RESULTS Whereas 20 % of patients had sarcopenia , low muscle mass and low muscle strength alone were observed in a further 24 % and 15 % of patients , respectively . Old age , comorbidities , protein-energy wasting , physical inactivity , low albumin , and inflammation associated with low muscle strength , but not with low muscle mass ( multivariate ANOVA interactions ) . During follow-up , 95 patients ( 29 % ) died and both conditions associated with mortality as separate entities . When combined , individuals with low muscle mass alone were not at increased risk of mortality ( adjusted hazard ratio [ HR ] , 1.23 ; 95 % confidence interval [ 95 % CI ] , 0.56 to 2.67 ) . Individuals with low muscle strength were at increased risk , irrespective of their muscle stores being appropriate ( HR , 1.98 ; 95 % CI , 1.01 to 3.87 ) or low ( HR , 1.93 ; 95 % CI , 1.01 to 3.71 ) . CONCLUSIONS Low muscle strength was more strongly associated with aging , protein-energy wasting , physical inactivity , inflammation , and mortality than low muscle mass . Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation Psychosocial factors and  interleukin-6 ( IL-6 ) levels are both related to risk of morbidity and mortality . The aim of this study was to investigate how a broad range of psychosocial factors related to levels of IL-6 in different media . Fifty-nine men and women aged 30 - 65 were recruited from a larger study and selected to cover a broad range of psychosocial status .  IL-6 levels were analyzed in serum , in saliva collected at home at three different time points during a day , and in the supernatant of cell cultures stimulated in vitro with lipopolysaccharide . After adjustments for age , gender , self-reported health problems , and lifestyle factors , IL-6-levels in serum were negatively correlated with coping and self-esteem , and positively correlated with cynicism , hostile affect , hopelessness , depression , and vital exhaustion . In saliva sample s , at all time points , IL-6 levels were positively correlated to cynicism , and IL-6 levels 30 min after awakening were also positively correlated with hopelessness , depression , and vital exhaustion . After adjustment for age and gender , cynicism , depression , and vital exhaustion were negatively correlated to IL-6 levels in the supernatant of cell cultures stimulated in vitro with lipopolysaccharide , but this effect was lost after control for self-reported health problems and lifestyle factors . In conclusion , we found that IL-6 levels in serum and saliva were negatively related to psychosocial re sources and positively related to psychosocial risk factors . These data strengthen the argument that IL-6 is involved in mediating the risk for disease development that has been associated with psychosocial factors Muscle mass decreases with age , leading to " sarcopenia , " or low relative muscle mass , in elderly people . Sarcopenia is believed to be associated with metabolic , physiologic , and functional impairments and disability . Methods of estimating the prevalence of sarcopenia and its associated risks in elderly population s are lacking . Data from a  population -based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico ( the New Mexico Elder Health Survey , 1993 - 1995 ) were analyzed to develop a method for estimating the prevalence of sarcopenia . An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a r and om sub sample ( n = 199 ) of participants and was extended to the total sample . Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 ( m2 ) being less than two st and ard deviations below the mean of a young reference group . Prevalences increased from 13 - 24 % in persons under 70 years of age to > 50 % in persons over 80 years of age , and were slightly greater in Hispanics than in non-Hispanic whites . Sarcopenia was significantly associated with self-reported physical disability in both men and women , independent of ethnicity , age , morbidity , obesity , income , and health behaviors . This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia BACKGROUND To describe the prevalence of sarcopenia in ambulatory patients with heart failure with preserved ejection fraction ( HFpEF ) and its relation to reduced exercise capacity , muscle strength , and quality of life ( QoL ) . METHODS AND RESULTS A total of 117 symptomatic out patients with HFpEF were prospect ively enrolled in Germany , Engl and , and Slovenia as part of the Studies Investigating Co-morbidities Aggravating Heart Failure ( SICA-HF ) .  Appendicular skeletal muscle ( ASM ) mass ( the sum of muscle mass in both arms and legs ) was assessed by DEXA . Echocardiography , 6-minute walk testing ( 6-MWT ) , muscle strength assessment , spiroergometry and QoL evaluation using EQ-5D Question naire were performed . Sarcopenia was defined as ASM 2 st and ard deviations below the mean of a healthy reference group aged 18 - 40years . Patients were divided into 3 groups according to the E/e ' value : ≤8 , 9 - 14 , and ≥15 . Sarcopenia was detected in 19.7 % of all patients . These patients performed worse during 6-MWT ( 404±116 vs. 307±145 m , p=0.003 ) and showed lower absolute peak oxygen consumption ( 1579±474 vs. 1211±442mL/min , p<0.05 ) . Both ASM and muscle strength were lowest in patients with E/e ' > 15 ( p<0.05 ) . Higher values of muscle strength/ASM were associated with a better QoL ( r=0.5 , p<0.0005 ) . Logistic regression showed ASM to be independently associated with reduced distance walked during the 6-MWT adjusted for NYHA , height , left atrium diameter , ferritin and forced expiratory volume in 1s ( FEV1 ) ( odds ratio 1.2 , p=0.02 ) . CONCLUSION Sarcopenia affects a clinical ly relevant proportion of patients with HFpEF  . Low ASM is strongly linked to reduced muscle strength , exercise capacity and QoL in these patients Background Sarcopenia is strongly associated with an inadequate intake of dietary protein . Dietary protein supplementation boosts muscle-protein synthesis and increases muscle mass in the elderly . This study tested whether adding a protein-rich food , ricotta cheese , to the habitual diet increased total appendicular skeletal muscle mass and strength in elderly people . Methods Participants ( n = 40 ) , were sarcopenic elderly men and women over 60 years of age . Two comparison groups were formed at r and om and followed for 3 months : the intervention group received 210 g/day of ricotta cheese plus the habitual diet , while the control group followed the habitual diet with no additional intervention . Total appendicular skeletal muscle ( TASM ) was assessed by dual-energy X-ray absorptiometry , while strength was measured using a h and held dynamometer at baseline and after the intervention period . The primary outcomes were the percentage of relative change in TASM and strength . Results The percentage of relative change in TASM was not significant between the groups after the intervention period . Muscle strength improved in the intervention group , but showed only a tendency towards significance ( P = 0.06 ) . Secondary analysis showed that the men in the intervention group gained 270 g in TASM compared to those in the control group , and improved their fasting insulin levels ( P = 0.05 ) , muscle strength , lean body mass in the arms , and body weight variables . Conclusion The results of this study indicate that a nutritional intervention using a high- quality protein food , specifically ricotta cheese , in order to increase the amount of protein intake might not be regarded as fully promising in elderly men and women with sarcopenia . However , the gender effects on muscle strength , lean tissue in the arms , homeostatic assessment of insulin resistance , and body weight detected in this study suggest that additional research is needed on elderly male subjects with sarcopenia Postmenopausal women are at increased risk to develop osteoporosis , coronary artery disease , heart failure , and hypertension . Interleukin-6 ( IL-6 ) may be a pathogenetic element in these disorders . Serum IL-6 levels increase during aging and seem to be related to increased body fat mass . In the present retrospective study we aim ed to investigate the role of hormone replacement therapy ( HRT ) on serum IL-6 levels and the interrelation of IL-6 and body fat mass . Parameters were assessed in a population -based sample of postmenopausal women ( n = 302 ) and , for comparison , 245 men of the same age . Women with HRT ( n = 92 ) had significantly lower serum IL-6 levels compared to subjects without HRT , which was independent of age , antihypertensive therapy , smoking habits , and blood pressure ( 1.5 + /- 0.1 vs. 2.9 + /- 0.6 pg/mL ; P = 0.017 ) . In women without  HRT , the body mass index ( BMI ) was correlated with serum IL-6 levels ( P < 0.001 ) . Multivariate analysis controlling simultaneously for the effects of blood pressure and heart rate confirmed the positive correlation ( P = 0.001 ) . However , in subjects with HRT  no such correlation between IL-6 and BMI was demonstrated , which was confirmed after controlling covariates . In male subjects , BMI correlated with serum IL-6 ( P = 0.009 ) , which was , however , blunted after controlling for blood pressure and heart rate , probably indicating an influence of the sympathetic nervous system on this interrelation . In conclusion , women receiving HRT display lower serum IL-6 levels and a blunted interrelation of IL-6 and BMI . As IL-6 may be a pathogenetic factor in age-related diseases , HRT-related inhibition of IL-6 secretion could be an important element for the favorable effects of HRT in postmenopausal women BACKGROUND & AIM Sarcopenia , the age-related decrease in muscle mass , strength , and function , is a main cause of reduced mobility , increased falls , fractures and nursing home admissions . Cross-sectional and prospect i ve studies indicate that sarcopenia may be influenced in part by reversible factors like nutritional intake . The aim of this study was to compare functional and nutritional status , body composition , and quality of life of older adults between age and sex-matched older adults with and without sarcopenia . METHODS In a multi-centre setting , non-sarcopenic older adults ( n = 66 , mean ± SD : 71 ± 4 y ) , i.e. Short Physical Performance Battery ( SPPB ) : 11 - 12 and normal skeletal muscle mass index , were recruited to match 1:1 by age and sex to previously recruited adults with sarcopenia : SPPB 4 - 9 and low skeletal muscle mass index . Health-related quality of life , self-reported physical activity levels and dietary intakes were measured using the EQ-5D scale and index , Physical Activity Scale for the Elderly ( PASE ) , and 3-day prospect i ve diet records , respectively . Concentrations of 25-OH-vitamin D , α-tocopherol ( adjusted for cholesterol ) , folate , and vitamin B-12 were assessed in serum sample s. RESULTS In addition to the defined components of sarcopenia , i.e. muscle mass , strength and function , reported physical activity levels and health-related quality of life were lower in the sarcopenic adults ( p < 0.001 ) . For similar energy intakes ( mean ± SD : sarcopenic , 1710 ± 418 ; non-sarcopenic , 1745 ± 513 , p = 0.50 ) , the sarcopenic group consumed less protein/kg ( -6 % ) , vitamin D ( -38 % ) , vitamin B-12 ( -22 % ) , magnesium ( -6 % ) , phosphorus ( -5 % ) , and selenium ( -2 % ) ( all p < 0.05 ) compared to the non-sarcopenic controls . The serum concentration of vitamin B-12 was 15 % lower in the sarcopenic group ( p = 0.015 ) , and all other nutrient concentrations were similar between groups . CONCLUSIONS In non-malnourished older adults with and without sarcopenia , we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels . Differences in nutrient concentrations and dietary intakes were identified , which might be related to the differences in muscle mass , strength and function between the two groups . This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions BACKGROUND The serum concentration of interleukin 6 ( IL-6 ) , a cytokine that plays a central role in inflammation , increases with age . Because inflammation is a component of many age-associated chronic diseases , which often cause disability , high circulating levels of IL-6 may contribute to functional decline in old age . We tested the hypothesis that high levels of IL-6 predict future disability in older persons who are not disabled . METHODS Participants at the sixth annual follow-up of the Iowa site of the Established Population s for Epidemiologic Studies of the Elderly aged 71 years or older were considered eligible for this study if they had no disability in regard to mobility or in selected activities of daily living ( ADL ) , and they were re-interviewed 4 years later . Incident cases of mobility-disability and of ADL-disability were identified based on responses at the follow-up interview . Measures of IL-6 were obtained from specimens collected at baseline from the 283 participants who developed any disability and from 350 participants selected r and omly ( 46.9 % ) from those who continued to be non-disabled . FINDINGS Participants in the highest IL-6 tertile were 1.76 ( 95 % CI , 1.17 - 2.64 ) times more likely to develop at least mobility-disability and 1.62 ( 95 % CI , 1.02 - 2.60 ) times more likely to develop mobility plus ADL-disability compared with to the lowest IL-6 tertile . The strength of this association was almost unchanged after adjusting for multiple confounders . The increased risk of mobility-disability over the full spectrum of IL-6 concentration was nonlinear , with the risk rising rapidly beyond plasma levels of 2.5 pg/mL. INTERPRETATION Higher circulating levels of IL-6 predict disability onset in older persons . This may be attributable to a direct effect of IL-6 on muscle atrophy and /or to the pathophysiologic role played by IL-6 in specific diseases Objective To investigate whether plasma interleukin-6 ( IL-6 ) is cross-sectionally related to poorer cognitive function and whether a baseline plasma IL-6 measurement can predict risk for decline in cognitive function in longitudinal follow-up of a population -based sample of nondisabled elderly people . Methods A prospect i ve cohort study of 779 high-functioning men and women aged 70 to 79 from the MacArthur Study of Successful Aging was conducted . Regression modeling was used to investigate whether baseline IL-6 levels ( classified by tertiles ) were associated with initial cognitive function and whether IL-6 levels predicted subsequent declines in cognitive function from 1988 to 1991 ( 2.5-year follow-up ) and from 1988 to 1995 ( 7-year follow-up ) . Results Subjects in the highest tertile for plasma IL-6 were marginally more likely to exhibit poorer baseline cognitive function ( i.e. , scores below the median ) , independent of demographic status , social status , health and health behaviors , and other physiologic variables ( odds ratio [ OR ] = 1.46 ; 95 % CI : 0.97 , 2.20 ) . At 2.5 years , those in both the second tertile of IL-6 ( OR = 2.21 ; 95 % CI : 1.44 , 3.42 ) and the third tertile ( OR = 2.03 ; 95 % CI : 1.30 , 3.19 ) were at increased risk of cognitive decline even after adjusting for all confounders . At 7 years of follow-up , only those in the highest IL-6 tertile were significantly more likely to exhibit declines in cognition ( OR = 1.90 ; 95 % CI : 1.14 , 3.18 ) after adjustment for all confounders . Conclusions The results suggest a relationship between elevated baseline plasma IL-6 and risk for subsequent decline in cognitive function . These findings are consistent with the hypothesized relationship between brain inflammation , as measured here by elevated plasma IL-6 , and neuropathologic disorders Objective Cancer cachexia is a paraneoplastic syndrome comprising involuntary weight loss and muscle depletion ( sarcopenia ) . Although weight loss has been associated with poor clinical outcome , there is only limited information on the prevalence and prognostic impact of sarcopenia in ovarian cancer so far . Methods Total skeletal muscle mass was determined by computed tomography image analysis of the third lumbar skeletal muscle cross-sectional area in 128 patients with advanced serous ovarian cancer . Longitudinal change of muscle mass was studied in  209 consecutive computed tomography scans  from 43 patients . Association with survival was determined using Cox proportional hazards model . Results The prevalence of sarcopenia at first diagnosis was 11 % ( 12/105 ; 95 % confidence interval [ CI ] , 6%–20 % ) . Sarcopenic patients had a significantly reduced progression-free ( hazard ratio , 2.64 ; 95 % CI , 1.24–5.64 ; P = 0.012 ) and overall survival ( hazard ratio , 3.17 ; 95 % CI , 1.29–7.80 ; P = 0.012 ) . On multivariable analysis , these prognostic effects remained significant after adjustment for age , International Federation of Gynecology and Obstetrics stage , and postsurgical residual disease . Longitudinal analyses identified both patients with loss and gain of muscle mass . However , change in muscle mass over time was not associated with survival . Conclusions Baseline sarcopenia is a prognostic factor in advanced serous ovarian cancer . Identification of sarcopenic patients and early enrollment in physical or nutritional education programs might thus be a feasible way to improve outcome and should be further evaluated in prospect i ve clinical trials Summary There is no clear consensus on definition , cut-points or st and ardised assessment s of sarcopenia . We found a lower limb strength assessment  was at least as effective in predicting balance , mobility and falls in 419 older people as muscle mass-based measures of sarcopenia . Introduction There is currently no consensus on the definition , cut-points or st and ardised assessment s of sarcopenia . This study aim ed to investigate whether several published definitions of sarcopenia differentiate between older people with respect to important functional and health outcomes . Methods Four hundred nineteen community-living older adults ( mean age 81.2 ± 4.5 , 49 % female ) completed assessment s of body composition ( dual-energy X-ray absorptiometry ) , strength , balance , mobility and disability . Falls were recorded prospect ively for a year using monthly calendars . Sarcopenia was defined according to four skeletal mass-based definitions , two strength-based definitions ( h and grip or knee extensor force ) and a consensus algorithm ( low mass and low strength or slow gait speed ) . Obesity was defined according to percentage fat mass or waist circumference . Results The four skeletal mass-based definitions varied considerably with respect to the percentage of participants classified as sarcopenic and their predictive accuracy for functional and health outcomes . The knee extension strength-based definition was equivalent to or better than the mass-based and consensus algorithm definitions ; i.e. weaker participants performed poorly in tests of leaning balance , stepping reaction time , gait speed and mobility . They also had higher physiological fall risk scores and were 43 % more likely to fall at home than their stronger counterparts . Adding obesity to sarcopenia definitions identified participants with greater self-reported disability . Conclusions A simple lower limb strength assessment was at least as effective in predicting balance , functional mobility and falls in older people as more expensive and time-consuming muscle mass-based measures . These findings imply that functional terms such as muscle weakness or motor impairment are preferable to sarcopenia Objectives Leucine-rich milk and whey proteins have been suggested for prevention of age related loss of muscle mass and strength i.e. sarcopenia . The effects of milk protein supplementation and low intensity home based physical exercise on body composition and muscle functions were investigated . Design A r and omized double blind crossover trial . Setting Community dwelling members of Helsinki rheumatoid association . Participants Older people ( N = 47 , mean age 69.5 years ) suffering from polymyalgia rheumatica . Intervention Patients performed as many st and ups as possible twice a day after which they ingested a regular ( Control ) or a whey protein enriched dairy product with high leucine content ( Test ) . The 8-week intervention periods were separated by a 4-week wash-out . Measurements Body composition was measured by dual x-ray absorptiometry and muscle functions by h and grip strength , force platform countermovement jump performance , chair st and test , and walking speed . Results The 16-week home-based post-exercise supplementation result ed in a 1.8 % increase ( p = 0.052 ) in lower limb muscle mass . Walking speed ( + 5.3 % , p = 0.007 ) and chair st and test performance ( −12.2 % , p < 0.001 ) were also improved . Furthermore , a tendency for increased jump power ( + 3.0 % , p = 0.084 ) was observed . However , significant and consistent differences were not found in the changes of muscle mass indices or muscle functions between supplements , but the test supplement tended to prevent accumulation of body fat . Conclusion A low intensity home based exercise program combined with post-exercise milk protein supplementation is feasible despite some gastrointestinal complaints and seems effective in improving the muscle mass and functions of older persons with a inflammatory disease . Further studies are needed to establish , whether and to what extent the use of leucine-enriched whey products prevent or treat age-associated sarcopenia and whether they are superior to the present commercial milk products Introduction The purpose of this study was to evaluate the prevalence of sarcopenia in a cohort of healthy community-dwelling elderly in an urban area in Barcelona ( Spain ) for native benchmarks and compare them with those published in other geographical areas . Material and methods We prospect ively evaluated a series of 200 healthy elderly in the community with preserved functional capacity and absence of cognitive impairment . We performed a comprehensive geriatric assessment and determined anthropometric data , muscle mass ( MM ) and the muscle mass index ( MMI ) . Assessment of muscle mass was performed by bioelectrical impedance analysis ( BIA ) . The cut-off point for defining sarcopenia MMI was established as less than 2 SD of the mean of a reference group comprising 220 healthy volunteers ( 20–42 years ) in the same area . Results were compared with studies undertaken in the USA , France and Taiwan . Results The cut-off points obtained were 8.31 Kg/m2 for men and 6.68 Kg/m2 for women , being similar to those observed in France and Taiwan but different from the USA . The prevalence of sarcopenia observed was 33 % for elderly women and 10 % for males . On comparison of the prevalence of sarcopenia in the four population s , we observed some differences , particularly in males . Conclusions We have defined reference values for sarcopenia , determined by BIA , in our setting . We also observed a remarkable prevalence of sarcopenia in the healthy elderly community , especially in females , showing some differences from those in other geographical regions Decreases in whole-body lean mass can cause sarcopenia , a disease frequently found in the elderly . This condition is frequently associated with frailty and disability in aging as well as the onset and progression of several geriatric syndromes . Sarcopenia therefore must be managed with multidimensional approaches that include physical training , nutritional support , and metabolic and anabolic treatment . The purpose of our study was to assess the effect of an orally administered special mixture of amino acids ( AAs ) in elderly subjects with reduced lean body mass and sarcopenia . A r and omized , open-label , crossover study was conducted in 41 elderly subjects ( age range : 66 - 84 years ) with sarcopenia , assigned to 2 distinct treatments ( AAs and placebo ) . All subjects had normal body weight ( body mass index within 19 - 23 ) . The AA treatment consisted of 70.6 kcal/day ( 1 kcal = 4.2 kJ ) of 8 g of essential AA snacks , given at 10:00 am and 5:00 pm . Lean mass was measured with dual-energy x-ray absorptiometry in leg , arm , and trunk tissues . Significant increases in whole-body lean mass in all areas were seen after 6 months and more consistently after 18 months of oral nutritional supplementation with AAs .  Fasting blood glucose , serum insulin , and homeostatic model assessment of insulin resistance ( an index of insulin resistance ) significantly decreased during AA treatment . Furthermore , a significant reduction in serum tumor necrosis factor-alpha ( TNF-alpha ) and a significant increase in both insulin-like growth factor-1 ( IGF-1 ) serum concentrations and in the IGF-1/TNF-alpha ratio were also found . No significant adverse effects were observed during AA treatment . These preliminary data indicate that nutritional supplements with the oral AA mixture significantly increased whole-body lean mass in elderly subjects with sarcopenia . The improvement in the amount of whole-body lean mass could be linked to increased insulin sensitivity and anabolic conditions related to IGF-1 availability
Conclusion This is the first study to demonstrate that a higher predictive IL-6 cut-off level should be determined for aging sarcopenia in men than in women
Background Aging sarcopenia characterized by low muscle mass with low muscle strength affects men and women differently .
The contribution of interleukin-6 ( IL-6 ) to sarcopenia has been suggested based on a negative correlation between plasma IL-6 and muscle function described by some studies .
However , no consensus regarding clinical ly relevant cut-off criteria has been reached .
Another question arises whether pooling male and female data is an accurate way to determine the predictive value of IL-6 in sarcopenia .
The present meta- analysis was design ed to assess : ( 1 ) whether plasma IL-6 in aged population s in fact correlates negatively to muscle strength ; ( 2 ) whether such a correlation exists both in men and in women ; and ( 3 ) whether plasma IL-6 shows a gender difference in old age .