Epidemiology of sarcopenia among the elderly in New Mexico. Sarcopenia in Advanced Serous Ovarian Cancer Development of a simple screening test for sarcopenia in older adults. Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study Sarcopenia during neoadjuvant therapy for oesophageal cancer: characterising the impact on muscle strength and physical performance The impact of sarcopenia on a physical activity intervention: The lifestyle interventions and independence for elders pilot study (LIFE-P) Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life. Value of sarcopenia assessed by computed tomography for the prediction of postoperative morbidity following oncological colorectal resection: A comparison with the malnutrition screening tool. Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2‐year prospective cohort study of the GAINA study
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 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 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 BACKGROUND AND AIMS sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals . We evaluated the impact of sarcopenia on the risk of all-cause death in a population of frail older persons living in community . METHODS we analysed data from the Aging and Longevity Study , a prospect i ve cohort study that collected data on all subjects aged 80 years and older residing in the Sirente geographic area ( n = 364 ) . The present analysis was conducted among those subjects who were between 80 and 85 years of age at the time of the baseline assessment ( n = 197 ) . The main outcome measure was all-cause mortality over 7-year follow-up . According to the European Working Group on Sarcopenia in Older People ( EWGSOP ) criteria , the diagnosis of sarcopenia required the documentation of low muscle mass and the documentation of either low muscle strength or low physical performance . Cox proportional regression models were used to estimate crude and adjusted hazard ratios and 95 % confidence intervals of death by the presence of sarcopenia . RESULTS using the EWGSOP-suggested criteria , 43 subjects with sarcopenia ( 21.8 % ) were identified . During the 7-year follow-up , 29 ( 67.4 % ) participants died among subjects with sarcopenia compared with 63 subjects ( 41.2 % ) without sarcopenia ( P < 0.001 ) . After adjusting for potential confounders including age , gender , education , activities of daily living ( ADL ) impairment , body mass index , hypertension , congestive heart failure , chronic obstructive pulmonary disease , number of diseases , TNF-α , participants with sarcopenia had a higher risk of death for all causes compared with non-sarcopenic subjects ( HR : 2.32 , 95 % CI : 1.01 - 5.43 ) . CONCLUSIONS our results obtained from a representative sample of very old and frail subjects show that sarcopenia is associated with mortality , independently of age and other clinical and functional variables Summary In this study , we compare the extent to which seven available definitions of sarcopenia and two related definitions predict the rate of falling . Our results suggest that the definitions of Baumgartner and Cruz-Jentoft best predict the rate of falls  among sarcopenic versus non-sarcopenic community-dwelling seniors . Introduction The purpose of the study is to compare the extent to which seven available definitions of sarcopenia and two related definitions predict the prospect i ve rate of falling . Methods We studied a cohort of 445 seniors ( mean age 71 years , 45 % men ) living in the community who were followed with a detailed fall assessment for 3 years . For comparing the rate of falls in sarcopenic versus non-sarcopenic individuals , we used multivariate Poisson regression analyses adjusting for gender and treatment ( original intervention tested vitamin D plus calcium against placebo ) . Of the seven available definitions , three were based on low lean mass alone ( Baumgartner , Delmonico 1 and 2 ) and four required both low muscle mass and decreased performance in a functional test ( Fielding , Cruz-Jentoft , Morley , Muscaritoli ) . The two related definitions were based on low lean mass alone ( Studenski 1 ) and low lean mass contributing to weakness ( Studenski 2 ) . Results Among 445 participants , 231 fell , sustaining 514 falls over the 3-year follow-up . The prospect i ve rate of falls in sarcopenic versus non-sarcopenic individuals was best predicted by the Baumgartner definition based on low lean mass alone ( RR = 1.54 ; 95 % CI 1.09–2.18 ) with 11 % prevalence of sarcopenia and the Cruz-Jentoft definition based on low lean mass plus decreased functional performance ( RR = 1.82 ; 95 % CI 1.24–2.69 ) with 7.1 % prevalence of sarcopenia . Consistently , fall rate was non-significantly higher in sarcopenic versus non-sarcopenic individuals based on the definitions of Delmonico 1 , Fielding , and Morley . Conclusion Among the definitions investigated , the Baumgartner definition and the Cruz-Jentoft definition had the highest validity for predicting the rate of falls Summary Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function . This prospect i ve , population -based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults . Introduction The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions . Methods N = 681 volunteers ( 48 % female ; mean ± SD age 61.4 ± 7.0 years ) participated in baseline and follow-up assessment s ( mean 5.1 ± 0.5 years later ) . Appendicular lean mass ( ALM ) was assessed by dual-energy X-ray absorptiometry , h and grip ( HGS ) and lower-limb ( LLS ) strength were assessed by dynamometry , and falls risk was determined using the physiological profile assessment . Anthropometric definitions ( ALM/height squared [ ALM – H ] , ALM/weight × 100 and a residuals method [ ALM – R ] ) and performance-based definitions ( HGS , LLS and upper- and lower-limb muscle quality [ LMQ ] ) of sarcopenia were examined . The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia . Results Sarcopenia prevalence increased after 5 years for all operational definitions except ALM – H ( men : −4.0 % ; women : −5.5 % ) . Men classified with sarcopenia according to anthropometric definitions , and women classified with sarcopenia according to performance-based definitions , had significant increases in falls risk over 5 years ( all P < 0.05 ) compared to individuals without sarcopenia . Significant sex interactions were observed for ALM-R , LLS and LMQ ( all P < 0.05 ) definitions . Conclusions Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions . Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults , but sex-specific differences may exist according to different anthropometric or performance-based definitions Abstract Background The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long‐term mortality and readmission in a population of elderly in patients in acute care wards . Methods We conducted a prospect i ve observational study in the acute care wards of a teaching hospital in western China . The muscle mass was estimated according to a previously vali date d anthropometric equation . H and grip strength  was measured with a h and held dynamometer , and  physical performance was measured via a 4 m walking test . Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia . The survival status and readmission information were obtained via telephone interviews at 12 , 24 , and 36 months during the 3 year follow‐up period following the baseline investigation . Results Two hundred and eighty‐eight participants ( mean age : 81.1 ± 6.6 years ) were included . Forty‐nine participants ( 17.0 % ) were identified as having sarcopenia . This condition was similar in men and women ( 16.9 % vs. 17.5 % , respectively , P = 0.915 ) . During the 3 year follow‐up period , 49 men ( 22.7 % ) and 9 women ( 16.4 % ) died ( P = 0.307 ) . The mortality of sarcopenic participants was significantly increased compared with non‐sarcopenic participants ( 40.8 % vs. 17.1 % , respectively , P < 0.001 ) . After adjusting for age , sex and other confounders , sarcopenia was an independent predictor of 3 year mortality ( adjusted hazard ratio : 2.49 ; 95 % confidential interval : 1.25–4.95 ) and readmission ( adjusted hazard ratio : 1.81 ; 95 % confidential interval : 1.17–2.80 ) . Conclusions Sarcopenia , which is evaluated by a combination of anthropometric measures , gait speed , and h and grip strength , is valuable to predict hospital readmission and long‐term mortality in elderly patients in acute care wards 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 OBJECTIVE The aim of the Intervention by Nutrition and Exercise ( INE ) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults . DESIGN A cluster-r and omized controlled trial . SETTING AND PARTICIPANTS This trial recruited community-dwelling adults aged 65 years and older in Japan . The 227 participants were cluster r and omized into a  walking and nutrition ( W/N ) group ( n = 79 ) , a  walking ( W ) group ( n = 71 ) , and a  control ( C ) group ( n = 77 ) . We analyzed the physical and biochemical measurements in this sub study . INTERVENTION Six months of mail-based intervention ( a pedometer-based walking program and nutritional supplementation ) . MEASUREMENTS The skeletal muscle mass index ( SMI ) using the bioelectrical impedance data acquisition system , biochemical measurements , such as those of insulinlike growth factor ( IGF-1 ) , dehydroepi and rosterone sulfate ( DHEA-S ) , and 25-hydroxy vitamin D ( 25[OH]D ) , as well as frailty , were assessed by the Cardiovascular Health Study criteria . RESULTS Participants in the W/N and W groups had significantly greater improvements in SMI , IGF-1 , and 25(OH)D ( P < .05 ) than those in the C group . Participants in the W/N group had significantly greater improvements in DHEA-S ( P < .05 ) than in the other groups . These effects were more pronounced in frail , older adults . CONCLUSION These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults , particularly in those who are frail 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 Purpose This study aim ed to determine the prevalence of sarcopenia and examine whether sarcopenia was associated with overall and breast-cancer-specific mortality in a cohort of women diagnosed with breast cancer ( stages I – IIIA ) . Methods A total of 471 breast cancer patients from western Washington State and New Mexico who participated in the prospect i ve Health , Eating , Activity , and Lifestyle Study were included in this study . Appendicular lean mass was measured using dual X-ray absorptiometry scans at study inception , on average , 12 months after diagnosis . Sarcopenia was defined as two st and ard deviations below the young healthy adult female mean of appendicular lean mass divided by height squared ( < 5.45 kg/m2 ) . Total and breast-cancer-specific mortality data were obtained from Surveillance Epidemiology and End Results registries . Multivariable Cox proportional hazard models assessed the associations between sarcopenia and mortality . Results Median follow-up was 9.2 years ; 75 women were classified as sarcopenic , and among 92 deaths , 46 were attributed to breast cancer . In multivariable models that included age , race-ethnicity/ study site , treatment type , comorbidities , waist circumference , and total body fat percentage , sarcopenia was independently associated with overall mortality ( hazard ratio ( HR ) = 2.86 ; 95 % CI , 1.67–4.89 ) . Sarcopenic women had increased risk of breast-cancer-specific mortality , although the association was not statistically significant ( HR = 1.95 , 95 % CI , 0.87–4.35 ) . ConclusionS arcopenia is associated with an increased risk of overall mortality in breast cancer survivors and may be associated with breast-cancer-specific mortality . The development of effective interventions to maintain and /or increase skeletal muscle mass to improve prognosis in breast cancer survivors warrants further study . Implication s for Cancer SurvivorsSuch interventions may help breast cancer patients live longer Purpose Preoperative chemo(radio)therapy for oesophageal cancer ( OC ) may have an attritional impact on body composition and functional status , impacting postoperative outcome . Physical decline with skeletal muscle loss has not been previously characterised in OC and may be amenable to physical rehabilitation . This study characterises skeletal muscle mass and physical performance from diagnosis to post-neoadjuvant therapy in patients undergoing preoperative chemo(radio)therapy for OC . Methods Measures of body composition ( axial computerised tomography ) , muscle strength ( h and grip ) , functional capacity ( walking distance ) , anthropometry ( weight , height and waist circumference ) , physical activity , quality -of-life and nutritional status were captured prospect ively . Sarcopenia status was defined as pre-sarcopenic ( low muscle mass only ) , sarcopenic ( low muscle mass and low muscle strength or function ) or severely sarcopenic ( low muscle mass and low muscle strength and low muscle function ) . Results Twenty-eight participants were studied at both time points ( mean age 62.86 ± 8.18 years , n = 23 male ) . Lean body mass reduced by 4.9 ( 95 % confidence interval 3.2 to 6.7 ) kg and mean grip strength reduced by 4.3 ( 2.5 to 6.1 ) kg from pre- to post-neoadjuvant therapy . Quality -of-life scores capturing gastrointestinal symptoms improved . Measures of anthropometry , walking distance , physical activity and nutritional status did not change . There was an increase in sarcopenic status from diagnosis ( pre-sarcopenic n = 2 ) to post-treatment ( pre-sarcopenic n = 5 , severely sarcopenic n = 1 ) . Conclusions Despite maintenance of body weight , functional capacity and activity habits , participants experience declines in muscle mass and strength . Interventions involving exercise and /or nutritional support to build muscle mass and strength during preoperative therapy , even in patients who are functioning normally , are warranted Objective To determine if sarcopenia modulates the response to a physical activity intervention in functionally limited older adults . Design Secondary analysis of a r and omized controlled trial . Setting Three academic centers . Participants Elders aged 70 to 89 years at risk for mobility disability who underwent dualenergy x-ray absorptiometry ( DXA ) for body composition at enrollment and follow-up at twelve months ( N = 177 ) . InterventionS ubjects participated in a physical activity program ( PA ) featuring aerobic , strength , balance , and flexibility training , or a successful aging ( SA ) educational program about healthy aging . Measurements Sarcopenia as determined by measuring appendicular lean mass and adjusting for height and total body fat mass ( residuals method ) , Short Physical Performance Battery score ( SPPB ) , and gait speed determined on 400 meter course . Results At twelve months , sarcopenic and non-sarcopenic subjects in PA tended to have higher mean SPPB scores ( 8.7±0.5 and 8.7±0.2 points ) compared to sarcopenic and non-sarcopenic subjects in SA ( 8.3±0.5 and 8.4±0.2 points , p = 0.24 and 0.10 ) , although the differences were not statistically significant . At twelve months , faster mean gait speeds were observed in PA : 0.93±0.4 and 0.95±0.03 meters/second in sarcopenic and non-sarcopenic PA subjects , and 0.89±0.4 and 0.91±0.03 meters/second in sarcopenic and non-sarcopenic SA subjects ( p = 0.98 and 0.26 ) , although not statistically significant . There was no difference between the sarcopenic and non-sarcopenic groups in intervention adherence or number of adverse events . Conclusion These data suggest that older adults with sarcopenia , who represent a vulnerable segment of the elder population , are capable of improvements in physical performance after a physical activity intervention 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 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 Computed tomography ( CT ) can be used for accurate estimation of whole-body muscle mass and muscle density and for detection of sarcopenia . The goal of this study was to evaluate the additional value of CT measured sarcopenia and muscle attenuation alongside the Malnutrition Universal Screening Tool ( MUST ) for the prediction of post-operative morbidity after oncological colorectal resection , whilst correcting for known risk factors . METHODS A prospect i ve cohort study of 80 patients undergoing elective colorectal surgery in the Netherl and s. Patients were screened for nutritional risk upon admission using the MUST . Additionally , preoperative CT scans were used to determine skeletal muscle mass for the detection of sarcopenia and muscle attenuation . Univariate and multivariable analyses were performed to evaluate associations between the MUST , muscle attenuation and sarcopenia on the one h and and post-operative complications measured by the Clavien-Dindo score on the other h and . RESULTS American Society of Anesthesiology-classification ( ASA ) ≥3 , age ≥70 , MUST ≥2 and lower than median muscle attenuation were significantly associated with a higher risk for postoperative complications ( Clavien-Dindo score ≥2 ) ( p ≤ 0.05 ) , whereas sarcopenia was not ( p = 0.59 ) . Multivariate analyses showed that only MUST ≥2 remained significantly associated with postoperative complications when corrected for age ( p = 0.03 , OR 5.8 , 95%CI 1.1 - 29.6 ) , but not when corrected for age ≥70 and ASA ≥3 . Muscle attenuation and sarcopenia were not significantly associated with postoperative complications . CONCLUSION Our results suggest that using CT measured sarcopenia may have only little additional value over the MUST for the prediction of increased short-term post-operative morbidity after oncological colorectal surgery . It also underlines the importance of currently implemented easy-to-use nutritional screening tools ( MUST ) and raises the question of the evaluation of muscle quality versus quantity in body composition imaging . However , further research is needed to investigate the role of sarcopenia for predicting outcome after colorectal surgery , and investigate the role of muscle attenuation measurements for the prediction of muscle function . CATEGORY OF SU BMI SSION : observational study AIM The purpose of the present study was to investigate whether sarcopenia was associated with future falls in the general Japanese older population . METHODS This study was a 2-year prospect i ve observational study . Participants were recruited from individuals who had an annual town-sponsored medical check-up and had not received nursing care . The inclusion criteria for participants in our study were : ( i ) agreement to participate ; ( ii ) living independently ; and ( iii ) the ability to walk to where the survey was carried out and to provide self-reported data . A total of 223 residents ( 82 men , 141 women ) participated in the baseline assessment in the study . Demographic information , previous fall history , locomotive syndrome , body function and structural measurements and pain at the knee and /or lumber spine were assessed . The Asian Working Group for Sarcopenia algorithm was used to classify the presence of sarcopenia , and assess the history  of falling when the participant received their annual medical check-up . RESULTS A total of 162 participants had an annual follow-up assessment , 50 of whom ( 30.8 % ) fell at least once during the 2-year observational period after baseline assessment . Previous falling history , prevalence of locomotive syndrome , sarcopenia and pain were significantly higher in participants who had fallen compared with participants who had not . Multiple logistic regression analysis showed the prevalence of sarcopenia was a significant predictor of falling . CONCLUSION The key finding of the present study suggests that sarcopenia is a risk factor for falling in older adults who are living independently even after adjustment for previous falls and confounding factors . Geriatr Gerontol Int 2017 ; 17 : 2124 - 2130
There is a lack of robust evidence to assess the strength of other treatment options
Objectives Sarcopenia , defined as an age-associated loss of skeletal muscle function and muscle mass , occurs in approximately 6 - 22 % of older adults .
This paper presents evidence -based clinical practice guidelines for screening , diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research ( ICSFR ) .