Using the Updated EWGSOP2 Definition in Diagnosing Sarcopenia in Spanish Older Adults: Clinical Approach.
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ABSTRACT:
SUBMITTER: Arnal-Gomez A
PROVIDER: S-EPMC7958601 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The European Working Group on Sarcopenia in Older People (EWGSOP) recently published an updated version (EWGSOP2). We aimed to compare the predictive values of EWGSOP-defined and EWGSOP2-defined sarcopenia for the incidence of falls and hospitalization in older adults. We defined sarcopenia according to the EWGSOP and the EWGSOP2. We further modified the cut-off points of the EWGSOP and EWGSOP2 according to the lowest quintile values of the gender-specific distribution of our study population, named "modified EWGSOP" and "modified EWGSOP2", respectively. We included 384 participants. During the follow-up, 98 participants (26.5%) and 51 participants (13.8%) had at least one fall or hospitalization, respectively. EWGSOP2-defined sarcopenia (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.22-1.84) and modified EWGSOP2-defined sarcopenia (HR 2.09, 95% CI 1.23-3.55) were significantly associated with an increased incidence of falls, respectively. EWGSOP-defined sarcopenia and modified EWGSOP-defined sarcopenia also have a trend to be associated with the incidence of falls, but the results were not statistically significant. Only modified EWGSOP2-defined sarcopenia (HR 2.07, 95% CI 1.01-4.27) was significantly related to an increased incidence of hospitalization. In conclusion, EWGSOP2-defined sarcopenia performed more sensitive than EWGSOP-defined sarcopenia for predicting the incidence of falls or hospitalization, especially when using the modified cutoffs.
| S-EPMC6881315 | biostudies-literature
Project description:Objectivesto analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults.Methodsa longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up.Resultscompared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16-1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24-1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49-2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off.Conclusionsusing LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults.
| S-EPMC9338689 | biostudies-literature
Project description:Over the last 3 years new definitions of sarcopenia by the Sarcopenia Definition and Outcome Consortium (2020, SDOC), European Working Group on Sarcopenia in Older People (2019, EWGSOP2) and Asian Working Group on Sarcopenia (2019, AWGS2) have been proposed. The objective of this scoping review was to explore predictive validity of these current sarcopenia definitions for clinical outcomes. We followed the PRISMA checklist for scoping reviews. Based on a systematic search performed by two independent reviewers of databases (Pubmed and Embase) articles comparing predictive validity of two or more sarcopenia definitions on prospective clinical outcomes published since January 2019 (the year these definitions were introduced) were included. Data were extracted and results collated by clinical outcomes and by sarcopenia definitions, respectively. Of 4493 articles screened, 11 studies (mean age of participants 77.6 (SD 5.7) years and 50.0% female) comprising 82 validity tests were included. Overall, validity tests on the following categories of clinical outcomes were performed: fracture (n = 40, assessed in one study), mortality (n = 18), function (n = 11), institutionalization (n = 7), falls (n = 4), and hospitalization (n = 2). Thereby, EWGSOP2 was investigated in 15 validity tests (18.3%) on all categories of clinical outcomes, whereas SDOC was investigated in four validity tests (4.9%) in one study on fractures in men only, and none of the validity tests investigated predictive validity by the AWGS2. However, we were not able to pool the data using a meta-analytic approach due to important methodological heterogeneity between the studies. We identified various definitions of clinical outcomes that were used to test predictive validity of sarcopenia definitions suggesting that an agreement on an operational definition of a clinical outcome is key to advance in the field of sarcopenia. Moreover, data on predictive validity using the sarcopenia definitions by the SDOC and AWGS2 are still scarce and lacking, respectively. In a next step, prospective studies including both women and men are needed to compare predictive validity of current sarcopenia definitions on defined key clinical outcomes.
| S-EPMC9891988 | biostudies-literature
Project description:The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report is to present updated diagnostic guidelines based on a thorough review of the literature and the authors' combined expertise based on the evaluation of >10 000 children for potential FASD in clinical settings and in epidemiologic studies in conjunction with National Institute on Alcohol Abuse and Alcoholism-funded studies, the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, and the Collaboration on FASD Prevalence. The guidelines were formulated through conference calls and meetings held at National Institute on Alcohol Abuse and Alcoholism offices in Rockville, MD. Specific areas addressed include the following: precise definition of documented prenatal alcohol exposure; neurobehavioral criteria for diagnosis of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder; revised diagnostic criteria for alcohol-related birth defects; an updated comprehensive research dysmorphology scoring system; and a new lip/philtrum guide for the white population, incorporating a 45-degree view. The guidelines reflect consensus among a large and experienced cadre of FASD investigators in the fields of dysmorphology, epidemiology, neurology, psychology, developmental/behavioral pediatrics, and educational diagnostics. Their improved clarity and specificity will guide clinicians in accurate diagnosis of infants and children prenatally exposed to alcohol.
| S-EPMC4960726 | biostudies-literature
Project description:BackgroundIn 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality.AimVerify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain).DesignA cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia.ResultsAmong the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040.ConclusionsAccording the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population.
| S-EPMC9022416 | biostudies-literature
Project description:Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson's Comorbidity Index (ACCI), number of medications, hospital stays and falls. Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke's R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.
| S-EPMC7344603 | biostudies-literature
Project description:This study aimed to analyze the efficacy of exercise interventions on muscle strength, muscle mass, and physical performance in older adults with sarcopenia. Randomized controlled studies assessing exercise effects on sarcopenia were searched in Web of Science, PubMed, Cochrane Library, ProQuest, EBSCOhost, Scopus, EMBASE, and VIP and CNKI up to 31 March 2022. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. The initial search identified 5379 studies, and 23 studies involving 1252 participants met the inclusion criteria for further analysis. Results revealed that exercise interventions can significantly improve grip strength (MD = 2.38, 95%CI = 1.33-3.43), knee extension strength (SMD = 0.50, 95%CI = 0.36-0.64), muscle mass of lower extremities (MD = 0.28, 95%CI = 0.01-0.56), walking speed (SMD = 0.88, 95%CI = 0.49-1.27), and functional mobility (MD = -1.77, 95%CI = -2.11--1.42) among older adults with sarcopenia. No significant exercise effects were found on fat-free muscle mass, appendicular muscle mass, skeletal muscle mass, and muscle mass of the upper extremities. The results of subgroup analysis indicated that both resistance training and multicomponent exercise could significantly increase the muscle strength, while aerobic exercise did not. The findings suggest that exercise intervention can effectively improve muscle function and physical performance in older adults with sarcopenia, but has limited effects on the muscle mass of the upper extremities. In addition, it is highly recommended to apply group-based and supervised resistance training and multicomponent exercise in the prevention and treatment of sarcopenia among the older population.
| S-EPMC9266336 | biostudies-literature
Project description:BackgroundIn 2019, EWGSOP2 proposed 4 steps to diagnose and assess sarcopenia. We aimed to quantify the prevalence of sarcopenia according to the EWGSOP2 diagnostic algorithm and to assess its applicability in elderly patients on hemodialysis.MethodsProspective study of 60 outpatients on chronic hemodialysis aged 75- to 95-years, sarcopenia was assessed according to the 4-step EWGSOP2: Find: Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls (SARC-F); Assess: grip strength by dynamometry (GSD) and sit to stand to sit 5 (STS5); Confirm: appendicular skeletal muscle mass (ASM) by bioimpedance; Severity: gait speed (GS), Timed-Up and Go (TUG), and Short Physical Performance Battery (SPPB).ResultsThe sequential four steps resulted in a prevalence of confirmed or severe sarcopenia of 20%. Most (97%) patients fulfilled at least one criterion for probable sarcopenia. The sensitivity of SARC-F for confirmed sarcopenia was low (46%). Skipping the SARC-F step increased the prevalence of confirmed and severe sarcopenia to 40% and 37%, respectively. However, 78% of all patients had evidence of dynapenia consistent with severe sarcopenia. Muscle mass (ASM) was normal in 60% of patients, while only 25% had normal muscle strength values (GSD).ConclusionsAccording to the 4-step EWGSOP2, the prevalence of confirmed or severe sarcopenia was low in elderly hemodialysis patients. The diagnosis of confirmed sarcopenia underestimated the prevalence of dynapenia consistent with severe sarcopenia. Future studies should address whether a 2-step EWGSOP2 assessment (Assess-Severity) is simpler to apply and may provide better prognostic information than 4-step EWGSOP2 in elderly persons on hemodialysis.
| S-EPMC8758069 | biostudies-literature
Project description:Sarcopenia, a core feature of the physical frailty syndrome, is characterized by multisystem physiological dysregulation. No study has explored qualitatively the hierarchical network of relationships among different dysregulated pathways involved in the pathogenesis of sarcopenia. We used 40 blood biomarkers belonging to community-dwelling prefrail and frail older persons to derive measures of multiple physiological pathways, and structural equation modeling to generate path network models of the multisystem physiological dysregulations associated with muscle mass and function (MMF). Insulin-leptin signaling and energy regulation, anabolic sex steroid regulation (testosterone, leptin), and tissue oxygenation (hemoglobin, red cell count) appear to be primary mediating factors exerting direct influences on MMF. There was additionally secondary mediatory involvement of myocyte- and adipocyte-derived cytokines, hypothalamic pituitary adrenal (HPA) stress hormones (cortisol, DHEAS), glomerular function, and immune cell regulatory and inflammatory cytokines and glycoproteins. We conclude that within a hierarchical network of multisystem physiological dysregulations in sarcopenia, dysregulated anabolic and catabolic pathways via sex steroids and insulin-leptin dual signaling and tissue hypoxemia are primary physiological dysregulations responsible for sarcopenia and frailty.
| S-EPMC6260914 | biostudies-literature
Project description:The European Working Group on Sarcopenia has recently proposed revised cut-off values for the definition of low grip strength (EWGSOP2). We therefore compared performance of the EWGSOP2 cut-off definition of low grip strength with other internationally used cut-off points in a sample of older patients. We analyzed geriatric assessment data in a cross-sectional sample of 98 older patients admitted to a post-acute care hospital. First, we compared prevalence of sarcopenia and frailty phenotype in our sample using low grip strength cut-points from the EWGSOP2 and seven other internationally used consensus statements. Second, we calculated correlations between low grip strength and two independent surrogate outcomes (i.e., gait speed, and the clinical frailty scale) for the EWGSOP2 and the other seven cut-point definitions. Prevalence of sarcopenia based on the EWGSOP2 grip strength cut-off values was significantly lower (10.2%) than five of the seven other cut-point definitions (e.g., 19.4% based on Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria). Similarly, frailty phenotype prevalence was significantly lower based on EWGSOP2 cut-points (57.1%) as compared to SDOC (70.4%). The correlation coefficient of gait speed with low grip strength based on EWGSOP2 cut-points was lower (0.145) as compared to other criteria (e.g., SDOC 0.240). Sarcopenia and frailty phenotype were identified considerably less using the EWGSOP2 cut-points for low grip strength, potentially underestimating prevalence of sarcopenia and frailty phenotype in post-acute hospital patients.
| S-EPMC8037004 | biostudies-literature