Combinations of Sarcopenia Diagnostic Criteria by Asian Working Group of Sarcopenia (AWGS) 2019 Guideline and Incident Adverse Health Outcomes in Community-Dwelling Older Adults.

This study aimed to investigate the association between combinations of sarcopenia criteria by the Asian Working Group of Sarcopenia (AWGS) 2019 guideline and incident adverse health outcomes. Longitudinal analyses of a cohort study. We conducted prospective 2-year follow-up analyses (N = 1959) among community-dwelling older adults enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS). From the KFACS, 1959 older adults (52.8% women; mean age = 75.9 ± 3.9 years) who underwent assessments for appendicular skeletal mass using dual-energy X-ray absorptiometry, handgrip strength, usual gait speed, 5-times sit-to-stand test, and Short Physical Performance Battery (SPPB) at baseline were included. Participants with each adverse health outcome [mobility disability, falls, and instrumental activities of daily living (IADL) disabilities] at baseline were excluded for each corresponding analysis. Multivariable logistic regression was performed to examine whether sarcopenia defined by different diagnostic criteria was associated with incident adverse health outcomes after 2 years. A total of 444 participants (22.7%) were diagnosed with sarcopenia as defined by AWGS 2019. In the multivariable analysis, sarcopenia defined as both low muscle mass and low physical performance increased the risk of mobility disability (OR 2.14, 95% CI 1.35-3.38) and falls (1.74, 95% CI 1.21-2.49). Only the criterion defined as both low muscle mass and physical performance using the SPPB increased the risk of falls with fracture (2.53, 95% CI 1.01-6.35) and IADL disabilities (2.77, 95% CI 1.21-6.33). However, sarcopenia defined as both low muscle mass and low hand grip strength showed no associations with the incidence of any of the adverse health outcomes. Our study suggests that the predictive value of adverse health outcomes for community-dwelling older adults is better when diagnosed with sarcopenia based on low muscle mass and physical performance. Furthermore, using the SPPB as a diagnostic tool for low physical performance may improve the predictive validity for falls with fracture and IADL disability. Our findings may be helpful for the early detection of individuals with sarcopenia who have a higher risk of adverse health outcomes.

Oh MH ，Shin HE ，Kim KS ，Won CW ，Kim M ... -  《-》

Sarcopenia in Korean Community-Dwelling Adults Aged 70 Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update.

To describe the prevalence of sarcopenia in a large group of community-dwelling older adults using the Asian Working Group for Sarcopenia (AWGS) 2019 definition and algorithm. Cross-sectional data analysis of a cohort study. The Nationwide Korean Frailty and Aging Cohort Study (KFACS). A total of 2123 ambulatory community-dwelling older adults, aged 70 to 84 years (mean, 75.9 ± 3.9 years; 49.5% women) were enrolled in the KFACS. Appendicular skeletal muscle mass was measured by dual-energy x-ray absorptiometry. Physical function was assessed by handgrip strength, usual gait speed, the 5-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. In a case-finding assessment, screening for sarcopenia was performed using the calf circumference (CC), SARC-F questionnaire, and SARC-F combined with CC (SARC-CalF). According to the AWGS 2019 algorithm, 43.5%, 7.5%, and 26.0% of the subjects in the whole study sample were classified as those at risk for sarcopenia according to CC, SARC-F, and SARC-CalF, respectively. The prevalence rates of possible sarcopenia using 3 screening tools for case-finding and muscle strength or physical performance tests according to the AWGS 2019 diagnostic algorithm were 20.1% in men and 29.2% in women. The prevalence rates of sarcopenia, when defined as low muscle mass plus low handgrip strength and/or slow gait speed, were significantly higher according to the AWGS 2019 (21.3% in men and 13.8% in women) than the AWGS 2014 (10.3% in men and 8.1% in women) definitions. The prevalence of severe sarcopenia was 6.4% in men and 3.2% in women. The results of our study suggest that the use of CC and SARC-CalF to screen for possible sarcopenia may be more suited than using the SARC-F questionnaire alone according to the AWGS 2019 diagnostic algorithm in community-dwelling adults aged 70 to 84 years. The prevalence of sarcopenia was significantly higher according to the AWGS 2019 than AWGS 2014 criteria.

Kim M ，Won CW 《-》

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

Sarcopenia is an important clinical syndrome in older people living with HIV (PLWH). With a change to the Asia sarcopenia definition in 2019, we aimed to determine whether health outcomes were associated with different definitions of sarcopenia among Asian PLWH. We performed a prospective cross-sectional study enrolling PLWH aged ≥35 years from January 2018 to November 2021. We defined sarcopenia by the Asia Working Group of Sarcopenia (AWGS) criteria in 2014 and 2019. AWGS-2014 included low muscle mass plus weak handgrip strength and/or slow gait speed. AWGS-2019 included low muscle mass plus low muscle strength or physical performance, while the presence of all defines severe sarcopenia. We measured appendicular skeletal muscle mass using dual-energy X-ray absorptiometry, handgrip strength, usual gait speed, five-time chair stand test and Short Physical Performance Battery. Correlations between each sarcopenia definition and health-related quality of life (using EQ-5D-5L and SF-36) and functional disability were determined. One hundred and fifty Asian PLWH were enrolled, 132 (88%) were male, mean age was 60±10 years, duration of HIV diagnosis was 13 (IQR 8-18) years and current CD4 count was 574 (IQR 362-762) cells/mm3 , 67 (45%) had multimorbidity, 64 (43%) had polypharmacy. Prevalence of sarcopenia by AWGS-2014, AWGS-2019 and severe sarcopenia was 17.3%, 27.3% and 18.0%, respectively. Age, education and polypharmacy were associated with sarcopenia. Sarcopenia (AWGS-2014) and severe sarcopenia were associated with mobility, physical functioning and physical component score (SF-36). All three criteria were associated with impaired instrumental activities of daily living (IADL). After age and sex adjustment, sarcopenia (AWGS-2014) (adjusted odds ratio/aOR 5.4, 95% confidence interval/CI 2.0-15.1) and severe sarcopenia (aOR 5.1, 95% CI 1.9-14.0) were associated with mobility and physical component score (SF-36) (β coefficients -5.3342, p = 0.022 and -5.412, p = 0.019). Sarcopenia (AWGS 2014) (aOR 5.2, 95% CI 1.7-16.2), sarcopenia (AWGS-2019) (aOR 4.5, 95% CI 1.5-13.1) and severe sarcopenia (aOR 3.5, 95% CI 1.1-10.9) were associated with impaired IADL in fully adjusted models. In a sample of Asian PLWH, 17.3%, 27.3% and 18.0% had sarcopenia as defined by AWGS-2014, AWGS-2019 and severe sarcopenia, respectively. Sarcopenia by AWGS-2014 and severe sarcopenia correlated with parameters of poor health outcomes, while sarcopenia by AWGS-2019 correlated with functional disability.

Luk FWL ，Li T ，Ho HY ，Chan YY ，Cheung SK ，Wong V ，Kwok TCY ，Lui G ... -  《-》

Prevalence of sarcopenia in community-dwelling older adults using the definition of the European Working Group on Sarcopenia in Older People 2: findings from the Korean Frailty and Aging Cohort Study.

in October 2018, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) updated their original definition of sarcopenia to reflect the scientific and clinical evidence that has accumulated over the last decade. to determine the prevalence of sarcopenia in a large group of community-dwelling older adults using the EWGSOP2 definition and algorithm. a cross-sectional study. the nationwide Korean Frailty and Aging Cohort Study (KFACS). a total of 2,099 ambulatory community-dwelling older adults, aged 70-84 years (mean age, 75.9 ± 4.0 years; 49.8% women) who were enrolled in the KFACS. physical function was assessed by handgrip strength, usual gait speed, the five-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. Appendicular skeletal muscle mass (ASM) was measured by dual-energy X-ray absorptiometry. according to the criteria of the EWGSOP2, the sarcopenia indicators of combined low muscle strength and low muscle quantity were present in 4.6-14.5% of men and 6.7-14.4% of women. The severe sarcopenia indicators of combined low muscle strength, low muscle quantity and low physical performance were present in 0.3-2.2% of men and 0.2-6.2% of women. Using the clinical algorithm with SARC-F as a screening tool, the prevalence of probable sarcopenia (2.2%), confirmed sarcopenia (1.4%) and severe sarcopenia (0.8%) was low. the prevalence of sarcopenia among community-dwelling older individuals varied depending on which components of the revised EWGSOP2 definition were used, such as the tools used to measure muscle strength and the ASM indicators for low muscle mass.

Kim M ，Won CW 《-》

Sit-to-Stand Video Analysis-Based App for Diagnosing Sarcopenia and Its Relationship With Health-Related Risk Factors and Frailty in Community-Dwelling Older Adults: Diagnostic Accuracy Study.

Ruiz-Cárdenas JD ，Montemurro A ，Martínez-García MDM ，Rodríguez-Juan JJ ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》