Diagnostic and prognostic value of calf circumference for sarcopenia in community-dwelling older adults.

An age-dependent normative values of calf circumference (CC) has been recently proposed as an accessible proxy for muscle mass. However, its usefulness to estimate sarcopenia has not been assessed. The objectives of the present study were to determine if the substitution of the classical way to assess muscle mass by these values have enough diagnostic accuracy and prognostic value among older adults living in the community. Data from the Toledo Study of Healthy Ageing (TSHA) were used. CC was measured using an anthropometric tape. We used two age-groups CC cut-off points: the TSHA CC median and the one proposed in the Longevity Check-up 7+ (Lookup 7+) project. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and FNIH criteria standardized for our population (sFNIH). Frailty (according to the Frailty Phenotype and the Frailty Trait Scale-5) and disability (Katz index) were assessed at baseline and follow-up. Mortality and first hospitalization were also recorded. Logistic (incident frailty and worsening disability) and Cox (mortality and hospitalization) regressions were performed. Diagnostic accuracy was assessed through Kappa index, AUCs, positive and negative predictive values. Predictive ability was assessed through AUCs and integrated AUCs (IAUCs). 1531 participants (74.8 ± 5.8 years; 45.6% men) were included in the analysis. Prevalence rates of sarcopenia were 22.7% (sFNIH), 15.0% (FNIH), and 13.9% (EWGSOP2). Using TSHA-based cut-points of CC, the prevalence of sarcopenia was 16.8% (sFNIH), 11.0% (FNIH), and 11.5% (EWGSOP2). According to LC7+-based CC cut-off points, sarcopenia prevalence was 17.6% (sFNIH), 11.9% (FNIH), and 12.4% (EWGSOP2). CC cut-off points showed low-to-moderate agreement (Kappa Index values between 0.49 and 0.69) with appendicular lean mass for the evaluation of sarcopenia. Sarcopenia identified by Lookup 7+ and TSHA CC cut-off points was associated with the adverse events examined, with similar AUCs and IAUCs than original sarcopenia definitions, and were lost after adjustment by baseline frailty, except when the original EWGSOP2 definition was used. Using normalized values of CC as a criteria of muscle mass shows moderate agreement with classical criteria for diagnosing sarcopenia and offer similar predictive value in community-dwelling older adults.

Álvarez-Bustos A ，Carnicero JA ，Coelho-Junior HJ ，Calvani R ，García-García FJ ，Marzetti E ，Landi F ，Rodriguez-Mañas L ... -  《-》

Relationship Between Sarcopenia and Frailty in the Toledo Study of Healthy Aging: A Population Based Cross-Sectional Study.

Frailty and sarcopenia are correlates of musculoskeletal aging that represent a state of vulnerability increasing the risk of negative health outcomes. Standardized definitions are lacking for both, and sometimes both concepts are used interchangeably. However, no large study has assessed the coexistence of these 2 entities in a cohort of older community-dwelling people. Data were taken from the Toledo Study of Healthy Aging (TSHA), a study of community-dwelling elderly (≥65 years). The study population consists of 1611 participants with frailty and sarcopenia assessments. For sarcopenia, we used 3 criteria: European Working Group on Sarcopenia in Older People (EWGSOP), the Foundation for the National Institutes of Health (FNIH), and the FNIH fitted to the cut-off points of our population [standardized FNIH (sFNIH)]. Frailty was assessed according to the Fried criteria with cut-off points adjusted to our population. We used logistic regression to assess the relationship between sarcopenia and frailty and measures of diagnostic accuracy to evaluate the potential use of sarcopenia as a diagnostic marker for frailty. The mean age of the population was 75.42 years (±5.86). Overall, 72 (4.5%) were frail. In addition, 352 (21.8%), 332 (20.6%), and 453 (28.1%) participants were considered sarcopenic according to the EWGSOP, FNIH, and sFNIH criteria, respectively. The prevalence of frailty among those with sarcopenia was 8.2% (29/352), 15.7% (52/332), and 10.4% (47/453). Moreover, among frail people, the prevalence of sarcopenia was 40.27%, 72.2%, and 65.3% according to the used criteria. Sarcopenia showed a low sensitivity (<10%) but high specificity (>97%) for the diagnosis of frailty, with a low intercorrelation (Cramer V = 0.16, 0.40, and 0.30) between the 3 criteria and frailty. Using multivariate logistic regression, frailty was associated with sarcopenia according to EWGSOP [odds ratio (OR) = 1.67, 95% confidence interval (CI) = 0.95, 2.96], FNIH (OR = 10.61, 95% CI = 5.8, 19.4), and sFNIH (OR = 6.63, 95% CI =3.5, 12.53). Frailty and sarcopenia are distinct but related conditions. Sarcopenia is not a useful clinical biomarker of frailty, but its absence might be useful to exclude frailty.

Davies B ，García F ，Ara I ，Artalejo FR ，Rodriguez-Mañas L ，Walter S ... -  《-》

The Performance and Associated Risks of the Criteria for Sarcopenic Obesity Proposed by the European Association for the Study of Obesity in a Geriatric Population.

Molina-Baena B ，Álvarez-Bustos A ，Carnicero JA ，García-García FJ ，Rodríguez-Mañas L ... -  《Nutrients》

Comparing EWGSOP2 and FNIH Sarcopenia Definitions: Agreement and 3-Year Survival Prognostic Value in Older Hospitalized Adults: The GLISTEN Study.

Sarcopenia is common among older hospitalized adults but estimates vary according to definitions used. Aims of this study were to investigate the agreement between the European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project criteria and to compare the predictive value of both definitions for 3-year mortality. Analysis was performed on 610 older hospitalized patients enrolled in the GLISTEN study. Participants were categorized as sarcopenic or not sarcopenic according to EWGSOP2 and FNIH definitions separately and in a four-group variable (neither criterion positive, only EWGSOP2, only FNIH, and both criteria). Sarcopenia prevalence was 22.8% and 23.9% using EWGSOP2 and FNIH criteria, respectively, with a low classification agreement (Cohen's kappa statistic: 0.29). Sarcopenic participants by each definitions had higher mortality rate when compared to those not sarcopenic (both log-rank test: p < .001). Participants who met both positive criteria had the shorter survival as compared with the other three groups. Cox models showed that, after adjustment for potential confounders, only EWGSOP2 definition predicted 3-year mortality (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.33-2.57). When the four-group variable was used, compared with the NO EWGSOP2/NO FNIH group, significant mortality risk was found for the EWGSOP2 (HR 2.08; 95% CI 1.38-3.16) and the combined EWGSOP2/FNIH group (HR 1.75; 95% CI 1.11-2.79). Agreement between EWGSOP2 and FNIH definitions is poor. Sarcopenia on hospital admission is associated with increased risk of 3-year mortality and EWGSOP2 criteria seem to have the highest predictive value.

Bianchi L ，Maietti E ，Abete P ，Bellelli G ，Bo M ，Cherubini A ，Corica F ，Di Bari M ，Maggio M ，Martone AM ，Rizzo MR ，Rossi AP ，Volpato S ，Landi F ，GLISTEN Group Investigators ... -  《-》

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》