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      Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study

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          Abstract

          Background

          Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. However, there remains a lack of consensus on the criteria and cut-off thresholds for assessing sarcopenia and SO. Moreover, limited data are available on the prevalence of these conditions in Latin American countries. To address this evidence gap, we aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥ 55 years in Lima, Peru.

          Methods

          Data collection for this cross-sectional study was conducted between 2018 and 2020 in two urban low-resource settings in Lima, Peru. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS) guidelines. We measured muscle strength by maximum handgrip strength; muscle mass using a whole-body single-frequency bioelectrical impedance analyzer, and physical performance using the Short Physical Performance Battery and 4-meter gait speed. SO was defined as a body mass index ≥ 30 kg/m 2 and sarcopenia.

          Results

          The study participants had a mean age of 66.2 years (SD 7.1), of which 621 (53.9%) were men, and 41.7% were classified as obese (BMI ≥ 30.0 kg/m 2). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3–25.1) using the EWGSOP2 criteria and 27.8% (95%CI:25.2–30.4) using the AWGS criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4–7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7–9.9) using AWGS criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8–20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3–1.3) to 5.0% (95%CI: 3.8–6.3).

          Conclusions

          Our findings reveal substantial variation in the prevalence of sarcopenia and SO when using different guidelines, underscoring the necessity for context-specific cut-off values. Nevertheless, regardless of the chosen guideline, the prevalence of probable sarcopenia and sarcopenia among community-dwelling older adults in Peru remains noteworthy.

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          Most cited references34

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          Sarcopenia: revised European consensus on definition and diagnosis

          Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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            A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.

            A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. A wide distribution of performance was observed for each test. Each test and a summary performance scale, created by summing categorical rankings of performance on each test, were strongly associated with self-report of disability. Both self-report items and performance tests were independent predictors of short-term mortality and nursing home admission in multivariate analyses. However, evidence is presented that the performance tests provide information not available from self-report items. Of particular importance is the finding that in those at the high end of the functional spectrum, who reported almost no disability, the performance test scores distinguished a gradient of risk for mortality and nursing home admission. Additionally, within subgroups with identical self-report profiles, there were systematic differences in physical performance related to age and sex. This study provides evidence that performance measures can validly characterize older persons across a broad spectrum of lower extremity function. Performance and self-report measures may complement each other in providing useful information about functional status.
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              A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach.

              the European Working Group on Sarcopenia in Older People has developed a clinical definition of sarcopenia based on low muscle mass and reduced muscle function (strength or performance). Grip strength is recommended as a good simple measure of muscle strength when 'measured in standard conditions'. However, standard conditions remain to be defined. a literature search was conducted to review articles describing the measurement of grip strength listed in Medline, Web of Science and Cochrane Library databases up to 31 December 2009. there is wide variability in the choice of equipment and protocol for measuring grip strength. The Jamar hand dynamometer is the most widely used instrument with established test-retest, inter-rater and intra-rater reliability. However, there is considerable variation in how it is used and studies often provide insufficient information on the protocol followed making comparisons difficult. There is evidence that variation in approach can affect the values recorded. Furthermore, reported summary measures of grip strength vary widely including maximum or mean value, from one, two or three attempts, with either hand or the dominant hand alone. there is considerable variation in current methods of assessing grip strength which makes comparison between studies difficult. A standardised method would enable more consistent measurement of grip strength and better assessment of sarcopenia. Our approach is described.
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                Author and article information

                Contributors
                Journal
                Res Sq
                ResearchSquare
                Research Square
                American Journal Experts
                13 June 2023
                : rs.3.rs-3031470
                Affiliations
                Universidad de San Martín de Porres
                Prisma
                Johns Hopkins University
                Johns Hopkins University
                University of Miami
                University College London
                Scientific University of the South
                Scientific University of the South
                Newcastle University
                Universidad de San Martín de Porres
                Author notes

                Authors’ contributions

                OFF, AZM: conceived the research question and conducted the analysis; interpretation, and drafting the manuscript. SP, JH, WCH, TS, FR, MW, JP: contribution to acquisition and data interpretation; ABO: contributed to data analysis and interpretation. All authors read, contribute to the interpretation and discussion of the findings. All authors approved the final manuscript and are accounted for the findings presented.

                Article
                10.21203/rs.3.rs-3031470
                10.21203/rs.3.rs-3031470/v1
                10312954
                37398477
                310df2c8-26ed-4dc0-88d9-7583f3fbf35c

                This work is licensed under a Creative Commons Attribution 4.0 International License, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

                History
                Funding
                Funded by: NIH Research Training
                Award ID: D43 TW009340
                Funded by: NIH Fogarty International Center, NINDS, NIMH, and NHBLI
                Award ID: K43TW011586
                Funded by: Mentored Research Scientist Development
                Award ID: 1K01HL140048
                Funded by: National Heart, Lung, and Blood Institute, National Institutes of Health
                Funded by: Global Excellence in Chronic Obstructive Pulmonary Disease Outcomes
                Funded by: UK Medical Research Council
                Award ID: MR/P008984/1
                Funded by: Global Alliance for Chronic Disease
                Categories
                Article

                sarcopenia,muscle strength,muscle mass,sarcopenic obesity,older people

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