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      Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis

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          Abstract

          Objective

          The purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia.

          Methods

          Prospective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI.

          Results

          Of the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96–4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80–5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes).

          Conclusion

          Sarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden.

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          Most cited references14

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          Epidemiology of sarcopenia among the elderly in New Mexico.

          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 populations 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 random subsample (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 standard 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.
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            Effects of aging on muscle fibre type and size.

            Aging has been associated with a loss of muscle mass that is referred to as 'sarcopenia'. This decrease in muscle tissue begins around the age of 50 years, but becomes more dramatic beyond the 60th year of life. Loss of muscle mass among the aged directly results in diminished muscle function. Decreased strength and power contribute to the high incidence of accidental falls observed among the elderly and can compromise quality of life. Moreover, sarcopenia has been linked to several chronic afflictions that are common among the aged, including osteoporosis, insulin resistance and arthritis. Loss of muscle fibre number is the principal cause of sarcopenia, although fibre atrophy--particularly among type II fibres--is also involved. Several physiological mechanisms have been implicated in the development of sarcopenia. Denervation results in the loss of motor units and thus, muscle fibres. A decrease in the production of anabolic hormones such as testosterone, growth hormone and insulin-like growth factor-1 impairs the capacity of skeletal muscle to incorporate amino acids and synthesise proteins. An increase in the release of catabolic agents, specifically interleukin-6, amplifies the rate of muscle wasting among the elderly. Given the demographic trends evident in most western societies, i.e. increased number of those considered aged, management interventions for sarcopenia must become a major goal of the healthcare profession.
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              The Predictive Value of the EWGSOP Definition of Sarcopenia: Results From the InCHIANTI Study.

              Sarcopenia is associated with increased risk of adverse outcomes in older people. Aim of the study was to explore the predictive value of the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic algorithm in terms of disability, hospitalization, and mortality and analyze the specific role of grip strength and walking speed as diagnostic criteria for sarcopenia.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 January 2017
                2017
                : 12
                : 1
                : e0169548
                Affiliations
                [1 ]Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
                [2 ]Aix-Marseille University, School of Medicine, Marseille, France
                [3 ]Life Sciences Library, University of Liège, Liège, Belgium
                University of British Columbia, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: CB JYR OB.

                • Data curation: CB.

                • Formal analysis: CB.

                • Funding acquisition: CB.

                • Investigation: CB MZ.

                • Methodology: CB FP OB.

                • Project administration: OB JYR.

                • Resources: JYR OB.

                • Supervision: OB JYR.

                • Validation: CB MZ.

                • Visualization: CB.

                • Writing – original draft: CB.

                • Writing – review & editing: CB MZ FP JYR OB.

                Article
                PONE-D-16-35735
                10.1371/journal.pone.0169548
                5240970
                28095426
                88e7177f-bbda-43bf-9ff6-3263295fd41e
                © 2017 Beaudart et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 6 September 2016
                : 19 December 2016
                Page count
                Figures: 2, Tables: 5, Pages: 16
                Funding
                Funded by: C.B. is supported by a fellowship from the FNRS (Fonds National de la Recherche Scientifique de Belgique—FRS-FNRS—www.frs-fnrs.be).
                Award Recipient :
                C.B. is supported by a fellowship from the FNRS (Fonds National de la Recherche Scientifique de Belgique—FRS-FNRS— www.frs-fnrs.be).
                Categories
                Research Article
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Sarcopenia
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Sarcopenia
                People and Places
                Demography
                Death Rates
                Research and Analysis Methods
                Database and Informatics Methods
                Database Searching
                Research and Analysis Methods
                Research Assessment
                Systematic Reviews
                Biology and Life Sciences
                Physiology
                Muscle Physiology
                Muscle Functions
                Medicine and Health Sciences
                Physiology
                Muscle Physiology
                Muscle Functions
                Research and Analysis Methods
                Bioassays and Physiological Analysis
                Muscle Analysis
                People and Places
                Population Groupings
                Age Groups
                Elderly
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Meta-Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Meta-Analysis
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized
                Uncategorized

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