The normal ageing process is accompanied by progressive declines in muscle mass and strength. Abnormal and excessive losses of skeletal muscle mass and quality emerge as a consequence of age-related musculoskeletal disorders, e.g. sarcopenia. The latter confers affected patients with increased risks of adverse outcomes, including falls, fractures, and mortality. Moreover, sarcopenic patients often exhibit higher levels of dependency and disability, both of which impact their health-related quality of life (HRQoL). HRQoL measures are well-characterised predictors of hard clinical outcomes, including hospitalisation and mortality. Accordingly, the use of sarcopenia-specific HRQoL tools in clinical practice and interventional trials is recommended by recent European Working Group on Sarcopenia in Older People (EWGSOP2) guidelines. This meta-analysis aimed to characterise the relationship between sarcopenia and patient-reported HRQoL.
Ageing is often associated with appetite reduction and ensuing weight loss. Although it is known that physical activity (PA) can prevent these ageing-related processes, the exact molecular mechanisms underpinning this ability remain unknown. Recent research has highlighted the role of exerkines, i.e. proteins released during and after PA, in controlling energy metabolism. Growth differentiation factor 15 (GDF-15), a stress-signalling cytokine secreted during PA and involved in ageing, exercise, and appetite control, has emerged as a potential mediator of late-life, ageing-related weight loss. This study aimed to explore the associations between PA, GDF-15, and body weight changes in older adults enrolled in the Multidomain Alzheimer Preventive Trial over a 3-year period.
This study investigates the connection between sarcopenia and age-related spinal deformities, focusing on lumbar paravertebral muscles (PVM) quality and volume. Results show that sarcopenic patients have higher ectopic fat infiltration in PVM, contributing to spinal deformities, highlighting the importance of understanding and addressing sarcopenia in relation to spinal health.
Appetite Loss, Malnutrition, and Mortality: a Significant Association in Need of Urgent Recognition?
This systematic literature review highlights the underrecognition of appetite loss in older adults and its association with malnutrition and mortality. The study underscores the urgent need for standardized screening and comprehensive guidelines to improve the assessment and management of appetite loss in this population.
This article provides an overview of the current state of research on anorexia of ageing, its metabolic implications, and potential biomarkers, highlighting the need for further investigation into appetite regulation in older adults to improve health outcomes and personalized nutritional care.
Muscle strength has recently been defined as sarcopenia’s main component by the revised European Working Group in Sarcopenia for Older People (EWGSOP2). This shift from muscle mass to strength has had transformative implications within clinical practice and has greatly facilitated sarcopenia’s diagnostic process. Despite this trailblazing consensus, sarcopenia remains an issue of growing concern throughout high-income countries (HICs). Although low- and middle-income countries (LMICs) are disproportionately affected by the threat of sarcopenia, their care providers and healthcare systems seem to be the least prepared to tackle it. The aim of this article is to expose the state of sarcopenia awareness and management in LMICs. It further proposes solutions to prepare the developing world for this growing concern.
Sarcopenia is characterised by an age-related decline in muscle mass and strength combined with impairments in physical function. The risk of falls, fractures, and death is doubled in individuals with sarcopenia compared to those without. This patient population also frequently possesses comorbid diseases, including diabetes, cardiovascular disease, dementia, and chronic obstructive pulmonary disease. This may significantly increase their risk of suffering adverse outcomes post-surgery. The aim of this editorial was to expose the serious nature of sarcopenia and underscore associated knowledge gaps in clinical practice.
Dynapenia is characterised by an age-related loss of muscle strength. When coupled with low muscle mass, it is instead diagnosed as sarcopenia according to the European Working Group on Sarcopenia in Older People revised guidelines (EWGSOP2). The SARS-CoV-2 infection is accompanied by severe inflammation and increased catabolism, which may significantly impact infected patients’ skeletal muscle structure and function. These impacts may be detrimental to elderly patients, who are disproportionately affected and already highly burdened by the disease. Recent studies have suggested that sarcopenia at the time of hospital admission may shape older patients’ length of stay and increase mortality in those with moderate to severe COVID-19. The aim of this study was to examine the association between simple clinical biomarkers, including those for the assessment of muscle function and frailty, and the risk of poor survival as well as increased length of hospital stay in older patients with COVID-19. Sarcopenia was screened using SARC-F, while frailty was assessed in accordance with the Rockwood Clinical Frailty Scale.
Patients with chronic kidney disease (CKD) possess an increased risk of developing physical or phenotypic frailty. The skeletal muscle dysfunction underpinning physical frailty has been associated with increased mortality. CKD-related phenotypic frailty shares features with ageing-related frailty, and CKD has thus been touted as a clinically relevant model of premature ageing. The aim of this review was to examine the metabolic basis and pathogenesis of the skeletal muscle dysfunction responsible for phenotypic frailty in patients with CKD.
Ageing is associated with increased fat accumulation and weight gain due to altered energy metabolism. Sarcopenia, defined as a loss of muscle mass and function associated with increased mortality risk, is also linked to ageing. Sarcopenia obesity (SO) refers to the combination of age-related sarcopenia and obesity, and stems from the negative correlation between intermuscular adipose tissue accumulation and muscle performance. While elderly patients with obesity possess lower death rates than those with lower body mass indexes, patients with SO have higher mortality rates than these same peers. This, as well as obesity’s protective role against sarcopenia in the elderly, is the basis of the commonly known ‘obesity paradox’. The aim of this review was to assess the current clinical evidence relating to SO.
Resilience is characterised by the ability to bounce back after exposure to a stressor or a form of adversity. It is frequently separated into physical and psychological components, with the former being defined as the ability to recover following age-related losses or disease. A decline in resilience is both a marker and a risk factor for accelerated ageing and frailty, respectively. The aim of this editorial was to showcase the importance of resilience in the recovery of frail patients. It also exposes the mechanisms behind resilience, as well as the gaps in its clinical assessment.
Frailty is characterised by increased vulnerability to acute stressors associated with an age-related decline in function across multiple physiological systems. Since it is an age-dependent clinical syndrome, countries with ageing populations, like the United Kingdom (UK), are predicted to become increasingly exposed to worsening frailty-associated patient outcomes and burdened healthcare systems. This article aimed to emphasise the importance of frailty-related education for healthcare professionals in the UK.