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Purpose: Loss of muscle power has a significant impact on mobility in geriatric populations, so this study sought to determine the extent and time course of performance decline in power-centric events throughout the life span via retrospective analyses of masters and elite track-and-field data. Methods: Four track-and-field events were selected based on maximal power output: the 100-m dash, long jump, high jump, and triple jump. Elite and masters athlete data were gathered from the World Masters Outdoor Championships and the International Amateur Athletic Federation World Athletics Championships (17,945 individual results). Data were analyzed by fitting individual and group results to quadratic and linear models. Results: Average age of peak performance in all events was 27.8 (0.8) years for men and 28.3 (0.8) years for women. Athlete performance decline best matched a linear model for the 5 years following peak performance (mean R2 =.68 [.20]) and for ages 35–60, but best matched a quadratic model for ages 60–90 and 35–90 (mean R2 =.75 [.12]). The average rate of decline for the masters data ages 35–60 ranged from 0.55% per year for men's 100-m dash to 1.04% per year for women's long jump. A significant age × sex interaction existed between men and women, with men declining faster throughout life in all events except the 100-m dash. Conclusions: Performance decline begins in the early 30s and is linear through middle age. This pattern of decline provides a basis for further research on power-decline pathophysiology and preventive measures starting in the 30s. [ABSTRACT FROM AUTHOR]

Back pain lifetime incidence is 60%–70%, while 12%–20% of older women have vertebral fractures (VFs), often with back pain. We aimed to provide objective evidence, currently lacking, regarding whether back pain and VFs affect physical activity (PA). We recruited 69 women with recent back pain (age 74.5 ± 5.4 years). Low- (0.5 < g < 1.0), medium- (1.0 ≤ g < 1.5), and high-impact (g ≥ 1.5) PA and walking time were measured (100 Hz for 7 days, hip-worn accelerometer). Linear mixed-effects models assessed associations between self-reported pain and PA, and group differences (VFs from spine radiographs/no-VF) in PA. Higher daily pain was associated with reduced low (β = −0.12, 95% confidence interval, [−0.22, −0.03], p =.013) and medium-impact PA (β = −0.11, 95% confidence interval, [−0.21, −0.01], p =.041), but not high-impact PA or walking time (p >.11). VFs were not associated with PA (all p >.2). Higher daily pain levels but not VFs were associated with reduced low- and medium-impact PA, which could increase sarcopenia and falls risk in older women with back pain. [ABSTRACT FROM AUTHOR]

Androgen deprivation therapy (ADT) forms the cornerstone in the treatment of advanced prostate cancer. However, by suppressing testosterone ADT results in a decrease of skeletal muscle mass. In this narrative review, we explore the magnitude and mechanisms of ADT-induced muscle mass loss and the consequences for muscle strength and physical performance. Subsequently, we elucidate the effectiveness of supervised resistance exercise training as a means to mitigate these adverse effects. Literature shows that resistance exercise training can effectively counteract ADT-induced loss of appendicular lean body mass and decline in muscle strength, while the effect on physical performances is inconclusive. As resistance exercise training is feasible and can be safely implemented during ADT (with special attention for patients with bone metastases), it should be incorporated in standard clinical care for prostate cancer patients (starting) with ADT. [ABSTRACT FROM AUTHOR]

Adequate body composition is essential for health, function, and independence in older adults. However, standard body composition assessments require complex and costly modalities, limiting their use for early detection of body composition changes and periodic follow-up. This study explored the ability of three practical measures—handgrip strength, five times sit-to-stand test, and upper limb loading during seated push-up test (ULL-SPUT)—to determine body composition in 109 older adults with and without sarcopenia. Participants (average age 76 years) were cross-sectionally measured for outcomes of the study. The ULL-SPUT and handgrip strength, but not the five times sit-to-stand test, significantly correlated with body composition (rs, r =.297–.827, p <.01). The ULL-SPUT, in combination with demographic data, could determine body composition up to 82%. Therefore, the ULL-SPUT may be a practical preliminary measure to identify older adults for whom standard body composition assessments and follow-up would prove timely and beneficial. [ABSTRACT FROM AUTHOR]

Resistance exercise training (RET) can be applied effectively to increase muscle mass and function in older adults (65–75 years). However, it has been speculated that older adults above 85 years are less responsive to the benefits of RET. This study compares the impact of RET on muscle mass and function in healthy older adults 65–75 years versus older adults above 85 years. We subjected 17 healthy older adults 65–75 years (OLDER 65–75, n = 13/4 [female/male]; 68 ± 2 years; 26.9 ± 2.3 kg/m2) and 12 healthy older adults above 85 years (OLDER 85+, n = 7/5 [female/male]; 87 ± 3 years; 26.0 ± 3.6 kg/m2) to 12 weeks of whole-body RET (three times per week). Prior to, and after 6 and 12 weeks of training, quadriceps and lumbar spine vertebra 3 muscle cross-sectional area (computed tomography scan), whole-body lean mass (dual-energy X-ray absorptiometry scan), strength (one-repetition maximum test), and physical performance (timed up and go and short physical performance battery) were assessed. Twelve weeks of RET resulted in a 10% ± 4% and 11% ± 5% increase in quadriceps cross-sectional area (from 46.5 ± 10.7 to 51.1 ± 12.1 cm2, and from 38.9 ± 6.1 to 43.1 ± 8.0 cm2, respectively; p <.001; η2 =.67); a 2% ± 3% and 2% ± 3% increase in whole-body lean mass (p =.001; η2 =.22); and a 38% ± 20% and 46% ± 14% increase in one-repetition maximum leg extension strength (p <.001; η2 =.77) in the OLDER 65–75 and OLDER 85+ groups, respectively. No differences in the responses to RET were observed between groups (Time × Group, all p >.60; all η2 ≤.012). Physical performance on the short physical performance battery and timed up and go improved (both p <.01; η2 ≥.22), with no differences between groups (Time × Group, p >.015; η2 ≤.07). Prolonged RET increases muscle mass, strength, and physical performance in the aging population, with no differences between 65–75 years and 85+ years older adults. [ABSTRACT FROM AUTHOR]

This study evaluated the relationship between the muscle mass of the gluteus medius (GM) and skeletal muscle mass index (SMI) measured in patients with hip fractures. In this study, 141 patients with hip fractures were divided into those with high or low SMI. The GM index (GMI) was calculated by dividing the GM by the square of the height in meters. The correlation between GMI and SMI was subsequently analyzed, and cutoff values for determining the loss of skeletal muscle mass were calculated using the receiver operating characteristic curve. GMI and SMI showed a positive correlation for both sexes (male: r =.890, female: r =.626, p <.001). The GMI cutoff values were 19.460 cm2/m2 for males and 17.850 cm2/m2 for females. Skeletal muscle mass evaluation of the GM could contribute to hip fracture recovery by improving mobility and facilitating the early diagnosis of loss of SMM. [ABSTRACT FROM AUTHOR]

This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed. [ABSTRACT FROM AUTHOR]

Background: The Skeletal Muscle Index (SMI) serves as an objective metric for assessing nutritional status in patients with malignant tumors. Research has found baseline nutritional status can influence both the efficacy and prognosis of targeted anti-tumor therapies, with growth factor tyrosine kinase inhibitors frequently inducing drug-related sarcopenia. Fruquintinib has received approval for the treatment of metastatic colorectal cancer. This study examines the prognostic significance of baseline SMI in patients with metastatic colorectal cancer undergoing treatment with fruquintinib. Additionally, the study investigates the incidence of SMI reduction following fruquintinib therapy to assess its impact on patient prognosis. Methods: A retrospective multicenter study was conducted to analyze patients with metastatic colorectal cancer who received fruquintinib treatment across eight medical centers in Eastern China. The muscle area at the third lumbar vertebra was assessed, and both baseline and post-treatment SMI values were calculated independently. The relationship between SMI and patient survival was subsequently examined. Results: The median progression-free survival (PFS) for the cohort of 105 patients was 4.2 months (95% CI, 3.7 to 4.9 months), while the median overall survival (OS) was 10.2 months (95% CI, 9.0 to 12.7 months). Notably, the baseline SMI prior to the initiation of fruquintinib therapy exhibited a significant correlation with OS (P = 0.0077). Multivariate analysis indicated that baseline SMI serves as an independent prognostic factor for OS (P = 0.005). Furthermore, after Propensity Score Matching (PSM) analysis, there was still a significant correlation between baseline SMI and OS. Among the patients, 28.87% developed sarcopenia following oral administration of fruquintinib. However, no statistically significant difference in OS was observed between the group with reduced SMI and the group without SMI reduction after treatment with fruquintinib. Conclusion: The baseline SMI was identified as an independent prognostic factor for OS and may influence the survival outcomes of patients with metastatic colorectal cancer undergoing treatment with fruquintinib. Despite the potential of fruquintinib to induce sarcopenia, no significant correlation was observed between changes in SMI following treatment and patient survival. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association of serum creatinine-cystatin C ratio (Cr/CysC) with long-term all-cause mortality and cause-specific (cardiovascular and cancer) mortality among US general adults. Methods: This nationally representative cohort study included adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Participants were linked to National Death Index data from the survey date through December 31, 2019. Weighted Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals (CIs), and restricted cubic splines and stratified analyses were also performed. Results: A total of 12,914 participants were included in this study (mean [SD] age, 45.3 [17.3] years; males, 48.9%). During a median follow-up of 17.9 years (maximum follow-up, 20.8 years), 3439 total deaths occurred, including 1098 cardiovascular deaths and 736 cancer deaths. Cumulative incidence curves revealed that increased Cr/CysC ratio had lower risk of all-cause (P < 0.001), cardiovascular (P < 0.001) and cancer (P < 0.001) mortality. Cox regression an Fine-Gray hazards models demonstrated that the multivariable-adjusted hazard ratios comparing the highest vs. lowest quartile of Cr/CysC ratio were 0.40 (95% CI, 0.34–0.47; P < 0.001) for all-cause mortality, 0.68 (95% CI, 0.52–0.88; P < 0.001) for cardiovascular mortality, and 0.51 (95% CI, 0.36–0.71; P < 0.001) for cancer mortality. Nonlinear association was observed for Cr/CysC ratio and all-cause mortality (P = 0.018 for nonlinearity), and linear associations were observed for Cr/CysC ratio and cardiovascular (P = 0.212 for nonlinearity) and cancer (P = 0.550 for nonlinearity) mortality. Besides, a series of sensitivity analyses ensured the robustness of the results. Conclusions: In this cohort of US adults, Cr/CysC ratio was negatively associated with all-cause, cardiovascular, and cancer mortality. Our study suggests that Cr/CysC ratio may serve as a simple and effective predictor of long-term health outcomes. [ABSTRACT FROM AUTHOR]

Odjectives: To investigate the predictive value of computed tomography (CT)-based transverse diameter (TD) and longitudinal diameter (LD) of the psoas muscle at the level of third lumbar vertebra for 28-day mortality in older patients with sepsis. Methods: This retrospective single-center cohort study included 115 septic patients aged over 65 years old who were admitted to ICU in Beijing-Chaoyang Hospital between July 2017 and July 2022. The TD and LD of psoas muscle were obtained by measurement on abdominal CT images. Logistic regression analysis was conducted to identify the prognostic factors for 28-day mortality in older patients with sepsis, and their predictive performances were evaluated using the receiver operating characteristic (ROC) curve. Results: Multivariable logistic analysis indicated that TD (OR: 0.405, 95% CI: 0.190–0.864) was a protective factor for 28-day mortality in older patients with sepsis, whereas LD was not. The areas under the curve (AUCs) of TD, APACHE II, and SOFA were 0.666 (95% CI: 0.565–0.767), 0.660 (95% CI: 0.561–0.760), and 0.679 (95% CI: 0.581–0.777), respectively. Furthermore, the AUCs for the combination of TD with APACHE II or SOFA were 0.766 (95% CI: 0.679–0.853, P < 0.001) and 0.765 (95% CI: 0.679–0.852, P < 0.001). Conclusions: TD of psoas muscle was a predictor for 28-day mortality in older patients with sepsis. The combination of TD with APACHE II or SOFA scores enhances the early identification of patients at high risk for poor prognosis. Clinical trial number: not applicable. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results. Aim: To investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older. Methods: A longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status. Results: LMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35–2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93–1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18–1.66). Conclusions: Identifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a generalized loss of skeletal muscle mass, strength, and performance, and early identification is crucial to minimize adverse outcomes. While sarcopenia is well-studied in older populations, data on its prevalence and risk factors in young adults with juvenile idiopathic arthritis (JIA) remain limited. Objectives: The study aimed to evaluate the prevalence of sarcopenia in young adults with JIA and to identify associated risk factors. Methods: A cross-sectional single-center study was conducted at the Rheumatology Department of Communal Noncommercial Institution "Oleksandrivska Clinical Hospital", Kyiv, Ukraine, involving 70 patients between November 2020 and November 2022. Initially, 84 patients were recruited; however, 14 were excluded due to joint replacement, diabetes, or refusal to participate. Sarcopenia was diagnosed using the Find-Assess-Confirm-Severity algorithm, assessing muscle strength with a dynamometer, confirming sarcopenia using dual-energy X-ray absorptiometry, and determining severity via gait speed tests. Univariable and multivariable logistic regression was used to identify factors associated with sarcopenia and reported as odds ratios (OR) and 95% confidence intervals (95% CI). Results: Low handgrip strength, sarcopenia, and severe sarcopenia were observed in 64% (45/70), 59% (41/70), and 34% (24/70) of the patients, respectively. Men were less likely to lose muscle mass than women were (OR 0.29, 95% CI 0.10–0.89; p = 0.03). Sarcopenia was significantly predicted by disease activity according to the Disease Activity Score 28 based on erythrocytes sedimentation rate (DAS28-ESR) and clinical Juvenile Arthritis Disease Activity Score (cJADAS27) (OR 2.08, 95% CI 1.15–3.76; p = 0.01; OR 1.15, 95% CI 1.04–1.27; p = 0.007, respectively), articular and extra-articular Juvenile Arthritis Damage Index (JADI) (JADI-A OR 2.29, 95% CI 1.23–4.25; p = 0.009; JADI-E OR 3.15, 95% CI 1.36–7.29; p = 0.008, respectively), and functional capacity according to the Health Assessment Questionnaire (OR 4.14, 95% CI 1.38–12.5; p = 0.01). Conclusion: Sarcopenia in young adults with JIA was associated with disease activity (measured by DAS28-ESR and cJADAS27), articular and extra-articular damage (measured by JADI indices), and lower functional capacity. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is an age-related, insidious, crippling but curable degenerative disease if diagnosed and treated early. However, no accessible and accurate early screening method is available for community settings that does not require specialized personnel. One of the hallmarks of sarcopenia is the pathological changes of muscle fiber type composition and motor unit firing patterns. Surface electromyography (sEMG) may serve as an effective tool for detecting differences between healthy and sarcopenic individuals due to its superior wearability and accessibility compared to other screening methods such as medical imaging and bioimpedance measurements, making it ideal for community-based sarcopenic screening. Our study aims to explore sEMG biomarkers that can be used for screening or diagnosis of sarcopenia. Results: We collected multi-channel sEMG signals from six forearm muscles of 98 healthy and 55 sarcopenic community-dwelling older adults. Participants performed grasp tasks at 20% and 50% of maximum voluntary contraction (MVC). Hexagons created by various EMG features, normalized with respect to respective MVC, and symmetry analyses were performed to estimate multi-muscle coordination patterns. An innovative index, namely incenter–circumcenter distance of muscle coordination (ICDMC), is proposed to discriminate between the healthy and sarcopenic groups. We utilized non-parametric tests to compare the ICDMC between the two groups, considering a p-value less than 0.05 statistically significant. The results showed that at 20% MVC, ICDMCs from root mean square (RMS), mean absolute value (MAV), slope sign changes (SSC) and wavelength (WL) showed statistically significant differences. More insights of this sEMG manifestation of sarcopenia were revealed by gender- and age-stratifications analyses. Conclusions: Our results demonstrated that there are clear sEMG manifestations of altered muscle coordination in sarcopenic patients. More consistent force generation patterns were observed in the sarcopenic group, especially at lower contraction intensities. The novel ICDMC can quantify differences between sarcopenic and healthy muscle. These results warrant further research to further develop more accessible sarcopenia screening strategies in community settings based on electrophysiological measurements such as sEMG. [ABSTRACT FROM AUTHOR]

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This investigation seeks to scrutinize the relationships between body composition metrics and the clinical outcomes observed in patients with cholangiocarcinoma (CCA). A comprehensive exploration was conducted across three prominent online databases: Embase, PubMed, and the Cochrane Library. This endeavor spanned the entirety of each database up to the cutoff date of September 29, 2023. To evaluate the quality of the included studies, the Newcastle-Ottawa scale was employed. This comprehensive analysis included a total of 26 articles with a combined patient cohort of 4398 individuals. The results demonstrated that CCA patients with low skeletal muscle index (SMI) had significantly inferior OS (HR: 1.93, p < 0.001) and RFS (HR: 2.02, p < 0.001), as well as a higher incidence of postoperative complications (OR: 1.69, 95% CI: 1.20–2.38, p < 0.001) compared to those with high SMI. The presence of sarcopenia in CCA patients was significantly related to poorer OS (HR: 1.96, p < 0.001) and RFS (HR: 2.05, p < 0.001), and a higher rate of postoperative complications (OR: 1.39, p = 0.049) in comparison to those without sarcopenia. Moreover, lower psoas muscle index (PMI) and myosteatosis were associated with shorter OS (PMI, HR: 1.56, p < 0.001; myosteatosis, HR: 1.49, p = 0.001) and RFS (PMI, HR: 2.16, p < 0.001; myosteatosis, HR: 1.35, p = 0.023). Our findings highlight incorporating body composition screening into clinical practice can help develop treatment strategies and optimize perioperative care, potentially improving patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a significant predictor of perioperative adverse outcomes for a variety of malignancies and has significant negative effects on surgical and oncology outcomes. The development of sarcopenia is mainly attributed to aging, inactivity, poor nutrition, and decreased testosterone levels, which suggest a poor prognosis after surgery. Therefore, the primary objective of this systematic review and meta-analysis was to determine the effect of sarcopenia on postoperative survival in patients with oral squamous cell carcinoma. Methods: We systematically searched databases including PubMed, Embase, Cochrane Library, Medline and Web of Science from inception to 12 July 2023, to determine the prognostic value of sarcopenia in oral squamous cell carcinoma. The primary outcome was three-year survival, and secondary outcomes were one-year survival, five-year survival, infection and pneumonia within 30 days postoperatively. Original studies comparing postoperative outcomes in patients with sarcopenia and non-sarcopenia for oral squamous cell carcinoma curative therapy were met the eligibility criteria. We used Endnote X9 for the screening process and used RevMan 5.4.1 for our meta-analysis, all results in this study were performed using a random-effects model. QUIPS (Quality in Prognosis Studies) tools and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) were used for risk of bias and quality of evidence assessment. Result: Ten original studies with 50611 patients met the inclusion criteria. Meta-analysis showed that patients with sarcopenia reduced three-year OS after surgery (OR = 0.73, 95% CI = 0.66-0.81, P < 0.00001). The one-year OS (OR = 0.71, 95% CI = 0.67-0.75, P < 0.00001) and five-year OS (OR = 0.60, 95% CI = 0.45-0.79, P = 0.0003) decreased significantly. Patients with sarcopenia had significantly increased 30-day postoperative mortality and an also increased risk of pneumonia (OR = 1.36, 95% CI = 1.24-1.49, P < 0.00001) and surgical site infection (OR = 2.49, 95% CI = 1.06-5.84, P = 0.04). Conclusion: Sarcopenia is associated with reduced survival in patients after curative resection. Meanwhile, 30-day mortality, postoperative pneumonia and surgical site infection were significantly higher than those in nonsarcopenic patients. Sarcopenia as an extremely important factor of postoperative adverse outcomes in OSCC patients need special attention. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42023444424. [ABSTRACT FROM AUTHOR]

Although sarcopenia has been a serious public health concern worldwide in recent years, its effective prevention and intervention measures are still lacking. The latest research has found that autophagy dysfunction is an essential mechanism in the pathogenesis of sarcopenia. And meanwhile, increasing studies have shown that phytonutrients consumption is positively correlated with the maintenance of skeletal muscle mass and strength, which involves the regulation of the autophagy pathway. However, due to the opposite environmental-dependent effect of autophagy in sarcopenia, targeting autophagy by phytonutrients as the treatment of sarcopenia is sometimes considered controversial. Thus, in this review, based on the illustration of the relationship between autophagy and skeletal muscle and the complex changes of autophagy in sarcopenia, the phytonutrients ameliorating sarcopenia by regulating autophagy are reviewed with emphasis, and the possible underlying mechanisms are systematically summarized. Despite some controversies, most current studies support the idea that maintaining basal and functional autophagy contributes to the treatment of sarcopenia. Several phytonutrients exhibit substantial beneficial effects on sarcopenia by targeting autophagy, with polyphenols (especially catechins and urolithin A) considered to be of potentially effective clinical relevance. Hence, the development of phytonutrients is a promising approach to the treatment of sarcopenia and its complications. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, gait disturbance, and intradialytic hypotension are among the various factors that contribute to fall risk. This study aimed to investigate the relationship between risk of sarcopenia, hemodialysis (HD) session, and long-term fall risk in older end-stage kidney disease (ESKD) patients by analyzing their spatiotemporal gait characteristics. Methods: We recruited 22 non-demented patients aged ≥ 65 years who were undergoing maintenance HD. Participants were divided into two groups based on their SARC-F score (< 4 and ≥ 4) to identify those with higher and lower risk of sarcopenia. Demographics, comorbidities, and renal parameters were compared between groups. Inertial measurement unit-based technology equipped with triaxial accelerometry and gyroscope was used to evaluate gait characteristics. The gait task was assessed both before and after dialysis using the Timed-Up and Go (TUG) test and a 10-meter walking test at a regular pace. Essential gait parameters were thoroughly analyzed, including gait speed, stride time, stride length, double-support phase, stability, and symmetry. We investigated the interaction between the dialysis procedure and gait components. Outcome of interest was any occurrence of injurious fall during follow-up period. Logistic regression models were employed to examine the relationship between baseline gait markers and long-term fall risk. Results: The SARC-F ≥ 4 group showed various gait abnormalities, including longer TUG time, slower gait speed, longer stride time, shorter stride length, and longer double support time compared to counterpart (SARC-F < 4). After HD sessions, the SARC-F ≥ 4 group showed a 2.0-second decrease in TUG task time, an 8.0 cm/s increase in gait speed, an 11.6% lower stride time, and a 2.4% increase in gait symmetry with significant group-time interactions. Shorter stride length and longer double support time were associated with injurious falls during the two-year follow-up. Conclusion: Our study demonstrated the utility of triaxial accelerometers in extracting gait characteristics in older HD patients. High-risk sarcopenia (SARC-F ≥ 4) was associated with various gait abnormalities, some of which partially improved after HD sessions. These gait abnormalities were predictive of future falls, highlighting their prognostic significance. [ABSTRACT FROM AUTHOR]

Background: The diabetic foot (DF) ulcer is the severe complication of type 2 diabetes mellitus (T2DM). Sarcopenia is characterized as the loss of muscle mass and strength, resulting in the increased risk of fracture and physical disability. Sarcopenia may affect the foot-ankle function in DF ulcer patients, compromise the quality of life. Objective: The aim was to clarify the effect of sarcopenia on foot-ankle function in patients with DF ulcer. Methods: In total of 108 T2DM patients with DF ulcer were enrolled. Based on the examination of muscle mass by dual energy X-ray absorptiometry (DXA) and grip strength and 5x sit-to-stand test, the DF patients were divided into sarcopenia and non-sarcopenia groups. The severity of DF ulcer was evaluated by Wagner classification. The foot-ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score. Results: DF patients with sarcopenia showed advanced age, lower BMI, longer duration of T2DM, and more severe Wagner classification, reduced appendicular skeletal muscle mass index (ASMI), grip strength, transcutaneous oxygenpressure (TcPO2) and prolonged time of 5X sit-to-stand test. The stratified comparison analysis indicated that severity of sarcopenia and DF ulcer, reduced TcPO2, and grip strength were aggravated with the impaired foot-ankle function (P < 0.05). Multivariate Logistic analysis showed that age, TcPO2, and severe sarcopenia were risk factors deteriorating the foot-ankle function. Conclusion: The sarcopenia is a key risk factor of decreasing foot-ankle function in patients with DF ulcer. Thus, the prevention of muscle mass and strength loss could be considered as part of comprehensive therapy for DF ulcer. [ABSTRACT FROM AUTHOR]

Background: The German version of the SarQoL®, a sarcopenia-specific quality of life (QoL) questionnaire, has not been validated hindering its widespread use. This study aimed to evaluate the psychometric properties of the German SarQoL®. Methods: Via a cross-sectional study participants were recruited in two geriatric outpatient facilities and one acute geriatric ward in Munich (Germany). Sarcopenia and probable sarcopenia were diagnosed with the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm. From 185 participants (age 79.8 ± 6.1), 77 had probable sarcopenia, and 51 had sarcopenia. Participants completed the SarQoL® and the European Quality-of-Life 5-Dimension (EQ-5D) questionnaires. The validation included examination of the discriminative power, construct validity, internal consistency, test-retest reliability, and floor/ceiling effects. Results: Lower SarQoL®scores for sarcopenic (p = 0.002) and probable sarcopenic subjects (p < 0.001) compared to controls indicated good discriminative power. Consistent construct validity was found for sarcopenic subjects: moderate to high correlations with domains capturing similar constructs of the EQ-5D: 'Activities of daily living' (r = -0.58, p < 0.001), 'Mobility' (r = -0.72, p < 0.001) and low correlations with domains related to different constructs like 'Pain' (r = -0.32, p < 0.022). Similar correlations were found for probable sarcopenic subjects. The Cronbach's alpha was 0.8. Test-retest reliability was excellent (intraclass coefficient correlation of = 0.96; 95% CI = 0.91–0.99), and no floor/ceiling effects were observed. Conclusion: QoL was similarly reduced in both patient cohorts compared to controls. The German SarQoL® is a valid and reliable instrument for measuring QoL in patients > 65 years of age with sarcopenia and probable sarcopenia and can now be used in epidemiological studies and clinical trials in a German-speaking population. Trial registration: German Clinical Trials Register (DRKS)-ID: DRKS00020504 (March 12th, 2021). [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is typically assessed through hand grip strength, walking speed, and chair stand tests. However, it has been inadequately examined in terms of other physical fitness (PF) components in community-dwelling older adults. Thus, in this study, we explored factors influencing the risk of sarcopenia in community-dwelling older adults. In addition, we analyzed the clinicodemographic characteristics of older adults with or without sarcopenia and investigated the effect of sex on their PF. Methods: This cross-sectional study included 745 older adults from a community health promotion program in Taiwan. Their clinicodemographic characteristics were recorded. PF was assessed through various tests, such as hand grip strength evaluation, 8-foot up-and-go test (8-UGT), 2-min step test, and 6-m walk test. PF and factors influencing sarcopenia risk were compared between older adults with sarcopenia (sarcopenia group) and those without it (nonsarcopenia group). A logistic regression model was performed to identify key factors associated with sarcopenia. Its predictive performance was evaluated by calculating the area under the receiver operating characteristic curve (ROC) curve. Results: Regardless of sex, the sarcopenia group performed worse in almost all components of PF—for example, upper and lower limb muscular strength and endurance, cardiopulmonary fitness, and balance—than did the nonsarcopenia group. However, for men, no significant between-group difference was observed in flexibility. The logistic regression model indicated age (odds ratio [OR]: 1.107), sex (OR: 2.881), Mini Nutritional Assessment—Short Form scores (OR: 0.690), and performance in 8-UGT (OR: 1.346) as factors influencing the risk of sarcopenia. The model exhibited excellent discriminative ability in predicting sarcopenia, as indicated by an area under the curve value of 0.867 (95% confidence interval: 0.827–0.906; p < 0.05). Conclusion: Older adults without sarcopenia tend to outperform those with sarcopenia in almost all PF measures, regardless of sex. Older age, male sex, low Mini Nutritional Assessment—Short Form scores, and poor performance in 8-UGT are associated with a high risk of sarcopenia. [ABSTRACT FROM AUTHOR]

Background & aims: Sarcopenia is common in patients with liver disease and both sarcopenia and short telomeres are associated with mortality, however their relationship in patients with liver disease remains unknown. Methods: A cohort of 16,072 adults from the National Health and Nutrition Examination Survey from 1999 to 2006 was analyzed. Liver disease was defined by aminotransferases and classified into etiology-based categories. Sarcopenia was defined by dual-energy x-ray absorptiometry. All analyses were conducted separately on each multiple imputation data set and combined via Rubin's rules. P-values for group comparisons were calculated by testing logistic regression parameter estimates. Cox proportional hazards regression was used for mortality analysis with mortality data available until 2015. Results: Sarcopenia was present in 9.5% of patients with liver disease. Age, race, income, education, physical inactivity, and certain medical comorbidities were associated with sarcopenia. Patients with liver disease and sarcopenia had significantly shorter telomeres than patients with liver disease without sarcopenia when unadjusted for age. The interaction between telomere length and sarcopenia was significantly associated with all-cause mortality. Conclusions: The implications of telomere length on all-cause mortality in patients with liver disease varied by age and sarcopenia status. Shorter telomeres appear to be more highly associated with increased mortality in older patients without sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia and rotator cuff tears are common among elderly patients. However, the role of sarcopenia in the management of rotator cuff tears has been often overlooked. This study aimed to elucidate the effects of sarcopenia-related traits on rotator cuff tears. Methods: Two-sample Mendelian randomization (MR) analyses based on genome-wide association study data were used to evaluate the causal relationships among appendicular lean mass (ALM), usual walking pace, low hand grip strength, and rotator cuff tears. Multivariate Mendelian randomization (MVMR) analyses were used to evaluate the direct effects of each muscle trait on the causal relationship. Results: Univariate MR analysis showed that ALM and usual walking pace were causally related to rotator cuff tears (odds ratio (OR) = 0.895; 95% confidence interval (CI), 0.758-0.966, P <0.001 and OR = 0.458, 95% CI, 0.276-0.762, P = 0.003, respectively), and there was no evidence of causality between low hand grip strength and rotator cuff tears (OR = 1.132, 95% CI, 0.913-1.404, P = 0.26). MVMR analysis confirmed the causal effects of ALM and walking pace on rotator cuff tears (OR = 0.918, 95% CI, 0.851-0.990, P = 0.03 and OR = 0.476, 95% CI, 0.304-0.746, P = 0.001, respectively). Conclusion: A causal genetic relationship exists between sarcopenia and rotator cuff tears. Sarcopenia-related traits including low muscle mass and physical function, increase the risk of rotator cuff tears. These findings provide new clinical insights and evidence-based medicine to optimize management of rotator cuff tears. [ABSTRACT FROM AUTHOR]

Background: Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear. Methods: This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022. All patients were managed using the enhanced recovery after surgery (ERAS) protocol, and elderly patients or those with loss of muscle mass or frailty underwent additional perioperative rehabilitation. Postoperative short-term outcomes were compared between the octogenarians and non-octogenarians. Results: We reviewed 251 patients including 44 octogenarians (17.5%). Octogenarians had higher rates of comorbidity (78.9% vs. 55.1%, P = 0.049) and sarcopenia (31.8% vs. 16.4%, P = 0.018) and a more impaired nutritional status than non-octogenarians and received postoperative rehabilitation more frequently (86.4% vs. 44.0%, P < 0.001, respectively). Under the rehabilitation-enhanced ERAS protocol, the postoperative major complication rate (25.0% vs. 24.6%, P = 0.960), the length of hospital stay (LOS) (P = 0.435), and the length of functional recovery (LOFR) (P = 0.110) did not differ between the two groups. In the multivariate analysis, age ≥ 80 years was not determined as a risk factor for major complications. Conclusions: Despite the poor functional and nutritional status of octogenarians, their postoperative major complication rates, LOS, and LOFR after PD were comparable with those of non-octogenarians under the rehabilitation-enhanced ERAS protocol. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia and frailty are common among elderly individuals and present substantial health hazards. Exploring their relationship is essential for optimizing geriatric healthcare, particularly within the context of China. Methods: A population-based cross-sectional design was employed using data from the China Health and Retirement Longitudinal Study (CHARLS). The study enrolled 5,714 participants aged ≥60 years who underwent assessment for sarcopenia following the criteria established by the Asia Working Group for Sarcopenia (AWGS 2019) in 2019. Frailty status was determined using a frailty index that categorized participants into robustness, pre-frailty, and frailty stages. Multivariable logistic regression models were employed to examine the relationship between sarcopenia and frailty and pre-frailty conditions. Subgroup and interaction analyses were performed to explore the robustness of the associations between sarcopenia and frailty across different subgroups. Results: Among the participants, 1,028 (18.0%) were identified as frailty, 2,987 (52.3%) as pre-frailty, and 645 (11.3%) had sarcopenia. Sarcopenia demonstrated an independent association with higher risks of frailty (OR = 2.13, 95% CI: 1.52–2.99) and pre-frailty (OR = 1.42, 95% CI: 1.20–1.81) in the multivariable logistic analysis. Subgroup and interaction analyses consistently demonstrated significant associations across nearly all demographic and health-related subgroups. Conclusions: This study highlights that sarcopenia is significantly and independently associated with frailty and pre-frailty among older adults in China. Early detection and targeted interventions for sarcopenia are crucial to mitigate frailty and its adverse health outcomes in aging populations, emphasizing the need for tailored healthcare strategies to promote healthy aging. [ABSTRACT FROM AUTHOR]

Introduction: Drug-induced sarcopenia has not received adequate attention. Meanwhile, there is growing recognition of the importance of effective pharmacovigilance in evaluating the benefits and risks of medications. Aims: The primary aim of this study is to investigate the potential association between drug use and sarcopenia through an analysis of adverse event reports from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) and to evaluate the genetic factors contributing to drug-induced sarcopenia using summary-data-based Mendelian randomization (SMR). Methods: We obtained reports of adverse drug reactions from FAERS. Primary outcomes included sarcopenia and potential sarcopenia. We calculated the Proportional reporting ratio (PRR) to assess the risk of specific adverse events associated with various drugs, applying chi-square tests for statistical significance. Additionally, we used SMR based on Genome-wide association study (GWAS) to evaluate the potential associations between drug target genes of some significant medications and sarcopenia outcomes. The outcome data for sarcopenia included metrics as hand grip strength and appendicular lean mass (ALM). Results: A total of 55 drugs were identified as inducing potential sarcopenia, and 3 drugs were identified as inducing sarcopenia. The top 5 drugs causing a potential risk of sarcopenia were levofloxacin (PRR = 9.96, χ2 = 1057), pregabalin (PRR = 7.20, χ2 = 1023), atorvastatin (PRR = 4.68, χ2 = 903), duloxetine (PRR = 4.76, χ2 = 527) and venlafaxine (PRR = 5.56, χ2 = 504), and the 3 drugs that had been proved to induced sarcopenia included metformin (PRR = 7.41, χ2 = 58), aspirin (PRR = 5.93, χ2 = 35), and acetaminophen (PRR = 4.73, χ2 = 25). We identified electron-transfer flavoprotein dehydrogenase (ETFDH) and protein Kinase AMP-Activated Non-Catalytic Subunit Beta 1 (PRKAB1) as the primary drug target genes for metformin, while Prostaglandin-endoperoxide Synthase 1 (PTGS1) and Prostaglandin-endoperoxide Synthase 2 (PTGS2) were considered the primary action target genes for aspirin and acetaminophen according to DrugBank database. SMR showed that the expression abundance of ETFDH was negatively correlated with right hand grip strength (blood: OR = 1.01, p-value = 1.27e-02; muscle: OR = 1.01, p-value = 1.42e-02) and negatively correlated with appendicular lean mass (blood: OR = 1.03, p-value = 7.73e-08; muscle: OR = 1.03, p-value = 1.67e-07). Conclusions: We find that metformin, aspirin, and acetaminophen are specifically noted for their potential to induce sarcopenia based on the analyses conducted. We perform signal mining for drug-associated sarcopenia events based on real-world data and provides certain guidance for the safe use of medications to prevent sarcopenia. [ABSTRACT FROM AUTHOR]

Objective: Insulin-like growth factor (IGF) is closely associated with sarcopenia, yet the causal relationship of this association remains unclear. This study aims to explore the potential causal relationship between members of the IGF family and sarcopenia from a genetic perspective through bidirectional Mendelian randomization (MR) analysis using two-sample datasets. Methods: Five genetically predicted factors of the IGF family (IGF-1, IGF-1R, IGF-2R, IGFBP-3, IGFBP-7) as one sample, while four relevant features of sarcopenia (low hand grip strength, appendicular lean mass, whole body fat-free mass, and walking pace) as another sample, in conducting a two-sample MR analysis. Results: The forward MR results of the relationship between IGF and sarcopenia showed that elevated levels of IGF-1 reduced the risk of low hand grip strength (OR = 0.936, 95% CI=0.892-0.983, P = 0.008) and increased appendicular lean mass of the extremities and whole body fat-free mass (OR = 1.125, 95% CI=1.070-1.182,P = 0.000; OR =1.076, 95% CI=1.047-1.106, P=0.000), reduced the risk of sarcopenia. Elevated IGF-1R also favored an increase in whole body fat-free mass (OR=1.023, 95% CI=1.008-1.038, P =0.002), and the appendicular lean mass trait was more pronounced with elevated IGFBP-3 and IGFBP-7 (OR=1.034, 95% CI=1.024-1.044, P =0.000; OR=1.020, 95% CI=1.010-1.030, P=0.000). Inverse MR results of the effect of sarcopenia on IGF showed that decreased hand grip strength may elevate IGF-1 levels (OR=1.243, 95% CI=1.026-1.505,P =0.027), whereas improvements in appendicular lean mass, whole body fat-free mass traits, and increased walking pace decreased IGF-1 levels (OR=0.902, 95% CI: 0.877-0.927, P = 0.000; OR=0.903, 95% CI=0.859-0.949,P = 0.000; OR=0.209, 95% CI=0.051-0.862,P = 0.045). Also decreased hand grip strength may elevate IGF-1R levels (OR=1.454, 95% CI=1.108-1.909, P =0.007), and appendicular lean mass stimulated high expression of IGFBP-1 (OR=1.314, 95% CI=1.003-1.722, P =0.047). Heterogeneity and pleiotropy were not detected in all results, and the results were stable and reliable. Conclusion: There is a bi-directional causal association between IGF family members and the risk of sarcopenia, which provides a more adequate basis for early biological monitoring of sarcopenia and may provide new targets for early intervention and treatment of sarcopenia. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital. Methods: A retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross‐sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender‐specific thresholds. Hospital billing data was used to gather costings (AU$). Results: Out of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, P < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, P = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m2, P < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, P = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, P = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, P = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien‐Dindo grade ≥3 complications, and prolonged stay increased overall cost (P < 0.05). Conclusion: Sarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost‐effectiveness of prehabilitation programmes targeting sarcopenia should be considered. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the efficacy of an intervention, based on the Health Belief Model (HBM) and social support, in promoting strength training (ST) among older adults. A two‐arm clustered randomized controlled trial (RCT) was conducted among 235 older adults from eight elderly centers in Hong Kong. The intervention group engaged in a 6‐month intervention comprising ST sessions, exercise consultations, social gatherings, and a buddy program, while the control group participated in social gatherings. Assessments were conducted at baseline (Month 0), post‐intervention (Month 6), and 3‐month follow‐up (Month 9), with primary outcome being the prevalence of meeting the American College of Sports Medicine (ACSM) recommendations of ST. Results showed that the intervention group reported significantly higher prevalence of meeting ACSM recommendations for ST at both post‐intervention and follow‐up. Linear mixed models showed significant interaction effect between condition and time on perceived susceptibility of sarcopenia and muscle strength and significant condition effect on self‐efficacy for ST, perceived severity of sarcopenia, perceived barriers of ST, and intention to perform ST. Findings suggest that the intervention, guided by HBM and social support, improves older adults' ST participation, muscle strength, perceptions on sarcopenia, and self‐efficacy for ST, which offers great potential for broader application in other settings. [ABSTRACT FROM AUTHOR]

Background: Age and sex differences in sarcopenic dysphagia are unknown. The purpose is to characterize age and sex differences in sarcopenic dysphagia. Methods: A cross‐sectional and retrospective cohort study using information from the Japanese database on sarcopenic dysphagia was performed. We investigated age and sex differences between sarcopenic dysphagia and other forms of dysphagia. We investigated whether differences in prognosis for swallowing function, as assessed by the Food Intake Level Scale, and activities of daily living (ADL), as assessed by the Barthel Index were influenced by age and sex in patients with sarcopenic dysphagia. Results: The study included 460 patients, including 229 men and 231 women, with a mean age of 81 ± 10 years. Fifty‐eight percent of the patients had sarcopenic dysphagia. Age was independently associated with sarcopenic dysphagia (odds ratio (OR): 1.056, 95% confidence interval (CI): 1.035, 1.078), although sarcopenic dysphagia could also be seen in those younger than 65 years. Sex was not independently associated with sarcopenic dysphagia. The age cut‐off for the diagnosis of sarcopenic dysphagia was 82 years in all patients (sensitivity, 0.660; specificity, 0.644), 80 years in men (sensitivity, 0.619; specificity, 0.631), and 83 years in women (sensitivity, 0.723; specificity, 0.577). Sarcopenic dysphagia showed no significant differences in the improvement of swallowing function and ADL based on age and sex. Conclusions: Sarcopenic dysphagia was most common in older adults in their 80s or older. The possibility of sarcopenic dysphagia should be considered when dysphagia is present in people 80 years of age or older. [ABSTRACT FROM AUTHOR]

Mesenchymal stromal cells (MSCs), also known as fibro‐adipogenic progenitors, play a critical role in muscle maintenance and sarcopenia development. Although analogous MSCs are present in various tissues, recent single‐cell RNA‐seq studies have revealed the inter‐tissue heterogeneity of MSCs. However, the functional significance of MSC heterogeneity and its role in aging remain unclear. Here, we investigated the properties of MSCs and their age‐related changes in seven mouse tissues through histological, cell culture, and genetic examinations. The tissue of origin had a greater impact on the MSC transcriptome than aging. By first analyzing age‐related changes, we found that Kera is exclusively expressed in muscle MSCs and significantly down‐regulated by aging. Kera knockout mice recapitulated some sarcopenic phenotypes including reduced muscle mass and specific force, revealing the functional importance of Kera in the maintenance of muscle youth. These results suggest that MSCs have tissue‐specific supportive functions and that deterioration in these functions may trigger tissue aging. [ABSTRACT FROM AUTHOR]

Sarcopenia, a leading cause for global disability and mortality, is an age‐related muscular disorder, characterized by accelerated muscle mass loss and functional decline. It is known that caloric restriction (CR), ketogenic diet or endurance exercise lessen sarcopenia and elevate circulating β‐hydroxybutyrate (β‐HB) levels. Whether the elevated β‐HB is essential to the reversal of sarcopenia, however, remains unclear. Here we show in both Caenorhabditis elegans and mouse models that an increase of β‐HB reverse myofiber atrophy and improves motor functions at advanced ages. β‐HB‐induced histone lysine β‐hydroxybutyrylation (Kbhb) is indispensable for the reversal of sarcopenia. Histone Kbhb enhances transcription of genes associated with mitochondrial pathways, including oxidative phosphorylation, ATP metabolic process and aerobic respiration. This ultimately leads to improve mitochondrial integrity and enhance mitochondrial respiration. The histone Kbhb are validated in mouse model with CR. Thus, we demonstrate that β‐HB induces histone Kbhb, increases mitochondrial function, and reverses sarcopenia. [ABSTRACT FROM AUTHOR]

Sarcopenia is a condition marked by a significant reduction in muscle mass and strength, primarily due to the aging process, which critically impacts muscle protein dynamics, metabolic functions, and overall physical functionality. This condition leads to increased body fat and reduced daily activity, contributing to severe health issues and a lower quality of life among the elderly. Recognized in the ICD‐10‐CM only in 2016, sarcopenia lacks definitive treatment options despite its growing prevalence and substantial social and economic implications. Given the aging global population, addressing sarcopenia has become increasingly relevant and necessary. The primary causes include aging, cachexia, diabetes, and nutritional deficiencies, leading to imbalances in protein synthesis and degradation, mitochondrial dysfunction, and hormonal changes. Exercise remains the most effective intervention, but it is often impractical for individuals with limited mobility, and pharmacological options such as anabolic steroids and myostatin inhibitors are not FDA‐approved and are still under investigation. This review is crucial as it examines the potential of natural products as a novel treatment strategy for sarcopenia, targeting multiple mechanisms involved in its pathogenesis. By exploring natural products' multi‐targeted effects, this study aims to provide innovative and practical solutions for sarcopenia management. Therefore, this review indicates significant improvements in muscle mass and function with the use of specific natural compounds, suggesting promising alternatives for those unable to engage in regular physical activity. [ABSTRACT FROM AUTHOR]

PURPOSE Computed tomography (CT)-based body composition parameters and the hepatic venous pressure gradient (HVPG) are key characteristics in patients with liver cirrhosis. The present study aims to explore the correlation between CT-based body composition parameters and HVPG, as well as the difference in HVPG between patients with and patients without sarcopenia. METHODS A literature search for studies reporting the correlation between HVPG and CT-based body composition parameters published in English up to August 2023 in four databases, Embase, MEDLINE (via PubMed), Web of Science, and Cochrane Library, was conducted. The correlation coefficient between HVPG and CT-based body composition parameters was the primary outcome, and the difference in the HVPG value between the sarcopenia and non-sarcopenia groups was the secondary outcome. A meta-analysis was conducted using a random-effects models. The methodologic quality was assessed using the Quality Assessment of Diagnostic Studies instrument. RESULTS A total of 652 articles were identified, of which nine studies (n = 1,569) met the eligibility criteria. Among them, seven studies reported the primary outcome via the muscle index, five via the skeletal muscle index (SMI), two via the psoas-muscle-related index (PRI), and three via two adipose tissue indexes. A total of five studies reported the secondary outcome: four via SMI and one via PRI. No evidence of a significant correlation was determined between the various body composition parameters and the HVPG value, either in the muscle index or the adipose tissue index. Higher HVPG values were observed in patients with sarcopenia than in patients without sarcopenia [pooled standardized mean difference (SMD): 0.628 (-0.350, 1.606), P < 0.001; I² = 92.8%; P < 0.001] when an Asian sarcopenia definition was adopted. In contrast, when a Western cut-off value was applied, the HVPG value was higher in patients without sarcopenia than in patients with sarcopenia [pooled SMD: -0.201 (-0.366, -0.037), P = 0.016; I² = 0.00%; P = 0.785]. CONCLUSION No sufficient evidence regarding a correlation between the CT-based body composition and HVPG value was discovered. The difference in the HVPG value between the sarcopenia and non-sarcopenia groups was likely dependent on the sarcopenic cut-off value. [ABSTRACT FROM AUTHOR]

Background/Objectives: Bone nonunion remains a clinical challenge in orthopedic surgery with significant impacts on mental and physical wellbeing for patients. There are several previously established risk factors of nonunion that are connected to nutrition, but this has yet to be substantially explored. This review seeks to assess all studies that present associations between nutrition and nonunion to understand the potential for clinical relevance in nonunion prevention. Methods: Case–control and cohort studies comparing nonunion risk based on nutritional factors were gathered through PubMed in July 2024. Data were extracted with dual verification through Covidence and assessed for bias using the Newcastle–Ottawa Scale. Results: A total of 21 studies were included in this literature review. Vitamin D deficiency was a significant risk factor of nonunion in six studies and not significant in six other studies. Albumin was significant in three of the five studies addressing this lab value. Iron deficiency anemia was significant in a study assessing its impact on nonunion. Calcium was not significant in the one study mentioned. ICD-10-coded malnutrition was significant in one of the two studies. Sarcopenia, nutritional care plans, and dietitian-diagnosed malnutrition were statistically significant clinical indicators for predicting nonunion, but food insecurity was insignificant. Conclusions: Vitamin D, calcium, albumin, iron deficiency anemia, sarcopenia, and clinically diagnosed malnutrition have all been associated with an increased risk of nonunion in observational studies and should be considered when preventing nonunion development. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a state with a progressive and generalized loss of skeletal muscle mass and strength. However, muscle strength and muscle mass are different features, which are usually not studied separately. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in chronic kidney disease (CKD). Methods: The study sample consisted of 84 patients with an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2. Muscle strength was estimated by measuring hand grip strength (HGS). Muscle quantity was measured with bioimpedance spectroscopy (BIS). Serum creatinine, urea, uric acid (UA), and albumin were measured as well. Results: Appendicular skeletal muscle mass (ASM) significantly and positively correlated with body mass, NH weight (normally hydrated weight), height, body mass index (BMI), lean tissue mass (LTM), lean tissue index (LTI), fat mass (FM), and fat tissue index (FTI), and was negatively associated with hydration status. HGS significantly and positively correlated with body mass, NH weight, height, LTM, LTI, and ASM, and was negatively associated with UA and urea. After adjustment for age, sex, and height, HGS remained significantly and negatively related with UA and hydration status. Conclusions: In CKD patients, ASM is determined by anthropometric parameters, but HGS is determined by both anthropometric and clinical variables specific for CKD. In order to study the determinants of HGS in CKD, relationships with HGS should be adjusted for anthropometric variables. [ABSTRACT FROM AUTHOR]

Background: Early prognostication of acute pancreatitis (AP) patients for those at high risk of complications during hospitalization can facilitate clinical decision-making. Sarcopenia has been proven to be a risk factor for poor prognosis in patients with AP. We aimed to evaluate the association between the muscle parameters measured in computed tomography (CT) and the clinical outcomes of hospitalized patients with AP. Methods: A total of 132 consecutive patients hospitalized between 1 January 2015 and 31 December 2021 for AP with a valid CT scan were analyzed. The first CT conducted during hospitalization was analyzed for psoas muscle area (PMA), index (PMI), and density (PMD) at the L3 vertebral level. The main adverse outcomes indicating a worse prognosis were the development of extrapancreatic complications, infections, ICU transfer, in-hospital mortality, and hospitalization length. Results: The lowest tertile of PMI, as a surrogate for sarcopenia, was significantly correlated with increased rates of extrapancreatic complications, infections, and longer hospitalizations. It was additionally correlated with a worse CT severity index. The results for PMA and PMD also showed worse outcomes, largely mirroring the results for PMI. Although in-hospital mortality was relatively low, none of the patients died in the highest tertile of PMI. A clear cutoff with sufficient predictive capability could not be found. Conclusions: A low psoas muscle index can serve as an additional potential predictive marker for more severe disease and worse outcomes in hospitalized acute pancreatitis patients. More studies are needed to determine its combination with existing prediction tools. [ABSTRACT FROM AUTHOR]

Findings regarding the relationship between sarcopenia and lymphoma have been inconsistent across studies. This study investigated the association between sarcopenia and lymphoma. We systematically searched the Embase, Science Direct, Cochrane Library, and PubMed databases from inception to 31 March 2024 to identify relevant studies. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Twenty-six studies with 3659 participants were included. Sarcopenic lymphoma patients had poor overall survival (OS) (HR = 1.88; 95% CI: 1.47–2.41; p < 0.001). The heterogeneity was high (I2=80%). However, the result of the Egger test indicated a significant publication bias (p < 0.001). After employing the trim and fill method to adjust for this bias, the HR of OS became non-significant (p > 0.05). The progression-free survival (PFS) was worse in sarcopenic patients (HR = 1.77; 95% CI: 1.37–2.29; p < 0.001; I2=70%). There was no significant publication bias (p > 0.05). In the subgroup analyses, sarcopenia was a negative predictor of OS in lymphoma patients who undergo hematopoietic cell transplantation (HCT) (HR = 1.61;95% CI: 1.19–2.18; I2=30%). Male lymphoma patients with sarcopenia had a significantly worse OS (HR = 2.29; 95% CI:1.24–4.24; p = 0.009). Among patients with primary central nervous system lymphoma (PCNSL), those with sarcopenia defined by temporal muscle thickness (TMT) exhibited significantly worse OS (HR = 2.20; 95% CI:1.04–4.65; p = 0.039; I2=68%). Sarcopenia is associated with worse PFS in lymphoma patients. Subgroup analyses indicate that sarcopenia is a negative predictor of OS after HCT, and male lymphoma patients who suffer from sarcopenia have higher mortality. Sarcopenia defined by TMT is also a negative predictor of OS for patients with PCNSL. [ABSTRACT FROM AUTHOR]

Background: Limited information is available regarding the impact of sarcopenia on the prognosis of antiangiogenic therapy in individuals with advanced non‐small cell lung cancer (NSCLC). This study primarily sought to examine the prognostic significance of sarcopenia in individuals with advanced NSCLC undergoing antiangiogenic therapy. Methods: We retrospectively enrolled all patients who met the inclusion and exclusion criteria from 2019 to 2021 at Nantong University Hospital. Patients were grouped according to the presence or absence of sarcopenia. After propensity score matching (PSM), progression‐free survival (PFS), overall survival (OS), and adverse event rates were compared between the two groups. Factors associated with prognosis were screened using univariate and multivariate analyses. Results: A total of 267 patients were included, with a total of 201 matched at baseline after PSM (77 in the sarcopenia group and 124 in the non‐sarcopenia group). The sarcopenia group had lower PFS (p = 0.043) and OS (p = 0.011) than the non‐sarcopenia group and a higher incidence of adverse events (p = 0.044). Multivariate analysis suggested that sarcopenia is an independent prognostic risk factor for OS in advanced NSCLC patients receiving antiangiogenic therapies (p = 0.009). Results of subgroup analyses showed some differences in the impact of sarcopenia on survival prognosis in populations with different characteristics. Conclusion: Patients with advanced NSCLC with comorbid sarcopenia exhibit a worse prognosis when treated with antiangiogenic therapy, and preventing and ameliorating sarcopenia may lead to better survival outcomes in patients with advanced NSCLC. [ABSTRACT FROM AUTHOR]

(1) Background: Hip fractures are highly prevalent traumatic events with significant functional consequences, particularly among the older population. These fractures are associated with increased mortality, postoperative complications, and functional dependence. Medical and nutritional factors such as malnutrition and sarcopenia are crucial for predicting functional outcomes and mortality in these patients. This study aimed to assess the nutritional status, vitamin D levels, and sarcopenia, as well as their relationship with mortality, mean hospital stay, and 30-day-readmission rate, in patients with hip fracture who underwent surgery in a rural hospital setting. (2) Methods: A longitudinal retrospective study involving 124 patients who underwent hip fracture surgery in 2021 was conducted. Sociodemographic, surgical, and nutritional data, including vitamin D, albumin, and blood urea nitrogen (BUN) levels, were collected. (3) Results: The average age of the sample was 89.1 years, with a postoperative 30-day-mortality rate of 8.1% and an average hospital stay of 10.4 days. Vitamin D deficiency was present in 79.7% of patients, and a high prevalence of malnutrition was indicated by low albumin and elevated BUN levels. Elevated BUN levels and low vitamin D levels were associated with higher mortality. (4) Conclusions: Adequate nutritional assessment in patients with hip fracture is vital for identifying the risks of complications and mortality. Understanding the current nutritional status and its associated complications will aid in developing strategies to improve health and reduce complications in the future. [ABSTRACT FROM AUTHOR]

Background/Objectives: There is currently limited understanding of the intricate dynamics between fat and muscle mass and the potential effect of dietary patterns. This study aimed to investigate the effects of overall dietary patterns on four body composition phenotypes associated with central obesity and low muscle mass in the middle-aged and elderly population of Korea. Methods: We examined data from 6120 adults aged ≥ 50 years, collected during the 4th (2008–2009) and 5th (2010–2011) Korea National Health and Nutrition Examination Survey. Participants were classified into four groups according to their combined status of central obesity and low muscle mass: healthy control, central obesity, low muscle mass, and sarcopenic obesity. Using factor analysis on the twenty-two pre-defined food groups, we identified three distinct dietary patterns: the "Healthy dietary pattern", "Convenience-based dietary pattern", and "Alcohol and side dish pattern". Multivariate analysis included potential confounders such as age, sex, place of residence, marital status, educational level, occupation, household income, and physical activity level. Results: Higher scores in the "Healthy dietary pattern" were associated with lower odds of sarcopenic obesity (OR = 0.61, 95% CI = 0.40–0.92, p for trend = 0.018). For the "Convenience-based dietary pattern", individuals in the third tertile of the dietary pattern score showed a marginal association with low muscle mass (OR = 1.18, 95% CI = 0.99–1.41, p for trend = 0.056). The "Alcohol and side dish pattern" was linked to higher odds of central obesity (OR = 1.22, 95% CI = 1.03–1.44, p for trend = 0.016) and low muscle mass (OR = 1.21, 95% CI = 1.01–1.45, p for trend = 0.043). Conclusions: The drinking practice of consuming foods high in saturated fats and salt alongside alcoholic drinks may negatively affect fat accumulation and muscle composition among older adults. Adopting a healthy eating pattern characterized by grains, vegetables, legumes, fruits, fish, and seaweed could be notably advantageous for promoting and maintaining healthy body composition and optimal skeletal muscle health. [ABSTRACT FROM AUTHOR]

Osteoarthritis, osteoporosis, and sarcopenia are prevalent musculoskeletal disorders that significantly impact the aging population's health and quality of life. Osteoarthritis, characterized by joint inflammation, leads to pain, stiffness, and reduced mobility. Osteoporosis, a condition marked by bone density loss, increases fracture susceptibility, especially in postmenopausal women and older adults. Sarcopenia, the age-related loss of muscle mass and function, contributes to frailty and an increased risk of falls. Combined, osteoarthritis, osteoporosis and sarcopenia constitute "Musculoskeletal Failure." These 3 conditions share common risk factors like aging, genetics, and hormonal changes, as well as unhealthy lifestyle behaviors resulting in systemic chronic inflammation. Healthy lifestyle behaviors, including regular physical activity and a nutritious diet across the lifespan play a crucial role in the prevention and management of musculoskeletal failure. Awareness of the relationship between lifestyle behaviors, systemic chronic inflammation and the development and progression of these 3 common conditions is a key step in prevention, early detection and are essential for addressing the complex interplay of these musculoskeletal disorders. As the global population ages, understanding and effectively preventing and managing osteoarthritis, osteoporosis, and sarcopenia become paramount for promoting healthy aging and mitigating the societal and economic burden associated with these conditions. [ABSTRACT FROM AUTHOR]

Sarcopenia involves a progressive loss of skeletal muscle force, quality and mass during ageing, which results in increased inability and death; however, no cure has been established thus far. Growth differentiation factor 5 (GDF5) has been described to modulate muscle mass maintenance in various contexts. For our proof of concept, we overexpressed GDF5 by AAV vector injection in tibialis anterior muscle of adult aged (20 months) mice and performed molecular and functional analysis of skeletal muscle. We analysed human vastus lateralis muscle biopsies from adult young (21–42 years) and aged (77–80 years) donors, quantifying the molecular markers modified by GDF5 overexpression in mouse muscle. We validated the major effects of GDF5 overexpression using human immortalized myotubes and Schwann cells. We established a preclinical study by treating chronically (for 4 months) aged mice using recombinant GDF5 protein (rGDF5) in systemic administration and evaluated the long-term effect of this treatment on muscle mass and function. Here, we demonstrated that GDF5 overexpression in the old tibialis anterior muscle promoted an increase of 16.5% of muscle weight (P = 0.0471) associated with a higher percentage of 5000–6000 µm2 large fibres (P = 0.0211), without the induction of muscle regeneration. Muscle mass gain was associated with an amelioration of 26.8% of rate of force generation (P = 0.0330) and better neuromuscular connectivity (P = 0.0098). Moreover, GDF5 overexpression preserved neuromuscular junction morphology (38.5% of nerve terminal area increase, P < 0.0001) and stimulated the expression of reinnervation-related genes, in particular markers of Schwann cells (fold-change 3.19 for S100b gene expression, P = 0.0101). To characterize the molecular events induced by GDF5 overexpression during ageing, we performed a genome-wide transcriptomic analysis of treated muscles and showed that this factor leads to a 'rejuvenating' transcriptomic signature in aged mice, as 42% of the transcripts dysregulated by ageing reverted to youthful expression levels upon GDF5 overexpression (P < 0.05). Towards a preclinical approach, we performed a long-term systemic treatment using rGDF5 and showed its effectiveness in counteracting age-related muscle wasting, improving muscle function (17.8% of absolute maximal force increase, P = 0.0079), ensuring neuromuscular connectivity and preventing neuromuscular junction degeneration (7.96% of AchR area increase, P = 0.0125). In addition, in human muscle biopsies, we found the same age-related alterations than those observed in mice and improved by GDF5 and reproduced its major effects on human cells, suggesting this treatment as efficient in humans. Overall, these data provide a foundation to examine the curative potential of GDF5 drug in clinical trials for sarcopenia and, eventually, other neuromuscular diseases. [ABSTRACT FROM AUTHOR]

Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population. [ABSTRACT FROM AUTHOR]

Branched-chain amino acids (BCAAs) are essential for muscle protein synthesis and are widely acknowledged for mitigating sarcopenia. Oligonol® (Olg), a low-molecular-weight polyphenol from Litchi chinensis, has also been found to attenuate sarcopenia by improving mitochondrial quality and positive protein turnover. This study aims to investigate the effect of Olg on BCAA-stimulated protein synthesis in sarcopenia. In sarcopenic C57BL/6 mice and senescence-accelerated mouse-prone 8 (SAMP8) mice, BCAAs were significantly decreased in skeletal muscle but increased in blood serum. Furthermore, the expressions of membrane L-type amino acid transporter 1 (LAT1) and branched-chain amino acid transaminase 2 (BCAT2) in skeletal muscle were lower in aged mice than in young mice. The administration of Olg for 8 weeks significantly increased the expressions of membrane LAT1 and BCAT2 in the skeletal muscle when compared with non-treated SAMP8 mice. We further found that BCAA deprivation via LAT1-siRNA in C2C12 myotubes inhibited the signaling of protein synthesis and facilitated ubiquitination degradation of BCAT2. In C2C12 cells mimicking sarcopenia, Olg combined with BCAA supplementation enhanced mTOR/p70S6K activity more than BCAA alone. However, blocked LAT1 by JPH203 reversed the synergistic effect of the combination of Olg and BCAAs. Taken together, changes in LAT1 and BCAT2 during aging profoundly alter BCAA availability and nutrient signaling in aged mice. Olg increases BCAA-stimulated protein synthesis via modulating BCAA transportation and BCAA catabolism. Combining Olg and BCAAs may be a useful nutritional strategy for alleviating sarcopenia. [ABSTRACT FROM AUTHOR]

Sarcopenia is a systemic medical disorder characterized by a gradual decline in muscular strength, function, and skeletal muscle mass. Currently, there is no medication specifically approved for the treatment of this condition. Therefore, the identification of new pharmacological targets may offer opportunities for the development of novel therapeutic strategies. The current in silico study investigated the active ingredients and the mode of action of Citri Reticulatae Pericarpium (CRP) in addressing sarcopenia. The active ingredients of CRP and the potential targets of CRP and sarcopenia were determined using various databases. The STRING platform was utilized to construct a protein–protein interaction network, and the key intersecting targets were enriched through the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses. Molecular docking was used to determine the binding interactions of the active ingredients with the hub targets. The binding affinities obtained from molecular docking were subsequently validated through molecular dynamics simulation analyses. Five active ingredients and 45 key intersecting targets between CRP and sarcopenia were identified. AKT1, IL6, TP53, MMP9, ESR1, NFKB1, MTOR, IGF1R, ALB, and NFE2L2 were identified as the hub targets with the highest degree node in the protein–protein interaction network. The results indicated that the targets were mainly enriched in PIK3-AKT, HIF-1, and longevity-regulating pathways. The active ingredients showed a greater interaction affinity with the hub targets, as indicated by the results of molecular docking and molecular dynamics simulations. Our findings suggest that the active ingredients of Citri Reticulatae Pericarpium, particularly Sitosterol and Hesperetin, have the potential to improve sarcopenia by interacting with AKT1 and MTOR proteins through the PI3K-AKT signaling pathway. [ABSTRACT FROM AUTHOR]

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This systematic review investigates the potential of bergamot, a polyphenol-rich citrus fruit, in improving osteosarcopenic obesity, a condition characterized by the simultaneous presence of osteoporosis, obesity, and sarcopenia. Bergamot extracts have been suggested to possess several pharmacological properties, including anti-inflammatory and antioxidant effects, which could be useful in the management of age-related diseases and neuromuscular health. The review highlights the promising effects of bergamot extracts on skeletal muscle mass and function, particularly in the context of obesity, metabolic syndrome, osteosarcopenic obesity, and osteoporosis. Furthermore, some studies have shown that bergamot extracts can improve the metabolic balance, endothelial function, and maximal oxygen uptake in athletes, highlighting their potential benefits for skeletal muscle health. Taken together, these results suggest that bergamot extracts, especially those rich in polyphenols, may be a valuable adjunct in the management of osteosarcopenic obesity and other associated clinical conditions involving pro-inflammatory effects on organs and tissues. [ABSTRACT FROM AUTHOR]

Summary: People with prior lean mass loss had a ~ 10% higher risk of MOF and ~ 22–26% higher risk of hip fracture, and the results were similar in people on anti-osteoporosis medications. Loss of lean mass is associated with increased fracture risk. Patients should be encouraged to pursue strategies to prevent loss of lean mass. Background: Sarcopenia increases fracture risk. If the risk persists after starting osteoporosis medication, patients may need to be encouraged to pursue strategies to prevent loss of lean mass. Objective: To estimate the effects of loss in appendicular lean mass (ALM) or total body lean mass (TBLM) on subsequent fracture risk and effect modification with anti-osteoporosis medication use. Methods: We conducted a registry-based cohort study linked to population-based data. We identified individuals ≥ 40 years of age with two DXA assessments ≥ 1 year apart and minimum 0.5 years of observation. ALM and TBLM were estimated from weight, sex, and percent fat from DXA (R2 = 0.91 and 0.84 vs total body DXA, respectively). We report hazard ratios (HR) from Cox regression models estimating time to first incident major osteoporotic fracture (MOF) and hip fracture, adjusted for fracture risk; osteoporosis medication was included as an interaction term and used to stratify analyses. Results: We included 21,249 individuals (mean 67 [SD 10] years, 95% female, 37% on osteoporosis medication). The mean follow-up was 7 years (SD 4). A total of 1868 and 548 people had incident MOF and hip fracture, respectively. People with prior ALM loss (HR per SD 1.09, 95% CI 1.04–1.15) or TBLM loss (HR per SD 1.09, 95% CI 1.42–1.14) had a higher risk of MOF. Hip fracture risk was greater in people with prior ALM loss (HR per SD 1.22, 95% CI 1.12–1.33) and TBLM loss (HR per SD 1.26, 95% CI 1.16–1.38). There were no interactions with anti-osteoporosis medication use (all p > 0.3). When restricted to people on anti-osteoporosis medication, each SD in ALM or TBLM loss was associated with 8–9% increased MOF risk and 18–23% increased hip fracture risk. Conclusions: Loss of lean mass is associated with increased fracture risk among individuals on anti-osteoporosis medication. Patients should be encouraged to pursue strategies to prevent sarcopenia. [ABSTRACT FROM AUTHOR]

Summary: Associations between different sarcopenia definitions and the risk of injurious falls were investigated in 75–80-year-old women in the Swedish SUPERB cohort. Only sarcopenia according to the Sarcopenia Definitions and Outcomes Consortium (SDOC) definition was associated with incident injurious falls with and without fractures in older women. Purpose: To investigate the association between three commonly used sarcopenia definitions and the risk of injurious falls in a population of older Swedish women. Methods: A total of 2,883 75–80-year-old women with complete data on relevant sarcopenia definitions from the Swedish SUPERB cohort were studied. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC: low handgrip strength and gait speed), revised European Working Group on Sarcopenia in Older People (EWGSOP2: low appendicular lean mass index (ALMI, dual-energy X-ray absorptiometry (DXA)-derived), appendicular lean mass (kg)/height (m2), hand grip strength (kg), or low chair stand time (s)), and Asian Working Group for Sarcopenia (AWGS: low ALMI and hand grip strength (kg) or low gait speed (m/s)). Questionnaires captured the occurrence of falls in the past 12 months. Incident injurious falls were identified using national registers. Cox regression (hazard ratios (HR) and 95% confidence intervals (CI)) analyses were performed without adjustment and after adjustment for age, body mass index, previous falls, and the Charlson comorbidity index. Results: During a median (IQR) follow-up time of 7.06 (6.2–7.9) years, there were 491 injurious falls without fracture and 962 injurious falls when also including falls resulting in a fracture. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased risk of injurious falls. Individuals with sarcopenia defined by SDOC had a higher risk of injurious falls with and without fracture (HR 2.11; 95% CI, 1.63–2.73 and HR, 2.16; 95% CI, 1.55–3.02, respectively). Conclusion: Sarcopenia definitions confined to muscle function and strength such as SDOC, rather than including DXA-determined ALMI (EWGSOP2 and AWGS), are associated with incident injurious falls with and without fractures in older women. [ABSTRACT FROM AUTHOR]