Browsing by Subject "Sarcopenia"

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  • Bjorkman, Mikko P.; Pitkala, Kaisu H.; Jyvakorpi, Satu; Strandberg, Timo E.; Tilvis, Reijo S. (2019)
    Objectives: To assess the prognostic significance of various characteristics and measurements of sarcopenia and physical functioning on all-cause mortality among home-dwelling older people with or at-risk of sarcopenia. Design: Cross-sectional and longitudinal analyses. Setting: Porvoo sarcopenia trial in open care. Participants: Community-dwelling people aged 75 and older (N = 428, of which 182 were re-examined at one year) with four years of follow-up. Measurements: Body mass index (BMI), physical functioning (physical component of the RAND-36) and physical performance tests (Short Physical Performance Battery (SPPB)), hand grip strength, walking speed, Charlson Comorbity Index, bioimpedance-based surrogates for muscle mass: Single Frequency Skeletal Muscle Index (SF-SMI), and Calf Intracellular Resistance Skeletal Muscle Index (CRi-SMI). Date of death was retrieved from central registers. Survival analyses were performed using Life-Table analyses and Cox models. Results: Most test variables (except BMI) were associated with four-year mortality in a dose-dependent fashion. After controlling for age, gender and co-morbidity, physical performance and functioning (both SPPB and RAND36), muscle strength (hand grip strength) and CRi-SMI appeared to be independent mortality risk indicators (p <0.001) whereas SF-SMI was not. When CRi-SMI values were grouped by gender-specific cut-off points, the probability of surviving for four years decreased by 66% among the older people with low CRi-SMI (HR = 0.34, 95%CI 0.15-0.78, p = 0.011). When low CRi-SMI was further controlled for SPPB, the prognostic significance remained significant (HR = 0.55, 95%CI 0.33-0.92, p = 0.021). After controlling for age, gender, comorbidity, and CRi-SMI, the physical component of the RAND-36 (p = 0.007), SPPB (p <0,001) and hand grip strength (p = 0.009) remained significant mortality predictors. Twelve-month changes were similarly associated with allcause mortality during the follow-up period. Conclusion: CRi-SMI, muscle strength, physical performance and physical functioning are each strong independent predictors of all-cause mortality among home-dwelling older people. Compared to these indicators, BMI seemed to be clearly inferior. Of two bioimpedance-based muscle indices, CRi SMI was better predictor of mortality than SF-SMI. In this regard, muscle mass, muscle strength and physical performance are all suitable targets for the prevention of sarcopenia-related over-mortality.
  • Björkman, Mikko P.; Suominen, Merja H.; Kautiainen, Hannu; Jyväkorpi, Satu K.; Finne-Soveri, Harriet U.; Strandberg, Timo E.; Pitkälä, Kaisu H.; Tilvis, Reijo S. (2020)
    Objectives: To test the long-term effects of whey-enriched protein supplementation on muscle and physical performance. Design: A 12-month randomized controlled double blind trial with a 43-month of post-trial follow-up. Setting: Porvoo, Finland. Participants: A total of 218 older (>74 years of age) community-dwelling people with sarcopenia. Intervention: (1) Control with no supplementation; (2) isocaloric placebo; and (3) 20 g x 2 whey-enriched protein supplementation. All participants were given instructions on home-based exercise, dietary protein, and vitamin D supplementation of 20 mu g/d. Measurements: Physical performance was assessed by short physical performance battery and continuous summary physical performance scores. Hand grip strength and calf intracellular resistance based skeletal muscle index were measured by bioimpedance spectroscopy. The measurements were performed at 0, 6, and 12 months. The post-trial follow-up was performed by a postal questionnaire and national census record data. Results: The participants were older (75-96 years of age) and mostly women (68%). The test supplements had no significant effects on physical performance; the 12-month changes for short physical performance battery were -0.55, -.05, and 0.03 points in control, isocaloric, and protein groups (P = .17), respectively. The changes in continuous summary physical performance scores were similar between the intervention groups (P = .76). The hand grip strength decreased significantly in all intervention groups, and the 12-month changes in calf intracellular resistance-based skeletal muscle index were minor and there were no differences between the intervention groups. One-half of the patients (56%) in both supplement groups reported mild gastrointestinal adverse effects. Differences were found neither in the all-cause mortality nor physical functioning in the post-trial follow-up. Conclusions: The whey-enriched protein supplementation in combination with low intensity home-based physical exercise did not attenuate the deterioration of muscle and physical performance in community-dwelling older people with sarcopenia. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
  • Järvinen, Tommi; Ilonen, Ilkka; Kauppi, Juha; Salo, Jarmo; Räsänen, Jari (2018)
    Background: Nutritional deficits, cachexia, and sarcopenia are extremely common in esophageal cancer. The aim of this article was to assess the effect of loss of skeletal muscle mass during neoadjuvant treatment on the prognosis of esophageal cancer patients. Methods: Esophageal cancer patients (N = 115) undergoing neoadjuvant therapy and surgery between 2010 and 2014 were identified from our surgery database and retrospectively analyzed. Computed tomography imaging of the total cross-sectional muscle tissue measured at the third lumbar level defined the skeletal muscle index, which defined sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women). Images were collected before and after neoadjuvant treatments. Results: Sarcopenia in preoperative imaging was prevalent in 92 patients (80%). Median overall survival was 900 days (interquartile range 334-1447) with no difference between sarcopenic (median = 900) and non-sarcopenic (median = 914) groups (p = 0.872). Complication rates did not differ (26.1% vs 32.6%, p = 0.725). A 2.98% decrease in skeletal muscle index during neoadjuvant treatment correlated with poor 2-year survival (log-rank p = 0.04). Conclusion: Loss of skeletal muscle tissue during neoadjuvant treatment correlates with worse overall survival.
  • Järvinen, Tommi; Ilonen, Ilkka; Kauppi, Juha; Salo, Jarmo; Räsänen, Jari (BioMed Central, 2018)
    Abstract Background Nutritional deficits, cachexia, and sarcopenia are extremely common in esophageal cancer. The aim of this article was to assess the effect of loss of skeletal muscle mass during neoadjuvant treatment on the prognosis of esophageal cancer patients. Methods Esophageal cancer patients (N = 115) undergoing neoadjuvant therapy and surgery between 2010 and 2014 were identified from our surgery database and retrospectively analyzed. Computed tomography imaging of the total cross-sectional muscle tissue measured at the third lumbar level defined the skeletal muscle index, which defined sarcopenia (SMI < 52.4 cm2/m2 for men and < 38.5 cm2/m2 for women). Images were collected before and after neoadjuvant treatments. Results Sarcopenia in preoperative imaging was prevalent in 92 patients (80%). Median overall survival was 900 days (interquartile range 334–1447) with no difference between sarcopenic (median = 900) and non-sarcopenic (median = 914) groups (p = 0.872). Complication rates did not differ (26.1% vs 32.6%, p = 0.725). A 2.98% decrease in skeletal muscle index during neoadjuvant treatment correlated with poor 2-year survival (log-rank p = 0.04). Conclusion Loss of skeletal muscle tissue during neoadjuvant treatment correlates with worse overall survival.
  • Jyväkorpi, S. K.; Urtamo, A.; Kivimäki, M.; Strandberg, T. E. (2020)
    Background & aim: Sarcopenia is associated with increased risk for several adverse health outcomes including frailty, disability, loss of independence, and mortality. We examined cross-sectional associations between sarcopenia and detailed dietary macronutrient composition in community-living oldest-old men (mean age 87). Methods: Participants were invited to a clinic visit in 2017/2018 including assessments of sarcopenia status using European Working Group on Sarcopenia in Older People's 2 (EWGSOP2) criteria and detailed macronutrient, vitamin D and food intakes retrieved from 3-day food diaries. Results: Of the 126 participants, 48 had probable sarcopenia and 27 sarcopenia. Sarcopenia was associated with lower energy (p = 0.020), total protein (p = 0.019), plant (p = 0.008) and fish proteins (p = 0.041), total fat (p = 0.015), monounsaturated fatty acids (MUFA) (p = 0.011), polyunsaturated fatty acids (p = 0.002), vitamin D intakes (p = 0.005) and, of fat quality indicators, MUFA: saturated fatty acid-ratio (p = 0.042). Conclusion: These findings suggest that sufficient energy and protein intakes, but also fat quality may be important along with healthy dietary patterns for prevention of sarcopenia in the oldest-old.
  • Strandberg, Timo; Pitkälä, Kaisu; Sipilä, Sarianna (2021)
    • Sarkopenia tarkoittaa etenevää yleistynyttä lihasmassan ja -voiman vähenemistä. Se ei ole ikään sidottu, mutta se on tavallisempi vanhalla iällä. • Patofysiologia on monimutkainen ja etiologia moninainen. Tehokas ehkäisy edellyttää elämänaikaisia toimia. • Sarkopenia lisää merkittävien kliinisten tapahtumien riskiä, mm. kaatumisia, toimintakyvyn ¬heikentymistä ja gerastenian kehittymistä. • Toistaiseksi paras hoito koostuu lihasvoimaharjoitusten ja ravitsemushoidon yhdistämisestä. ¬Spesifisiä lääkehoitomahdollisuuksia tutkitaan.
  • Björkman, Mikko P.; Jyväkorpi, Satu K.; Strandberg, Timo; Pitkälä, Kaisu H.; Tilvis, Reijo S. (2020)
    BACKGROUND: Bioimpedance skeletal muscle indices (SMI) are used as a surrogate for skeletal muscle mass, but their associations with physical functioning and obesity need further evaluation. AIMS: To compare the associations of body mass index (BMI), bioimpedance spectroscopy-based calf intracellular resistance (Cri-SMI), and single-frequency bioimpedance analysis (SF-SMI) indices with physical performance and the functioning of community-dwelling older people at risk of or already suffering from sarcopenia. METHODS: Pre-intervention measurements of the screened subjects and the participants of the Porvoo sarcopenia trial (N = 428) were taken. Cri-SMI, whole-body SF-SMI, and BMI were related to hand-grip strength, walking speed, short physical performance battery (SPPB), and the physical component of the RAND-36. RESULTS: Among the older people (aged 75-96), Cri-SMI correlated inversely with age (men r = - 0.113, p < 0.001; women r = - 0.287, p < 0.001), but positively with SPPB (r = 0.241, p < 0.001) and the physical component of the RAND-36 (r = 0.114, p = 0.024), whereas BMI was inversely associated with SPPB (r = - 0.133, p < 0.001) and RAND-36 (r = - 0.286, p < 0.001). After controlling for age, gender, and comorbidity, one unit of Cri-SMI (cm2/Ω) was associated with a 3.3-fold probability of good physical performance (SPPB ≥ 9 points, OR = 3.28, p < 0.001) and one unit of BMI (kg/m2) decreased the respective probability 4% (OR= 0.96, p = 0.065). Physical inactivity partly explained the negative association of BMI. When Cri-SMI and BMI were controlled for, a 1% difference in Cri-SMI was associated with a 0.7% (p < 0.001) higher probability of good performance, the respective figure being - 2.2% (p = 0.004) for BMI. The associations of SF-SMI with physical functioning indices were insignificant. CONCLUSIONS: Independent of each other, Cri-SMI was positively and BMI was inversely associated with the physical performance and functioning of community-dwelling older people who were at risk of or already suffering from sarcopenia. We found no association between SF-SMI and physical functioning.