Cerebellar-limbic neurocircuit is the novel biosignature of physio-cognitive decline syndrome.

Both physical and cognitive deficits occur in the aging process. We operationally defined the phenomenon as physio-cognitive decline syndrome (PCDS) and aimed to decipher its corresponding neuroanatomy patterns and neurocircuit. High resolution 3T brain magnetic resonance imaging (MRI) images from a community-dwelling longitudinal aging cohort were analysed. PCDS was defined as weakness (handgrip strength) and/or slowness (gait speed) concomitant with impairment in any cognitive domain (defined by 1.5 standard deviation below age, sex-matched norms), but without dementia or disability. Among 1196 eligible ≥ 50-year-old (62±9 years, 47.6%men) subjects, 15.9% had PCDS. Compared to the other participants, individuals with PCDS had significantly lower gray-matter volume (GMV) in the bilateral amygdala and thalamus, right hippocampus, right temporo-occipital cortex, and left cerebellum VI and V regions. The regions of reduced GMV in people with PCDS were similar between the middle-aged and older adults; whereas larger clusters with more extensive GMV-depleted regions were observed in ≥65-year-olds with PCDS. Diffusion-weighted tractography showed disrupted hippocampus-amygdala-cerebellum connections in subjects with PCDS. The neuroanatomic characteristics revealed by this study provide evidence for pathophysiological processes associated with concomitant physio-cognitive decline in the elderly. This neurocircuit might constitute a target for future preventive interventions.

Epidemiology of Sarcopenia and Factors Associated With It Among Community-Dwelling Older Adults in Taiwan.

BACKGROUND: Sarcopenia is a well-recognized geriatric syndrome. We sought to determine the prevalence of sarcopenia and factors associated with it among community-dwelling older adults in Taiwan. METHODS: A cross-sectional study was conducted in Yuanshan Township, Yilan County, Taiwan. Data of 731 community-dwelling adults aged 65 and older were evaluated. Demographic characteristics, anthropometry, medical history, biochemistry results, and dual-energy X-ray absorptiometry results were collected for analysis. RESULTS: Males had a higher rate of sarcopenia than did females and had lower values for body weight, body mass index, waist circumference, percentage of body fat, and lean body mass. Poor nutritional status as determined by the Mini Nutritional Assessment correlated positively with markers for sarcopenia. Levels of vitamin D and folic acid correlated positively with some sarcopenia markers. CONCLUSIONS: Gender differences and nutritional factors may influence the development of sarcopenia. Vitamin D is positively correlated with relative appendicular skeletal muscle mass in males with sarcopenia, and folic acid was positively correlated with gait speed in females with sarcopenia.

Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia.

Sarcopenia was recently classified a geriatric syndrome and is a major challenge to healthy aging. Affected patients tend to have worse clinical outcomes and higher mortality than those without sarcopenia. Although there is general agreement on the principal diagnostic characteristics, initial thresholds for muscle mass, strength, and physical performance were based on data from populations of predominantly Europid ancestry and may not apply worldwide. The Asian Working Group for Sarcopenia (AWGS) issued regional consensus guidelines in 2014, and many more research studies from Asia have since been published; this review summarizes recent progress. The prevalence of sarcopenia estimated by the AWGS criteria ranges between 4.1% and 11.5% of the general older population; however, prevalence rates were higher in Asian studies that used European Working Group on Sarcopenia in Older People cut-offs. Risk factors include age, sex, heart disease, hyperlipidemia, daily alcohol consumption, and low protein or vitamin intake; physical activity is protective. Adjusting skeletal muscle mass by weight rather than height is better in showing the effect of older age in sarcopenia and identifying sarcopenic obesity; however, some Asian studies found no significant skeletal muscle loss, and muscle strength might be a better indicator. Although AWGS 2014 diagnostic cut-offs were generally well accepted, some may require further revision in light of conflicting evidence from some studies. The importance of sarcopenia in diverse therapeutic areas is increasingly evident, with strong research interest in sarcopenic obesity and the setting of malignancy. Pharmacologic interventions have been unsatisfactory, and the core management strategies remain physical exercise and nutritional supplementation; however, further research is required to determine the most beneficial approaches.

Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis), handgrip strength (<26 kg for men and <18 kg for women), and usual gait speed (<0.8 m/s). However, a number of challenges remained to be solved in the future. Asia is made up of a great number of ethnicities. The majority of currently available studies have been published from eastern Asia, therefore, more studies of sarcopenia in south, southeastern, and western Asia should be promoted. On the other hand, most Asian studies have been conducted in a cross-sectional design and few longitudinal studies have not necessarily collected the commonly used outcome indicators as other reports from Western countries. Nevertheless, the AWGS consensus report is believed to promote more Asian sarcopenia research, and most important of all, to focus on sarcopenia intervention studies and the implementation of sarcopenia in clinical practice to improve health care outcomes of older people in the communities and the healthcare settings in Asia.