Endocrinology of Aging From a Muscle Function Point of View: Results From the Toledo Study for Healthy Aging.

INTRODUCTION: Aging is a process that involves a reduction in muscle strength and anabolic hormone concentrations, which impacts significantly on health. AIM: To study the hormone/total strength (H/TS) ratio as a proxy of anabolic insensitivity status in elders, and its relationship with disability, hospitalization, and mortality risk. DESIGN: A total of 1462 persons aged ≥65 years from the Toledo Study of Healthy Aging participated in this study. Serum concentrations of insulin like growth factor 1, total and free testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and 17ß-estradiol were measured. Total maximal voluntary isometric strength was obtained (handgrip, shoulder, hip, and knee) using standardized techniques and equipment. Physical activity was recorded by physical activity scale for the elderly questionnaire. Associations of the H/TS ratio with hospitalization and mortality were assessed using logistic regression models, and participants stratified into quartiles for each H/TS ratio. RESULTS: In women, all individual ratio H/TS models showed a strong to moderate increased risk for death and hospitalization. In men, all models revealed a significant positive association of the ratio H/TS with mortality rate but not for hospitalization (P < .01). Participants who have 2 or more H/TS ratios in the worst quartile increased the risk of hospitalization and mortality at least by 2-fold. CONCLUSIONS: We demonstrate the main role that muscle function plays in the relationship between the hormonal status and hospitalization and mortality risk; this could be taken into consideration as a way to classify patients for hormonal therapy.

Prevalencia de sarcopenia en consultas de geriatría y residencias. Estudio ELLI / Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study

Introducción: Existen hasta ahora pocos estudios sistemáticos con los nuevos criterios diagnósticos sobre la prevalencia de la sarcopenia en distintos niveles asistenciales geriátricos. Objetivo: Conocer la prevalencia de sarcopenia, aplicando los criterios y el algoritmo diagnóstico propuesto por el European Working Group on Sarcopenia in older People (EWGSOP), en personas mayores que acuden a consultas externas de geriatría y en aquellas que están ingresadas en residencias. Material y métodos: Estudio multicéntrico nacional en 2 muestras de personas mayores: una formada por aquellas que acuden a consultas externas de geriatría hospitalarias, y la otra por aquellas que están ingresadas en una residencia. Se recogen variables demográficas, antecedentes clínicos, medicamentos consumidos, presencia de síndromes geriátricos, situación funcional (valoración de las actividades básicas e instrumentales de la vida diaria), movilidad, situación cognitiva, comorbilidad, calidad de vida, valoración nutricional y parámetros analíticos. Para realizar el diagnóstico de sarcopenia se valora la velocidad de la marcha (4 m), la fuerza de prensión de la mano y la composición corporal mediante bioimpedanciometría. Resultados: Utilizando el algoritmo diagnóstico del EWGSOP se espera obtener datos sobre la prevalencia de sarcopenia en la población mayor española. Además se analizará la concordancia entre los 3 parámetros de la definición (masa muscular, fuerza muscular y rendimiento físico) y se aplicarán los diferentes puntos de corte existentes para cada uno de ellos, explorando el rendimiento diagnóstico de cada uno de ellos. Por último, se analizarán los datos demográficos, antropométricos y funcionales que definen a los pacientes con sarcopenia Conclusiones: El estudio ELLI permitirá profundizar en el conocimiento de la prevalencia de sarcopenia en los mayores de nuestro entorno (AU)

Background: There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. Objective: To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. Material and methods: A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4 m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. Results: Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. Conclusions: The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population (AU)

[Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study]. / Prevalencia de sarcopenia en consultas de geriatría y residencias. Estudio ELLI.

BACKGROUND: There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. OBJECTIVE: To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. MATERIAL AND METHODS: A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. RESULTS: Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. CONCLUSIONS: The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population.