Comprehensive geriatric assessment as an essential tool to register or update DNR codes in a tertiary care hospital.

PURPOSE: To investigate the prevalence of Do not Resuscitate (DNR) code registration in patients with a geriatric profile admitted to Antwerp University Hospital, a tertiary care hospital in Flanders, Belgium, and the impact of comprehensive geriatric assessment (CGA) on DNR code registration. PATIENTS AND METHODS: Retrospective analysis of a population of 543 geriatric patients (mean age 82.4 ± 5.19 years, 46.4% males) admitted to Antwerp University Hospital from 2018 to 2020 who underwent a CGA during admission. An association between DNR code registration status before and at hospital admission and age, gender, ethnicity, type of residence, clinical frailty score (CFS), cognitive and oncological status, hospital ward and stay on intensive care was studied. Admissions before and during the first wave of the pandemic were compared. RESULTS: At the time of hospital admission, a DNR code had been registered for 66.3% (360/543) of patients. Patients with a DNR code at hospital admission were older (82.7 ± 5.5 vs. 81.7 ± 4.6 years, p = 0.031), more frail (CFS 5.11 ± 1.63 vs. 4.70 ± 1.61, p = 0.006) and less likely to be admitted to intensive care. During the hospital stay, the proportion of patients with a DNR code increased to 77% before and to 85.3% after CGA (p < 0.0001). Patients were consulted about and agreed with the registered DNR code in 55.8% and 52.1% of cases, respectively. The proportion of patients with DNR codes at the time of admission or registered after CGA did not differ significantly before and after the start of the COVID-19 pandemic. CONCLUSION: After CGA, a significant increase in DNR registration was observed in hospitalized patients with a geriatric profile.

Validation of SARC-F-Proxy for the Screening of Sarcopenia in Older Patients with Cognitive Impairment.

Objectives: The SARC-F is a validated questionnaire for the screening of sarcopenia in an older population. However, the clinical relevance of this self-reported questionnaire in patients with cognitive problems is questionable. This study aims to validate the SARC-F-Proxy as an alternative screening tool for sarcopenia in patients with cognitive impairment. Methods: This cross-sectional study included hospitalised community-dwelling older adults aged 60 years or older with confirmed cognitive impairment. Three SARC-F questionnaires were completed: one by patients, one by informal caregivers and one by formal caregivers. Muscle strength, mass and physical performance were measured by handgrip strength, anthropometric measurements, and gait speed respectively. The recently updated EWGSOP2 diagnostic criteria were used as the "gold standard" for diagnosis of sarcopenia. Results: The prevalence of sarcopenia using SARC-F-Proxy was 75.4% for SARC-F-Proxy-Formal caregiver and 66% for SARC-F-Proxy-Informal caregiver. SARC-F-Proxy had high sensitivity (85.9% for SARC-F-Proxy-Formal caregiver and 77% for SARC-F-proxy-informal caregiver) and low specificity (46.5% for SARC-F-Proxy-Formal caregiver and 54.7% for SARC-F-Proxy-Informal caregiver). Conclusions: the proxy-reported SARC-F questionnaire can be applied as a surrogate for the SARC-F in the screening of sarcopenia in hospitalised community-dwelling older people with known or suspected cognitive impairment. Second, the results in this study suggest a higher reliability when the proxy-reported questionnaire is performed by the formal caregiver.

Muscle measurements in daily clinical practice: correlations between ultrasound, bioelectrical impedance analysis and hand grip strength.

Objectives: Muscle ultrasound is gaining importance as a measurement tool to evaluate sarcopenia in daily clinical practice. This study sought to collect reference values of the biceps brachii (BB) in healthy subjects, and to correlate them to bioelectrical impedance analysis (BIA) and hand grip strength (HGS). Methods: Ultrasound was used to measure muscle thickness (MT), cross-sectional area (CSA) and muscle stiffness (EG). Lean mass (LM), fat mass (FM) and phase angle (PhA) were measured by BIA. HGS was measured using a Jamar dynamometer. Intra-rater reliability was calculated using intraclass correlation (ICC). Correlations were investigated using Pearson correlation (PCC). Results: One-hundred-twenty-three Caucasian individuals (51 male and 72 female subjects) between 18 and 69 years old were included. ICC for ultrasound was 0.99 (CI 0.98-0.99). LM, PhA and HGS showed significant correlations with MT and CSA in the entire population (PCC>0.684). These correlations were more significant and stronger in male than in female subjects (PCC>0.419 and >0.279 resp.). Significant correlations with respect to FM and EG were seen exclusively in female subjects. Conclusion: Significant correlations were observed between parameters of muscle quantity measured by ultrasound, BIA and HGS. Intra-rater reliability was excellent. Future studies in larger populations are needed to clarify the observed gender differences.

Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study.

BACKGROUND: Polypharmacy is highly prevalent in older patients with multimorbidity and is associated with increased risk of adverse drug events. This pilot study investigated the added value of a bedside medication review with cognitive and depression screening by a clinical pharmacist to identify potentially inappropriate medications (PIMs) and medication use issues in older patients with polypharmacy. METHODS AND RESULTS: In the period from September 2018 to March 2019, a clinical pharmacist took part in the comprehensive geriatric assessment of 37 older patients hospitalized at Antwerp University Hospital and conducted a medication review consisting of a record review, a bedside interview questionnaire covering medication use, evaluation of cognitive function (abbreviated MMSE), depression (GDS-4), and systematic check for possible PIMs (STOPP/START criteria). Patients were 83±4 years old and on a median of 12 home medications (range 5-20). The clinical pharmacist formulated an average of 7.7 recommendations to optimize medication use per patient, of which 89.9% were considered clinically relevant by the geriatrician. Only 2 out of 286 PIMs were discovered during routine electronic validation of medication prescriptions. Supervision of medication intake was absent in 75% of cognitively impaired patients, but advice to do so was implemented in 86.4% of cases. The multidisciplinary geriatric advice was communicated to the treating physician, who fully implemented 33.8% of the recommendations. CONCLUSIONS: Bedside medication review with cognitive and depression screening by a clinical pharmacist is useful to discover polypharmacy related problems and medication intake issues in a population of geriatric patients. Systematic screening for cognitive impairment and depression are needed to detect patients in need of support for correct medication use and therapy compliance.

Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update.

PURPOSE: In 2018, the SARCUS working group published a first article on the standardization of the use of ultrasound to assess muscle. Recommendations were made for patient positioning, system settings and components to be measured. Also, shortcomings in knowledge were mentioned. An important issue that still required standardization was the definition of anatomical landmarks for many muscles. METHODS: A systematic search was performed in Medline, SCOPUS and Web of Sciences looking for all articles describing the use of ultrasound in the assessment of muscle not described in the first recommendations, published from 01/01/2018 until 31/01/2020. All relevant terms used for older people, ultrasound and muscles were used. RESULTS: For 39 muscles, different approaches for ultrasound assessment were found that likely impact the values measured. Standardized anatomical landmarks and measuring points were proposed for all muscles/muscle groups. Besides the five already known muscle parameters (muscle thickness, cross-section area, pennation angle, fascicle length and echo-intensity), four new parameters are discussed (muscle volume, stiffness, contraction potential and microcirculation). The former SARCUS article recommendations are updated with this new information that includes new muscle groups. CONCLUSIONS: The emerging field of ultrasound assessment of muscle mass only highlights the need for a standardization of measurement technique. In this article, guidelines are updated and broadened to provide standardization instructions for a large number of muscles.

Physical components of frailty in predicting mortality after transcatheter aortic valve implantation (TAVI).

OBJECTIVE: This study investigates physical, nutritional and psychological components of frailty in predicting postoperative mortality after transcatheter aortic valve implantation (TAVI). METHODS: A single centre retrospective observational study was conducted from July 2015 until January 2019. Psychological, nutritional and physical components of frailty were measured. Sarcopenia was defined as having both gait speed and grip strength under the threshold. The primary endpoint was the cumulative all-cause 1-year mortality. Secondary endpoint was 30 days all-cause mortality. RESULTS: A total of 125 patients were included. The primary endpoint was observed in 18 patients (14.4%). Five patients died within the first 30 days (4.0%). None of the frailty tests were correlated with early mortality. However, at one year, the nutritional components albumin and Mini Nutritional Assessment - short form (MNA-SF) and the physical components gait speed, chair stand test, TUG, SPPB, EFT and sarcopenia were associated with increased mortality after TAVI. A significant difference in mortality was present if stratified for MNA-SF (log-rank p = .008), sarcopenia (log-rank p < .001), SPPB (log-rank p = .003) and EFT score (log-rank p < .001). CONCLUSIONS: Mainly nutritional and physical components of frailty were associated with 1-year mortality after TAVI.

Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses.

CONTEXT: Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions. OBJECTIVE: The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years. DATA SOURCES: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance. DATA EXTRACTION: Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. DATA ANALYSIS: A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, ß-hydroxy-ß-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate. CONCLUSIONS: Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.

The association between muscle mass and the degree of myosteatosis of the psoas muscle and mortality in older patients with cancer.

OBJECTIVE: Comprehensive geriatric assessment (CGA) is used for oncological management in older patients. The evaluation of muscle characteristics is currently not included in the CGA. This study investigates whether muscle mass and the degree of myosteatosis is associated with mortality in older patients with cancer. METHODS: CGA was performed in a cohort of older patients with cancer. Cross sectional area (CSA) and mean pixel density (Hounsfield units, HU), as measure for respectively muscle mass and myosteatosis, were obtained from CT images of the psoas muscle at the level of mid L3. Mortality was recorded. Correlation was determined between CSA and HU. Paired sample t-test was used to follow changes in muscle mass and density. Logistic regression was performed to define relevant prognostic factors for mortality. RESULTS: In total, 183 patients were included (86 male and 97 female), 120 patients (66%) died. Mean age was 80 years (range 70-94 years). Mean days of survival was 606 (range 1-2023). There was a significant correlation between CSA and HU (PCC = 0.196) at time of diagnosis and at follow-up (PCC = 0.257). There was a significant decrease in CSA (p = .008) and HU (p = .004) in men at follow-up. No significant changes were observed in women. In multivariate analysis, a higher gender-corrected CSA was linked to a lower mortality rate with an odds ratio of 0.657 (CI = 0.457-0.944, p = .023). No association was found between HU and mortality. CONCLUSIONS: Muscle mass correlated with the degree of myosteatosis. CSA and HU tended to decrease during follow-up. Having a greater CSA was prognostic for a lower mortality rate.

Usability and Pitfalls of Shear-Wave Elastography for Evaluation of Muscle Quality and Its Potential in Assessing Sarcopenia: A Review.

Sarcopenia is age-related progressive and generalized loss of skeletal muscle mass and strength. Its prevalence is rising, which poses a burden for society because it increases disability and dependency and therefore raises health care costs. Muscle mass quality, however-an essential part of sarcopenia-is not easily diagnosable yet. Recent interest has risen for ultrasonographic evaluation of muscle. This review introduces muscle elastography as a possible, easy and cheap tool to evaluate qualitative muscle parameters. Basic principles of muscle elastography are described, as well as different elastography techniques and some technical considerations. Furthermore, a proposal for practical guidelines is offered and factors influencing muscle stiffness are highlighted.

Comprehensive Quantitative Spatiotemporal Gait Analysis Identifies Gait Characteristics for Early Dementia Subtyping in Community Dwelling Older Adults.

Background: Recent studies associated gait patterns with cognitive impairment stages. The current study examined the relation between dementia type and spatiotemporal gait characteristics under different walking conditions in pre and mild neurocognitive disorder stage. Methods: Community-dwelling older adults (age 50+) with memory complaints consulting a memory clinic underwent, at baseline and during follow-up (every 4 months), a standard dementia assessment and a comprehensive spatiotemporal gait analysis [walking on an electronic walkway at usual pace (UP) with and without a counting-backwards (CW) or animal-reciting dual-task (AW), at fast (FP) and at slow (SP) pace]. At baseline the participants were categorized according to the Clinical Dementia Rating (CDR) scale. At the end of the study, the dementia diagnosis was used to stratify the categories in three outcome groups: developed "No-dementia," "AD+FTD" (grouping Alzheimer's or Fronto-temporal dementia) or "VascD+LBD" dementia (grouping Vascular dementia or Lewy body dementia). The gait characteristics were compared per category in paired groups. Sub-analyzing in the ≥70-years-old participants evaluated the age effect. Results: Five hundred and thirty-six participants, age 50-to-95-years old were followed for 31-to-41 months. In the CDR 0, no differences were seen between eventual dementia and no-dementia individuals. In the CDR 0.5, CW dual task cost (DTC) step width was larger in the imminent "AD+FTD" and AW (normalized) gait speed was slower in the future "VascD+LBD" group compared to the no-dementia participants. Slower UP (normalized) gait speed differed the future "VascD+LBD" from the "AD+FTD" individuals. In the CDR 1: Wider steps in UP, SP and CW differed the "VascD+LBD" from the "AD+FTD" group. In the ≥70-years old CDR 0 category, higher AW cycle time variability in the imminent "AD+FTD" dementia group, wider UP step width and higher AW cycle time variability in the "VascD+LBD" group differed them from the no-dementia group up to 3 years before dementia diagnosis. The distinctive gait characteristics between the no-dementia and the imminent dementia groups in CDR 0.5 and CDR 1 remained the same as in the overall group. However, no gait differences were found between "VascD+LBD" and "AD+FTD" groups in the pre-dementia stages. Conclusion: Distinctive spatiotemporal gait characteristics were associated with specific dementia types up to 3 years before diagnosis. The association is influenced by the cognitive stage and age.

The prevalence and health burden of malnutrition in Belgian older people in the community or residing in nursing homes: results of the NutriAction II study.

INTRODUCTION: In 2008, the NutriAction study showed that (risk of) malnutrition was highly prevalent (57%) among Belgian older people living in the community or in a nursing home. In 2013, this study was repeated to re-evaluate the occurrence of malnutrition, as well as mobility problems and dependence in activities of daily living (ADL). METHODS: Health care professionals (HCPs) associated with homecare organizations and nursing homes across Belgium were invited to screen their patients and complete an online questionnaire. Nutritional status, presence of pre-specified comorbidities, mobility, and ADL dependency were assessed. RESULTS: In total, 3299 older patients were analysed: 2480 (86.3 ± 6.3 years) nursing home (NH) residents and 819 (82.7 ± 6.1 years) community dwelling (CD). Overall, 12% was malnourished (MNA-SF score < 8) and 44% was at risk of malnutrition (MNA-SF 8-11). The highest prevalence of (risk of) malnutrition was observed in NHs (63%) and in patients with dementia (CD: 68%; NH: 82%) or depression (CD: 68%; NH: 79%). Of all malnourished individuals, 49% was recognized as malnourished by HCPs and 13% of the malnourished recognized themselves as such. Mobility (stair climbing and walking) and ADL dependency (Belgian KATZ score) were impaired in older people with (risk of) malnutrition in comparison with individuals with normal nutritional status (p < 0.001). DISCUSSION: Despite public awareness initiatives, the prevalence of malnutrition remained stable among Belgian older people seen by HCPs in the period 2008-2013. Moreover, malnutrition is not well recognized. CONCLUSION: Under-recognition of malnutrition is problematic, because associated loss of mobility and independence may accelerate the transformation of frailty into disability in older people.

[Validation of the Dutch EAT-10 for screening of oropharyngeal dysphagia in the elderly population]. / Validatie van de EAT-10 in het Nederlands ter screening van orofaryngeale dysfagie in een oudere populatie.

The prevalence of oropharyngeal dysphagia (OD) in the elderly population >76y is estimated at 26%. OD can lead to malnutrition, depression, diminished quality of life and increased mortality in the elderly. Despite these important complications, OD is still underdiagnosed due to a lack of a reliable and easily applicable screening tool. The Eating Assessment Tool-10 (EAT-10) questionnaire consists of ten statements about symptoms and signs of OD. In the current literature, a cut-off value of ≥3 points is preferred to be considered as in risk for OD. The EAT-10 questionnaire shows good internal consistency and reliability and is validated in different languages with comparable results. The purpose of this study is to validate the EAT-10 questionnaire in Dutch. The results show a strong test-retest reliability (Spearman's rho 0.841) and an internal consistency of 0.917 via Cronbach's alpha. The Dutch EAT-10 questionnaire is well applicable in a clinical environment with a mean duration of 2 minutes and 28 seconds (± 1 minute and 32 seconds) to complete the test. Validation of the Dutch EAT-10 questionnaire makes screening of OD in the Dutch (elderly) population possible.

Sarcopenia: revised European consensus on definition and diagnosis.

Background: in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives: to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations: sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions: EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

Prevalence of sarcopenia and 9-year mortality in nursing home residents.

BACKGROUND: Sarcopenia is a progressive loss of muscle mass, strength, and function. It is linked to functional decline, and secondary to this, to nursing home admission. AIMS: To look into the prevalence of sarcopenia in a nursing home population and to gain insight into the relation of sarcopenia with mortality in this cohort. METHODS: A longitudinal cohort follow-up started in October 2007 in 52 nursing homes in Belgium. Following data were procured: anthropometrics (weight/length), body composition (muscle mass through bio-impedance absorptiometry, BIA), functional status (Katz), nutritional status (mini-nutritional assessment-short form, MNA), and a number of laboratory parameters. RESULTS: In total, 745 residents were included. Mean age was 84.6 ± 7.2 years. Mean follow-up time was 1632 ± 1026 days. In total, 17% had severe sarcopenia, 45% had moderate sarcopenia, and 38% had no sarcopenia. Following items were significant (p < 0.05) on univariate analysis with mortality as outcome: sarcopenia, gender, BMI, skeletal muscle mass, age, MNA, and functional level. In multivariate analysis, only MNA, skeletal muscle mass, and age were still significant. Odds ratio for skeletal muscle mass was 1.171 for the highest percentile group, 2.277 for the middle percentile group, and 4.842 for the lowest percentile group. DISCUSSION: The prevalence of sarcopenia was higher than in comparative literature, for which there are a few hypotheses. Cut-off values for sarcopenia using BIA for specific cohorts need to be re-evaluated. CONCLUSIONS: It seems to remain useful to screen for muscle mass in institutionalized elderly, because there is a clear and significant correlation with long-term mortality.

Correction to: The prevalence and health burden of malnutrition in Belgian older people in the community or residing in nursing homes: results of the NutriAction II study.

In the original publication, table row alignment was incorrectly formatted for all the tables. The corrected tables are given below.

Antidepressant use in older inpatients: current situation and application of the revised STOPP criteria.

OBJECTIVES: Antidepressant use increases as age rises. Moreover, older patients are more sensitive to side effects and drug interactions. This descriptive study aims to map antidepressant use among patients at the geriatrics department of a university hospital and to evaluate whether prescribing happens in an evidence-based manner. METHODS: Patients aged 75 years and over, admitted to the geriatrics department of the Middelheim Hospital in Antwerp between February and July 2017 were included. We checked whether they took antidepressants, which types and doses were prescribed, who prescribed the antidepressants, and whether prescribing was in concordance with the revised STOPP (Screening Tool of Older People's Prescriptions) criteria. RESULTS: Out of the 239 included patients, 61 were found to use antidepressants, with depression being the most important indication. General practitioners appeared to be the most frequent prescribers. Trazodone was the most prescribed antidepressant and was often used for sleeping disorders. Antidepressants were taken longer than recommended in almost one out of five cases. Patients with diabetes and renal insufficiency were prescribed antidepressants less frequently. Only 2.8% of the study participants were prescribed antidepressants for anxiety disorders. CONCLUSION: We can conclude that prescription of antidepressants in older patients at the geriatrics department is often not evidence based. Clear guidelines may offer a solution; therefore more studies are needed on antidepressant use in older patients.

The impact of cognitive impairment on the physical ageing process.

BACKGROUND: Physical decline and cognitive degeneration characterise the ageing process. AIM: Physical parameters, performance and the functional indexes were studied in relation to age in healthy and cognitively impaired older persons to understand the interactions and changes during normal ageing, cognitive decline and progression to frailty. METHODS: Cross-sectional analysis was performed on a data registry of an ambulatory Memory Diagnosis Centre. The quantitative gait characteristics at usual pace, body composition parameters, disability scales (activity of daily living and instrumental activity of daily living) and Rockwood frailty index were compared in cognitively healthy (CHI), mild cognitively impaired, mildly and moderately demented < 80-years old and > 80-years old adults. RESULTS: Quality of gait deteriorated with age in CHI and cognitively impaired. Skeletal muscle mass index decreased when cognitive status worsened. Disability and frailty correlated with increasing cognitive impairment. Age, gender, cognitive impairment, body composition and Rockwood's Frailty scale had a combined forecasting effect, as well as the individual effect on the gait characteristics. Disability score, Frailty index, skeletal muscle mass and skeletal muscle mass index, gait speed, normalised mean step length and swing time variability in mildly demented < 80-years old adults mirrored the parameters in the CHI > 80-years old. CONCLUSION: Quantitative gait characteristics, muscle mass and disabilities change along with cognitive impairment, frailty and age. A more rapid physical ageing process accompanies cognitive decline. Therefore, gait characteristics should be age-referenced and studies on gait in older persons should include muscle mass, frailty and cognitive parameters.

Prevalence of dynapenia and presarcopenia related to aging in adult community-dwelling Mexicans using two different cut-off points.

OBJECTIVES: To estimate the prevalence of dynapenia, presarcopenia, and sarcopenia in a Mexican community using two different cutoffs. MATERIALS AND METHODS: This cross-sectional study included 724 subjects (521 women and 203 men) adults ≥ 50 years community-dwelling from Mexico City. We determined the prevalence of different muscle-related syndromes. Muscle strength was measured with handgrip strength and muscle mass was estimated by bioelectrical impedance. For the diagnosis of sarcopenia and presarcopenia, two criteria were used: (1) the cut-off points proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and (2) the cut-off points less than two standard deviations for gender-specific mean of Mexicans young adults. RESULTS: Muscle mass decreases with age, but not as rapid as muscle strength. With the specific Mexican cut-off points, the general prevalences were: 27.4% for dynapenia (n = 199), 12.8% for presarcopenia (n = 93), and 6.6% for sarcopenia (n = 48). In contrast, the prevalences were higher when we used the cut-off points for Caucasians (EWGSOP): 33.9% for dynapenia (n = 246), 38.1% for presarcopenia (n = 276), and 15.2% for sarcopenia (n = 110). CONCLUSIONS: Diagnoses of dynapenia, presarcopenia, and sarcopenia should be estimated from cut-off points of the specific population; otherwise, it might be overestimated or underestimated. Early diagnosis of any of these conditions in community can prevent the occurrence of adverse effects.