Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data.

Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL.

Falls and Sleep Disorders in Spanish Alzheimer's Disease in Nursing Homes: An Observational Study.

OBJECTIVE: The main objective of this study was to establish a relationship between the number of falls and sleep problems experienced by patients with Alzheimer's disease. MATERIALS AND METHODS: This was a cross-sectional study. A total of 114 Spanish aged people with Alzheimer's disease institutionalized in nursing homes and 80 independent Spanish aged people without neurodegenerative diseases living at home were enrolled in this study and completed in-person interviews and digital questionnaires. RESULTS: The mean age was 78.98 ± 8.59 years. Sleep disorders were related to continuous stress (p = 0.001; OR = 4.729) and a high frequency of falls (p = 0.001; OR = 2.145), while predictor variables associated with falls in patients with Alzheimer's disease were continuous medical visits (ß = 0.319, p < 0.001), family history of dementia (ß = 0.212; p = 0.014), and sleep disorders (ß = 0.235; p = 0.007). Second, the analysis showed that moderate physical activity (p = 0.001; OR = 0.147), continuous medical visits (p < 0.001; OR = 0.621), and high level of study (p = 0.011; OR = 0.334) were protective factors against Alzheimer's, while older age (p = 0.035; OR = 1.087), type II Diabetes Mellitus (p = 0.042; OR = 3.973), number of falls (p = 0.021; OR = 1.409), and daily drug intake (p = 0.001; OR = 1.437) were risk factors for Alzheimer's. CONCLUSIONS: Sleep disturbances are related to stress and falls in a sample of 114 Spanish AD aged people institutionalized in nursing homes, and the falls they experience are related to ongoing medical visits, a history of dementia, and sleep disturbances. Therefore, a bidirectional relationship was established between falls and sleep disorders in these patients. Moreover, this study showed that a greater frequency of falls and high daily drug intake could constitute novel risk factors for Alzheimer's disease, in addition to already known factors, such as age and type II Diabetes Mellitus, while being physically active and a high level of studies are protective factors against Alzheimer's disease.

Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: A randomised controlled trial.

The aim of the present study was to analyze the effects of a Qigong exercise programme on the severity of the menopausal symptoms and health-related quality of life (HRQoL) of community-dwelling postmenopausal women. This was done by means of a randomised clinical trial with a sample of 125 women who were assigned to either a control (n = 62) or an experimental group (n = 63). The severity of their menopause-related symptoms and HRQoL were assessed through the Menopause Rating Scale (MRS) and the 36-item Short-Form Health Survey (SF-36) respectively, before and after the intervention period. The main findings of our study reveal significant improvement in the severity of menopausal symptoms at the somatic, psychological, and urogenital levels, as well as in the total score of the MRS. Additionally, participants assigned to the Qigong group experienced improvement in the general health, physical functioning, role-physical, bodily pain, vitality, and mental health domains of the 36-item Short-Form Health Survey, as well as in its physical component and mental component summaries. We can therefore conclude that, among Spanish postmenopausal women, a twelve-week Qigong exercise programme has beneficial effects on the severity of menopausal symptoms and HRQoL.HighlightsWe have studied the effects of Qigong on menopause-related quality of life.Qigong is a useful tool in the management of the severity of menopausal symptoms.A 12-week Qigong programme showed benefits on health-related quality of life.Trial registration: ClinicalTrials.gov identifier: NCT03989453.

High-intensity interval training among middle-aged and older adults for body composition and muscle strength: A systematic review.

Background: The aging of population is leading to the investigation of new options to achieve healthy aging. One of these options is high-intensity interval training (HIIT), although its effects on body composition and muscle strength are currently unclear. The objective of this systematic review is to examine the scientific publications on the effects of HIIT on the body composition and muscle strength of middle-aged and older adults. Methods: The search was carried out in the PubMed, Cochrane Plus, Web of Science, CINAHL and SciELO databases without limitation of publication dates. The literature search, data extraction and systematic review were performed following the PRISMA standards and the risk of bias of the selected studies was assessed using the Cochrane Collaboration Risk-of-Bias. Results: Initially 520 publications were identified, out of which a total of 8 articles were finally selected to be included in this systematic review. Improvements in body composition were seen in six of the selected items and an increase in muscle strength in seven of the eight. Regarding physical function, improvements were found in both gait speed and balance. Conclusions: This systematic review found that HIIT is effective in improving body composition and increasing muscle strength. However, when comparing HIIT to moderate-intensity continuous training, it is not clear that HIIT is more beneficial; a firm conclusion cannot be drawn due to the scarcity of published studies, their variety in methodology and the ambiguity of their results, so it is suggested to carry out more research in this area.

Qigong for mental health and sleep quality in postmenopausal women: A randomized controlled trial.

BACKGROUND: Menopause is one of the stages in a woman's life that affects her psychological health, the most frequent being anxiety and depression. In addition, another problem related to this stage is the lack of sleep that causes a decrease in the quality of sleep. The purpose of this randomized controlled trial was to analyze the effectiveness of a Qigong exercise program on sleep quality, anxiety, and depression in Spanish postmenopausal women. METHODS: A total of 125 women were randomly assigned to an experimental group (EG) (n = 63) that carried out a Qigong exercise program for 12 weeks, or a control group (CG) (n = 62), which did not perform any type of intervention. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). RESULTS: Women who underwent an intervention program experienced significant improvements for all measured variables, except for the use of sleeping medication and daytime dysfunctions that did not show any significant effect with respect to the group and group × time interaction. CONCLUSIONS: After an intervention based on a BaDuanJin Qigong exercise program for 12 weeks, improvements were observed in sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, the total score of the PSQI, anxiety and depression in postmenopausal Spanish women.

SARC-F and the Risk of Falling in Middle-Aged and Older Community-Dwelling Postmenopausal Women.

(1) Background: The objective of the present study was to determine the ability of the SARC-F questionnaire to identify individuals at risk of falling among middle-aged and older community-dwelling postmenopausal women. (2) Methods: An analytical cross-sectional study was conducted on 157 women (70.80 ± 8.37 years). The SARC-F questionnaire was used to screen for risk of sarcopenia. Fear of falling and balance confidence, as measured by the Falls Efficacy Scale-International (FES-I) and the Activities-Specific balance Scale-16 items (ABC-16) respectively, were used to assess risk of falling. Anxiety and depression (Hospital Anxiety and Depression Scale), fatigue (Fatigue Severity Scale), body mass index, waist-to-hip ratio, and sleep duration were also determined. (3) Results: Logistic regression showed that higher risk of falling as assessed by FES-I was associated with higher SARC-F scores (OR = 1.656), anxiety levels (OR = 1.147), and age (OR = 1.060), while increased SARC-F scores (OR = 1.612), fatigue (OR = 1.044), and shorter sleep duration (OR = 0.75) were related to ABC-16 scores. In addition, a SARC-F cutoff of 1.50 (83.33% sensitivity and 59.13% specificity) and 3.50 (44.44% sensitivity and 89.26% specificity) were shown to be able to discriminate participants at risk of falling according to the FES-I and the ABC-16, respectively. (4) Conclusions: our results show that SARC-F is an independent predictor of the risk of falling among middle-aged and older community-dwelling postmenopausal women.

Associations between the Severity of Sarcopenia and Health-Related Quality of Life in Community-Dwelling Middle-Aged and Older Adults.

(1) Background: The aim of this study was to analyze the associations between severity of sarcopenia and health-related quality of life (HRQoL) among community-dwelling middle-aged and older adults. (2) Methods: A cross-sectional study involving 304 older-adult participants was used to assess the severity of sarcopenia by measuring muscle strength (handgrip dynamometer), muscle mass (bioelectrical impedance analysis), and physical performance (Timed Up-and-Go test). The generic 36-item Short-Form Health Survey (SF-36) was used to evaluate HRQoL. Anxiety and depression (Hospital Anxiety and Depression Scale) as well as age were considered as possible confounders. Probable sarcopenia was determined by low muscle strength; confirmed sarcopenia was defined by the presence of both low muscle strength and muscle mass; and severe sarcopenia was defined by low muscle strength and mass along with poor physical performance. (3) Results: The linear regression analysis showed that the presence of probable sarcopenia was associated with the SF-36 domains physical role (adjusted R2 = 0.183), general health (adjusted R2 = 0.290), and social functioning (adjusted R2 = 0.299). As for the SF-36 mental (MCS) and physical (PCS) component summary scores, probable sarcopenia, as well as depression and anxiety, remained associated with MCS (adjusted R2 = 0.518), and these three variables, together with age, were linked to PCS (adjusted R2 = 0.340). (4) Conclusions: Probable sarcopenia, but not confirmed or severe sarcopenia, was independently associated with poor HRQoL. More precisely, it was related to PCS and MCS, as well as to the physical role, general health, and social functioning of SF-36 domains.

Muscle Strength and Physical Performance Are Associated with Reaction Time Performance in Older People.

BACKGROUND: Functional mobility and muscle strength are well known risk factors for sarcopenia. Furthermore, possible associations have been suggested between predisposing factors of sarcopenia and reaction time among the elderly. This study aims to analyze possible associations of functional mobility and muscle strength and reaction times in a population of people aged >60 years. METHODS: A total of 290 older people (69.35 ± 5.55 years) participated in this study. The following parameters were assessed: optoacoustic lower-limb reaction time (OALLRT); acoustic lower-limb reaction time (ALLRT); optic lower-limb reaction time (OLLRT, using an optical detection system), functional mobility (through the timed up-and-go test) and muscle strength (using a dynamometer). RESULTS: Our results show that lower values of muscle strength were associated with increased reaction times in OALLRT (ß = -0.170; 95% confidence interval -0.011-0.000; R2 = 0.237; p = 0.035) and in ALLRT (ß = -0.228; 95% confidence interval -0.011-0.002; R2 = 0.199; p = 0.006). CONCLUSION: Increased muscle strength (which at low values are risk factors for sarcopenia) was associated with decreased reaction times in people >60 years of age.

Effects of HIIT and MIIT Suspension Training Programs on Sleep Quality and Fatigue in Older Adults: Randomized Controlled Clinical Trial.

Poor sleep quality lessens general health quality and is related to physical and mental problems. Moreover, fatigue is one of the foremost common complaints in medical care and plays a role in the decreasing quality of life of the older population. For these reasons, the objective of this study was to examine the effect of high- and moderate-intensity interval training programs (HIIT vs. MIIT)-both consisting of twelve weeks of TRX training-on the sleep quality and fatigue levels of the elderly. A randomized controlled clinical trial (NCT03404830) was conducted. A total of 82 subjects were randomized to either a HIIT group (n = 28) that performed a main squat activity with a suspension system, comprising four four-minute intervals between 90-95% of the maximum heart rate (HR), an MIIT group (n = 27) with an intensity of 70% of the maximum HR, and a control group (CG) (n = 27) that continued their daily lifestyle. The two exercise groups trained twice a week for 12 weeks, with each session lasting 45 min. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI), and fatigue was assessed using the fatigue severity scale (FSS). Outcomes were measured before the intervention and after the intervention period. Post-intervention sleep quality measurements revealed a statistically significant interaction regarding group × time (p < 0.005) and fatigue (p = 0.002). Specifically, fatigue decreased in the HIIT group between both measurement moments (p = 0.003). In addition, differences were obtained in the post-intervention measure between the HIIT and MIIT groups (p = 0.013) and HIIT and control (p = 0.029). Our analysis indicates that a population of the elderly showed improvements in sleep quality and fatigue after performing a high-intensity intervention using suspension training (TRX), with markedly better results in the HIIT group.

Associations of sleep and depression with obesity and sarcopenia in middle-aged and older adults.

OBJECTIVES: To analyze the association of depression and the quality and duration of sleep with general and abdominal obesity, sarcopenia, and sarcopenic obesity (SO) in Spanish middle-aged and older adults. STUDY DESIGN AND OUTCOME MEASURES: A total of 304 people (mean age 72.04 ± 7.88 years, 83.88 % women) participated in this study. Body mass index, waist circumference, skeletal muscle mass index (bioelectrical impedance analysis), and hand-grip strength were used to evaluate sarcopenia, obesity, and SO. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Sleep duration (hours) was categorized as either short (<6), normal (6-8), or long (>8). Depression was measured using the Hospital Anxiety and Depression Scale. Fatigue (Fatigue Severity Scale), nutritional status (Mini Nutritional Assessment Survey) and physical activity (PA) level (International Physical Activity Questionnaire-Short Form) were also assessed. Independent associations were evaluated by multivariate logistic regressions. RESULTS: Only depression was associated with sarcopenia (OR = 1.10, 95 % CI = 1.02-1.19). Poorer sleep quality (OR = 1.06, 95 % CI = 1.06-1.11) and short sleep duration (OR = 2.63, 95 % CI = 1.45-4.78) were related to general obesity, as well as fatigue and low PA level. Poor sleep latency (OR = 1.43, 95 % CI = 1.09-1.87) was linked to abdominal obesity, along with fatigue, low PA level, older age, and female sex. Finally, short sleep duration (OR = 5.25, 95 % CI = 1.97-14.00), together with fatigue, low PA level, and male sex were associated with OS. CONCLUSION: Among Spanish middle-aged and older adults, after adjusting for potential confounding variables, depression was uniquely associated with sarcopenia, while short sleep duration was related to general and sarcopenic obesity, and poor sleep quality was linked to general and abdominal obesity.

Female Sexual Function and Its Association with the Severity of Menopause-Related Symptoms.

The aim of this study was to examine female sexual functioning and its association with the impact of the symptoms of menopause among Spanish postmenopausal women. A total of 182 postmenopausal women (65.59 ± 7.93 years) participated in this cross-sectional study. The female sexual function index (FSFI) and the menopause rating scale (MRS) were used to analyze sexual function and severity of menopausal symptoms, respectively. Age, education, area of residence, occupation, and depression (Hospital Anxiety and Depression Scale) were considered as possible confounders. The results of a linear multivariate regression analysis showed that the severity of urogenital menopause-related symptoms was associated with lower values in the FSFI total score and the lubrication, satisfaction, arousal, and orgasm domains. These last three subscales were also linked to severe psychological impact, while the MRS total score was only related to the desire domain. Regarding confounders, being younger, working, and residing in a rural area were all linked to better sexual function. All effect sizes were large (adjusted R2 > 0.35). In conclusion, after controlling for possible confounders, postmenopausal women who experience a severe impact of menopausal symptoms endure poorer sexual function, particularly when said symptoms are urogenital or psychological in nature.

Impact of Psychological Distress and Sleep Quality on Balance Confidence, Muscle Strength, and Functional Balance in Community-Dwelling Middle-Aged and Older People.

The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, ABC), muscle strength (hand grip dynamometer), and functional balance (Timed Up-and-Go test) were assessed. Psychological distress and sleep quality were evaluated by the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Age, sex, physical activity level, nutritional status, and fatigue were included as possible confounders. Multivariate linear and logistic regressions were performed. Higher values of anxiety (OR = 1.10), fatigue (OR = 1.04), and older age (OR = 1.08) were associated with an increased risk of falling (ABC < 67%). Greater muscle strength was associated with male sex and improved nutritional status (adjusted R2 = 0.39). On the other hand, being older and using sleeping medication were linked to poorer functional balance (adjusted R2 = 0.115). In conclusion, greater anxiety levels and the use of sleep medication were linked to a high risk of falling and poorer functional balance, respectively. No associations were found between muscle strength and sleep quality, anxiety, or depression.

Psychometric Properties of the Spanish Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia.

The Sarcopenia and Quality of Life questionnaire (SarQol®) is a self-administered multidimensional sarcopenia-specific tool designed for community-dwelling subjects aged 65 years and older. The purpose of the present study was to evaluate the psychometric properties of the Spanish version of the SarQoL®. A total of 252 participants aged ≥ 65 years voluntarily participated in this cross-sectional study. Handgrip strength and bioelectrical impedance analysis were used for sarcopenia screening. Discriminative power, internal consistency, test-retest reliability, and floor and ceiling effects were analyzed. The generic 36-item Short-Form Health Survey (SF-36), the European Quality of Life 5-Dimension-3 Level (EQ-5D-3L), and the Hospital Anxiety and Depression Scale (HADS) were also used for convergent and divergent validity. Significant differences between sarcopenic (n = 66) and non-sarcopenic participants were observed for SarQoL® total score (p = 0.008) and for all domains except D2-locomotion. A high internal consistency of SarQoL® total score (Cronbach's alpha = 0.904) was found, and significant domain-to-total score correlations were obtained (all p < .001). Test-retest data showed excellent reliability for SarQoL® total score (ICC = 0.99; 95%CI 0.98-0.99) and in all dimensions, except for D6-leisure and D7-fears activities (substantial). No floor and ceiling effects were observed for SarQoL® total score. SarQoL® total score showed good and acceptable correlations(p < 0.001) with the selected domains of the SF-36 and EQ-5D-3L which have similar dimensions (convergent validity). Low and non-significant correlations existed with anxiety, depression, and EQ-5D-3L self-care and pain/discomfort domains (divergent validity). The Spanish SarQoL® shows satisfactory general psychometric properties in Spanish-speaking older adults from Spain and is able to discriminate between older adults with and without sarcopenia.

Suspension Training HIIT Improves Gait Speed, Strength and Quality of Life in Older Adults.

This study aimed to evaluate the effects of a 12-week high-intensity interval exercise (HIIT) training program involving suspension exercises (TRX) on the muscle strength, body composition, gait speed, and quality of life of older adults. A total of 82 older adults were randomly assigned to 3 groups: a HIIT group (n=28), a continuous intensity training group (MIIT group, n=27), or a control group (CG, n=27). Compared to MIIT and CG, participants of the HIIT group showed significant post-intervention improvements in BMI (p=.002 and p<.001, respectively) and gait speed (p<.001 for both). Handgrip strength increase was also observed after HIIT (p=.002), but no differences were observed with MIIT and CG. Compared with MIIT and control groups, HIIT showed improvements in the SF-36 domains: general health (p<.001 for both) health changes (p<.001 for both), vitality (p=.002 and p=.001 respectively) and physical functioning (p=.036 and p<.001 respectively). Our results suggest that a HIIT training program with TRX have benefits in BMI, handgrip strength, gait speed, and quality of life in older adults.

Risk of Falls in Healthy Older Adults: Benefits of High-Intensity Interval Training Using Lower Body Suspension Exercises.

The objective of this study was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) programs, both with a suspension training system, on several fall risk factors in healthy older adults. A total of 82 participants (68.23 ± 2.97 years) were randomized to HIIT (n = 28), MIIT (n = 27), or control (n = 27) groups. Balance confidence (Activities-specific Balance Confidence Scale), fear of falling (Falls Efficacy Scale-International), dynamic balance (Timed Up and Go test), and gait analysis (OptoGait optical detection system) were assessed. Statistical analysis showed improvements after the intervention in the HIIT group compared with the MIIT and control groups regarding the fear of falling (p < .05 and p < .01, respectively), gait (both ps < .05), and dynamic balance (p < .05 and p < .01, respectively), whereas both HIIT and MIIT groups improved balance confidence compared with the control group (p < .01 and p < .05, respectively). We can conclude that HIIT has significant beneficial effects of fall risk in older adults.

Exercise alone or combined with dietary supplements for sarcopenic obesity in community-dwelling older people: A systematic review of randomized controlled trials.

Sarcopenic obesity (SO) represents a major public health concern. Physical activity has been recommended to minimize functional decline in the elderly and it may also be relevant to SO management. The purpose of this systematic review of randomized controlled trials (RCTs) was to investigate the effects of different exercise modalities, alone or combined with nutritional supplementation, on body composition, muscle strength and physical function in healthy community-dwelling older adults with SO. A literature search was performed using the PubMed, SCOPUS, CINAHL and Cochrane Plus databases. The main inclusion criteria were that the papers were English-language reports of RCTs involving healthy community-dwelling adults aged ≥60 years with SO. The initial search identified 2073 publications from the 4 databases and 72 additional records; 42 full-text records were assessed for eligibility and 8 articles were finally included. The search was conducted from December 1, 2017 to January 8, 2018. The types of exercises were resistance and aerobic training, either alone or combined, and whole-body electromyostimulation. Protein supplementation was included in three studies. The diversity of the methodologies employed and of the results observed does not allow us to reach a clear conclusion. Whereas five of the studies reported improvements in obesity, results were contradictory concerning muscle mass. Increases in muscle strength appeared especially with resistance training and do not seem to be linked to protein supplementation. On the other hand, improvements in physical function were reported in programs combining aerobic and resistance training with nutritional supplementation. We believe that it is of the utmost importance that a certain degree of homogeneity is kept concerning the methods and criteria used in the diagnosis of SO, so that the effects of specific physical exercise programs, whether alone or combined with nutritional supplements, can be assessed with precision.