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 characterize
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.
Treatment of postmenopausal osteoporosis with parathyroid hormone (1-34) decreases the risk of vertebral and nonvertebral fractures; increases vertebral, femoral, and total-body bone mineral density; and is well tolerated. The 40-microg dose increased bone mineral density more than the 20-microg dose but had similar effects on the risk of fracture and was more likely to have side effects.
Risedronate significantly reduces the risk of hip fracture among elderly women with confirmed osteoporosis but not among elderly women selected primarily on the basis of risk factors other than low bone mineral density.
SummaryGuidance is provided in a European setting on the assessment and treatment of postmenopausal women with or at risk from osteoporosis.IntroductionThe European Foundation for Osteoporosis and Bone disease (subsequently the International Osteoporosis Foundation) published guidelines for the diagnosis and management of osteoporosis in 1997. This manuscript updates these in a European setting.MethodsThe following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case finding strategies; investigation of patients; health economics of treatment.Results and conclusionsA platform is provided on which specific guidelines can be developed for national use.
Introduction:
The postpartum period represents the time of risk for the emergence of
maternal postpartum depression. There are no systematic reviews of the
overall maternal outcomes of maternal postpartum depression. The aim of this
study was to evaluate both the infant and the maternal consequences of
untreated maternal postpartum depression.
Methods:
We searched for studies published between 1 January 2005 and 17 August 2016,
using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane
Pregnancy and Childbirth Group trials registry.
Results:
A total of 122 studies (out of 3712 references retrieved from bibliographic
databases) were included in this systematic review. The results of the
studies were synthetized into three categories: (a) the maternal
consequences of postpartum depression, including physical health,
psychological health, relationship, and risky behaviors; (b) the infant
consequences of postpartum depression, including anthropometry, physical
health, sleep, and motor, cognitive, language, emotional, social, and
behavioral development; and (c) mother–child interactions, including
bonding, breastfeeding, and the maternal role.
Discussion:
The results suggest that postpartum depression creates an environment that is
not conducive to the personal development of mothers or the optimal
development of a child. It therefore seems important to detect and treat
depression during the postnatal period as early as possible to avoid harmful
consequences.
ObjectiveThe purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia.MethodsProspective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI.ResultsOf the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96–4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80–5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes).ConclusionSarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden.
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