BackgroundSarcopenia, defined as the age-related loss of muscle mass and low muscle function.1 The prevalence of sarcopenia worldwide by meta-analysis of 35 articles was 10% (95% CI: 8%–12%) in men and 10% (95% CI: 8%–13%) in women, respectively.2 A review of the literature on osteoarthritis (OA) and sarcopenia has shown that the age factor that contributes to the development of OA includes a decrease in muscle strength. In people with OD of the lower extremity, the frequency of falls was increased by a factor of 2–5.3 OA contributed to the development of sarcopenia in elderly women.4 ObjectivesPerform body composition and muscle analysis in patients with osteoarthritis and identify risk factors for sarcopenia that affect patients with osteoarthritis.MethodsProspective study of 159 women, mean age 74±13.3. The walking speed, handgrip strength were evaluated to apply the European Working Group on Sarcopenia. Assessment of appendicular skeletal muscle mass (ALM/h2) and total body fat were assessed using DXA, on Hologic Explorer machines. Covariates were determined by questionnaires and interviews.Results31.45% of people with OA older than 65 years had sarcopenia. Patients with OA had a decrease in muscle strength and function, regardless of sarcopenia. Statistically significantly more frequent in patients with OA were lower indexes of lean mass index (ALM/h2) and body mass index (BMI) (p<0.01). The incidence of sarcopenia increased with age (p<0.01). 61.5% of patients with sarcopenia significantly more often had high values of c-reactive protein – CRP (x2=31.18, p<0.0001). Patients with sarcopenia were statistically significantly more likely to have vitamin D deficiency than patients without sarcopenia (x2=8.11, p<0.01). Cases of falls were observed in 90% of patients with sarcopenia (x2=79.29, p<0.001). Low physical activity 86% of patients with sarcopenia are statistically significantly higher than in patients without sarcopenia (95% CI: 73.3–94.2, p<0.01).ConclusionsWith age, patients with sarcopenia and OA had a significant decrease in muscle mass and physical activity, an increase in the incidence of falls. Patients with sarcopenia had high CRP levels and vitamin D deficiency than patients without sarcopenia.References[1] Milte R, Crotty M. Musculoskeletal health, frailty and functional decline. Best Pract Res Clin Rheumatol. 2014;28(3):395–410.[2] Shafiee G, Keshtkar A, Soltani A, et al. Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. Journal of Diabetes & Metabolic Disorders2017;16:21.[3] Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD. Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults?Womens Health (Lond Engl)2012;8(6):685–96.[4] Kemmler W, Teschler M, Goisser S, Et al. Prevalence of sarcopenia in germany and the corresponding effect of osteoarthritis in females 70 years and older living in the community: results of the FOrMosA study. Clinical Interventions in Aging2015;10:1565–1573.Disclosure of Intere...
The global diversion of health resources during the COVID-19 pandemic from the provision of routine medical care, and the more frequent and severe course of this infection in older patients justify the need to study the impact of the pandemic on the management of patients with osteoporosis.Aim – to assess the impact of the COVID-19 pandemic on the management of patients with osteoporosis, as well as the impact of anti-osteoporotic drugs on the incidence of COVID-19.Material and methods. A cross-sectional study was conducted, including a telephone survey and analysis of outpatient records of 304 patients with osteoporosis, who were recommended therapy with anti-osteoporotic medications. The average age was 70.8±8.8 years. The vast majority of patients took bisphosphonates in oral or parenteral forms.Results. Problems with the timely conduct of laboratory tests were noted by 91 (30.4%) subjects, DXA testing – 98 (32.8%). 65 (22.1%) were unable to receive the drug in a timely manner. Problems were more common when taking parenteral drugs (p=0.002). The cumulative incidence of COVID-19 was 12.2%, which is twice as high as in the population. There was a tendency to a lower incidence of confirmed SARS-CoV-2 infection when treated with denosumab or zoledronic acid. COVID-19 cases were not associated with either a vitamin D dose or a 25(OH)D level.Conclusions. During the COVID-19 pandemic, there is a significant decline in the quality of medical care for patients with osteoporosis, which cannot but lead to a new epidemic in the future – an epidemic of low-energy fractures. Our data confirmed the predisposition of older age groups to a higher incidence of COVID-19. However, there is no clear association of osteoporosis therapy with the risk of developing clinical manifestations of COVID-19.
Vitamin D deficiency is quite сommon and highly prevalent in some regions of the world,seriously сompromising quality of elderly people life. Optimal vitamin D level in serum is assoсiated with stronger muscles and indicates additional 4–11 % improvement of muscularperformance and 17 % risk reduction of elderly people fаlls. Inсreased risk of falls due to sarcopenia is strongly associated with such undеsirable health outcomes as disаbility, institutionalization, and eventually death. This study analyzes vitamin D status in 69 elderly people with sarcopenia among 230 patricipants (96.5 % of women, mean age of 74.1 ± 6.5 years), equaling to 30 % (8.7 % in men, 91.3 % in women) prevalence in this age group. For evaluation of sarcopenia level, EWGSOP criteria were used. Muscle strength was assessed by a handheld dynamometer and muscle functioning was evaluated by SPPB-tests (walking speed, Five-Times-Sit-to-Stand-Test and standing balance). Insufficient vitamin D supply was found in 97 % of subjects with sarcopenia and 85.8 % — without sarcopenia. Optimal vitamin D levels were identified only in 3 % of sarcopenic subjects and 14.2 % of non-sarcopenic ones with p < 0.01.Mean Vitamin 25 (OH) D level in general population constituted 19.6 ± 5.44 ng/ml. Mean vitamin D level amog sarcopenic subjects aged 65–84 years constituted 18.2 ± 3.04 ng / ml, while among older individuals aged 85+ years — 15.1 ± 6.43 ng / ml, p > 0.05. Histroy of falls within 12 months prior to the study was reported in 89.9 % of patients with sarcopenia. Among them vitamin D deficiency was found in 60.3 % (95 % CI: 53.0–67.4, χ2 = 8.81 with p = 0.012). 85.8 % of individuals with vitamin D deficiency had low muscle strength (χ2 = 174.61, p < 0.001). 60.4 % of participants with sarcopenia and vitamin D deficiency had low total SPPB score (CI: 45.3–74.2, p < 0.05). Obtained data is indicative of high vitamin D deficiency prevalence. It was found out that Sarcopenia increases risk of vitamin D deficiency by 1.2 times (RR 1.2,95 % CI: 1.06–1.36, p < 0.01) in all studied age groups.
BackgroundIn accordance with the updated recommendations of the EWGSOP (2018), sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime [1]. Sarcopenia and osteoarthritis significantly affect the self-esteem quality of life which is associated with a decrease in muscle strength and muscle performance, falls, joint pain [2]. In 2015, the SarQoL® questionnaire (Sarcopenia and Quality of Life, www.sarqol.org) was developed, specific to patients with sarcopenia. Improvement of quality of life should be the priority of any interventions to prevent and treat osteoarthritis and sarcopenia in the ageing population [3].ObjectivesPerform quality of life analysis in patients with osteoarthritis and sarcopenia.MethodsProspective study of 159 women, mean age 74 ± 13.3. Sarcopenia was diagnosed according to the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP, 2010). Life quality assessment was performed using EQ-5D questionnaires and a specific questionnaire in patients with sarcopenia SarQoL.Results31.45% of people with OA older than 65 years had sarcopenia. The results of the study showed a statistically significant decrease in overall health on the questionnaire EQ-5D in patients with sarcopenia compared with patients without sarcopenia (0.48 ± 0.22 points and 0.74 ± 0.27 points, respectively, p <0.01) and no differences according to the EQ-VAS scale in the studied groups (p> 0.05). The decrease in the general health status of EQ-5D in patients with OA sarcopenic compared with non-sarcopenic is associated with a restriction of the usual daily activities: in 70% (95% CI: 55.4-82.1) and 52.3% (95% CI: 42.5-61.9) respectively, (p <0.01). In patients with OA, reduced global SarQoL in sarcopenic subjects compared to non-sarcopenic ones: 50,65±14,23 vs. 75,10±14,46, р<0,001. Significantly lower scores for all domains were found in patients with OA sarcopenic compared with non-sarcopenic patients (р<0.001).ConclusionIn patients with OA sarcopenic, the quality of life is worse than that of non-sarcopenic due to a decrease in habitual daily activities, probably associated with low muscle strength.References[1] Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Guidelines. Sarcopenia: revised European consensus on definition and diagnosis on definition and diagnosis. Age and Ageing 2018; 0: 1–16. doi: 10.1093/ageing/afy169Milte R, Crotty M. Musculoskeletal health, frailty and functional decline. Best Pract Res Clin Rheumatol. 2014;28(3):395–410[2] Beaudart С., Biver E., Bruyère O. et al. Assessment of Quality of Life in Musculo-Skeletal Health. Aging Clin Exp Res. 2018 May; 30(5): 413–418Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD. Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults? Womens Health (Lond Engl). 2012;8(6):685–96[3] Beaudart C, Biver E, Reginster J-Y, et al. Development of a self-administrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQoL. Age Ageing. 2015; 44 ...
Yuliya Safonova is a young and talented Ukrainian poet from Kharkiv. She has a blemish from her childhood, but it did not prevent her from being strong and positive, which allowed her to withstand the test of fate. Great contribution was made to the wrapping up of her character by her parents, believing in her talent and supporting her on her life path. The girl has a particularly strong spiritual connection with her father, who inspires her to take creative steps and, at the same time, is a major critic of her works. Yuliya’s mother is very caring, and pays special attention to her daughter's education, supporting her in every possible way. Personally, I consider this woman a heroine who carries out daily maternal exploits. Julia is open for communication. Yuliya writes poems from an early age, so she found her own way to release her creative energy. Each of her poems is filled with emotions and experiences. In 2009, Yuliya became the winner of the contest "Gifted Youth" in the nomination "Children's Creativity in Poetry". Today, her life credo is: smile to the world - and the world will smile to you! The Soul and the Word Collection was released in 2014. I bring to your attention several poems from this collection: «You were right here beside me» and «Song: Lady “Grinch”».
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