Association between skeletal muscle mass index and lung function/respiratory muscle strength in older adults requiring long-term care or support

Sawaya, Yohei; Ishizaka, Masahiro; Kubo, Akira; Shiba, Tomoaki; Hirose, Tamaki; Onoda, Ko; Maruyama, Hitoshi; Urano, Tomohiko

doi:10.1589/jpts.32.754

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…Based on the above, we hypothesized that the diaphragm might be less likely to develop respiratory sarcopenia. Furthermore, because our prior fundamental study showed that MEP was independently associated with skeletal muscle mass index (SMI), we also hypothesized that sarcopenia is more associated with expiratory muscle strength than inspiratory muscle strength ( Sawaya et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is not associated with inspiratory muscle strength but with expiratory muscle strength among older adults requiring long-term care/support

Sawaya

Shiba

Ishizaka

et al. 2022

PeerJ

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Background Recently, the concept of respiratory sarcopenia has been advocated, but evidence is lacking regarding which respiratory parameters are appropriate indicators. Therefore, we investigated the association between sarcopenia, respiratory function, and respiratory muscle strength to identify the most appropriate parameters for respiratory sarcopenia. Methods We included 124 older adults (67 men, 57 women; average age 77.2 ± 8.3 years) requiring long-term care/support who underwent Day Care for rehabilitation. Handgrip strength, usual gait speed, and skeletal muscle mass were measured using bioelectrical impedance analysis. Participants were then diagnosed with sarcopenia using the algorithm of the Asian Working Group for Sarcopenia 2019. Parameters of respiratory function (forced vital capacity, forced expiratory volume in one second [FEV1.0], FEV1.0%, and peak expiratory flow rate) and respiratory muscle strength (maximal expiratory pressure [MEP] and maximal inspiratory pressure) were also measured according to American Thoracic Society guidelines. Respiratory parameters significantly related to sarcopenia were identified using binomial logistic regression and receiver operating characteristic analyses. Results Seventy-seven participants were classified as having sarcopenia. Binomial logistic regression analysis showed that MEP was the only respiratory parameter significantly associated with sarcopenia. The cut-off MEP value for predicting sarcopenia was 47.0 cmH20 for men and 40.9 cmH20 for women. Conclusions The most appropriate parameter for assessing respiratory sarcopenia may be MEP, which is an indicator of expiratory muscle strength, rather than FVC, MIP, or PEFR, as suggested in previous studies. Measuring MEP is simpler than measuring respiratory function parameters. Moreover, it is expected to have clinical applications such as respiratory sarcopenia screening.

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Section: Introductionmentioning

confidence: 99%

Sarcopenia is not associated with inspiratory muscle strength but with expiratory muscle strength among older adults requiring long-term care/support

Sawaya

Shiba

Ishizaka

et al. 2022

PeerJ

Self Cite

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“…Longitudinal data show increased risk for renal dysfunction in sarcopenic and obese people [ 56 ]. These patients also demonstrate poor respiratory muscle performance, which is not frequently checked in routine care even for people with symptoms such as dyspnea, and it is associated with respiratory dysfunction in these individuals when they contract COVID-19 [ 15 , 35 , 57 ].…”

Section: Relevance Of Body Composition To Sarcopenia and Covid-19mentioning

confidence: 99%

“…Preexisting sarcopenia is associated with progressing to disease severity in COVID-19 patients reflected by polypharmacy, multiple organ failure, intensive-care unit (ICU) admission, increased need for mechanical ventilation, and mortality [29][30][31][32][33][34]. Among community-dwelling older adults, muscle mass is an independent correlate of maximum expiratory pressure, an indicator of respiratory muscle strength [35]. Myokines produced by wasting muscle (e.g., interleukin-(IL-) 6 and IL-7) can considerably alter immunity [36].…”

Section: Introductionmentioning

confidence: 99%

Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era

Ali

2021

International Journal of Endocrinology

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Although the numbers of aged populations have risen considerably in the last few decades, the current coronavirus disease 2019 (COVID-19) has revealed an extensive vulnerability among these populations. Sarcopenia is an age-related disorder that increases hospitalization, dependencies, and mortality in older adults. It starts to develop in midlife or even earlier as a result of unbalanced diet/poor nutrition and low levels of physical activity, in addition to chronic disorders such as obesity and diabetes mellitus. Given that social isolation is adopted as the most protective measure against COVID-19, the level of physical activity and the intake of adequate diet have considerably declined, especially among older adults—denoting an increased possibility for developing sarcopenia. Research also shows a higher vulnerability of sarcopenic people to COVID-19 as well as the development of wasting disorders such as sarcopenia and cachexia in a considerable proportion of symptomatic and recovering COVID-19 patients. Muscular wasting in COVID-19 is associated with poor prognosis. Accordingly, early detection and proper management of sarcopenia and wasting conditions in older adults and COVID-19 patients may minimize morbidity and mortality during the current COVID-19 crisis. This review explored different aspects of screening for sarcopenia, stressing their relevance to the detection of altered muscular structure and performance in patients with COVID-19. Current guidelines recommend prior evaluation of muscle strength by simple measures such as grip strength to identify individuals with proven weakness who then would be screened for muscle mass loss. The latter is best measured by MRI and CT. However, due to the high cost and radiation risk entailed by these techniques, other simpler and cheaper techniques such as DXA and ultrasound are given preference. Muscle loss in COVID-19 patients was measured during the acute phase by CT scanning of the pectoralis muscle simultaneously during a routine check for lung fibrosis, which seems to be an efficient evaluation of sarcopenia among those patients with no additional cost. In recovering patients, muscle strength and physical performance have been evaluated by electromyography and traditional tests such as the six-minute walk test. Effective preventive and therapeutic interventions are necessary in order to prevent muscle loss and associated physical decline in COVID-19 patients.

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“…Endothelial injury is associated with the severity of pulmonary insult in COVID-19 [64]. Poor muscle mass and strength negatively correlate with the respiratory muscle strength, which is reflected by maximum expiratory pressure [65]. Therefore, sarcopenia may exacerbate pulmonary function in older COVID-19 patients [36,66].…”

Section: Risk For Covid-19 In Sarcopenia and Related Conditionsmentioning

confidence: 99%

Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults

Ali

2021

BioMed

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The tremendously rising numbers of aged populations are associated with a heightened risk for motor and functional declines. Sarcopenia is an active age-related process that involves progressive losses of skeletal muscle mass, muscle strength, and muscle function. Muscle failure is a major cause of frailty, disability, falls, hospitalization, dependency, institutionalization, and low quality of life in older seniors. Therefore, sarcopenia considerably heightens the annual cost of care worldwide. This narrative review elaborates on sarcopenia as a deleterious condition in old age while spotting the light on its association with the coronavirus disease 2019 (COVID-19). It discusses its pathophysiology and the most possible options for preventing and treating sarcopenia. The literature shows that the dynamic of sarcopenia is complex, involving multifaceted physiological alterations relevant to aging, unhealthy behaviors (e.g., undernutrition or inadequate dietary intake and physical inactivity/immobility or sedentary lifestyle), and multiple pathogenic conditions such as metabolic, inflammatory, and endocrinal disorders. Frail individuals express nutritional deficiencies, immune deficit, oxidative stress, metabolic alterations, gut microbial alterations, neurological insult, etc. Such physiological dysfunctions are closely linked to increased vulnerability to COVID-19 among older adults and people with non-communicable diseases such as diabetes mellitus, cardiovascular disorders, and obesity. Available studies report higher occurrence of severe COVID-19 and COVID-19-related complications (ICU admission, mechanical ventilation, and in-hospital mortality) among frail compared with non-frail and prefrail individuals. Effective pharmacological treatments of sarcopenia are not currently available. However, physical activity and nutritional interventions (e.g., fast digestive proteins, vitamin D, and natural products such as bee products) may prevent the development of sarcopenia in early stages of the disease or limit disease progress. Such interventions may also lower vulnerability to COVID-19.

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Association between skeletal muscle mass index and lung function/respiratory muscle strength in older adults requiring long-term care or support

Cited by 10 publications

References 28 publications

Sarcopenia is not associated with inspiratory muscle strength but with expiratory muscle strength among older adults requiring long-term care/support

Sarcopenia is not associated with inspiratory muscle strength but with expiratory muscle strength among older adults requiring long-term care/support

Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era

Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults

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