Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study

Landi, Francesco; Cruz-Jentoft, Alfonso J.; Liperoti, Rosa; Russo, Andrea M.; Giovannini, Silvia; Tosato, Matteo; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

doi:10.1093/ageing/afs194

Cited by 521 publications

(380 citation statements)

References 28 publications

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“…Regardless of the definition used, prevalence increases with age but women do not always have a higher prevalence than men (53)(54)(55) . Early evidence suggests that sarcopenia defined by the European definition is associated with health outcomes including self-reported health, disability and mortality (54,56,57) . However, theses definitions are all relatively new and have been little scrutinised.…”

Section: Sarcopeniamentioning

confidence: 99%

Ageing well: a review of sarcopenia and frailty

Keevil

Romero-Ortuño

2015

Proc. Nutr. Soc.

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Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' 'Ageing well' has been declared a global health priority by the World Health Organisation and the role of sarcopenia and frailty in late-life health is receiving increasing attention. Frailty is the decline in an individual's homeostatic function, strength and physiologic reserves leading to increased vulnerability, while sarcopenia describes the loss of muscle mass and function with age. The conceptual definitions of these conditions have been widely agreed but there is a lack of consensus on how to measure them. We review the different operational definitions described in the literature and the evidence that, whatever definition used, the prevalence and clinical impact of these conditions is high. We also consider the commonality of low physical function to both conditions, a feature which could provide a pragmatic way forward in terms of identifying those at risk. Objective measures of physical function such as usual walking speed are simple and feasible measures, extensively validated against health outcomes. Additionally, clinical applications of sarcopenia and frailty are reviewed with particular consideration to their potential role in the management of older people undergoing surgery. Frailty appears to outperform traditional anaesthetic and surgical risk scores in terms of its association with post-operative complications, length of hospital stay, institutionalisation and mortality. However, even within this sub-specialty area there is wide variation in the approaches used to measure frailty and there is an urgent need for studies to utilise established, validated and reproducible methods to identify sarcopenia and frailty in their study participants, in order to expedite scientific development. Sarcopenia: Frail elderly: AgeingBy 2050 the proportion of the world's population aged ⩾60 years is projected to be 22 %, double the proportion recorded at the turn of the new millennium (1) . Although population ageing is in one way a great public health success story, with mortality rates among older people continuing to fall (2) , in another way it presents significant challenges. For example, in the UK 60 % of people admitted to hospital are ⩾65 years old despite this age-group only comprising 17 % of the total UK population (3) . This disproportionate use of healthcare services by older people not only demonstrates the significant economic implications of an ageing population (4) , but also the morbidity experienced by many older people, reducing quality of life. However, it is not inevitable that *Corresponding author: Dr V. L. Keevil, fax +44 (0)1223 748676, email vlk20@cam.ac.uk Abbreviations: CGA, comprehensive geriatric assessment; FI, frailty index; PFP, physical frailty phenotype.

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Section: Sarcopeniamentioning

confidence: 99%

Ageing well: a review of sarcopenia and frailty

Keevil

Romero-Ortuño

2015

Proc. Nutr. Soc.

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“…15 Sarcopenia has a strong connection with a frail state as decreasing muscle mass in the elderly plays a role in the evolution of frailty. 1,17 From an endocrine point of view, an enhanced risk of sarcopenia and frailty is seen in relation to having low gonadal hormone levels and insulin-like growth factor-1 (IGF-1), along with high levels of inflammatory mediators, low vitamin D, and being in a pro-coagulative state. 16 Poor nutritional intake is also characteristic of both frailty and sarcopenia.…”

Section: What Is Frailty?mentioning

confidence: 99%

Frailty and perioperative outcomes: a narrative review

Beggs

Sepehri

Szwajcer

et al. 2014

Can J Anesth/J Can Anesth

137

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Background Frailty has no single universally accepted definition or method for assessment. It is commonly defined from a physiological perspective as a disruption of homeostatic mechanisms ultimately leading to a vulnerable state. Numerous scoring indices and assessments exist to assist clinicians in determining the frailty status of a patient. The purpose of this review is to discuss the relationship between frailty and perioperative outcomes in surgical patients. Principal findings We performed a review to determine the association of frailty with perioperative outcomes in patients undergoing a wide variety of surgical procedures. A scoping literature search was performed to capture studies from MEDLINE Ò , EMBASE TM , and CENTRAL (Cochrane), which resulted in locating 175 studies across the three electronic databases. After an article screening process, 19 studies were found that examined frailty and perioperative outcomes. The studies used a range of assessments to determine frailty status and included patients in a variety of surgical fields. Regardless of surgical population and method of frailty assessment, a relationship existed between adverse perioperative outcomes and frailty status. Frail patients undergoing surgical procedures had a higher likelihood than non-frail patients of experiencing mortality, morbidity, complications, increased hospital length of stay, and discharge to an institution. Conclusions Patients undergoing surgery who are deemed frail, regardless of the scoring assessment used, have a higher likelihood of experiencing adverse perioperative outcomes. With the lack of a unified definition for frailty, further research is needed to address which assessment method is most predictive of adverse postoperative outcomes.

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“…For instance, the conversion of type II (fast) fibers to type I (slow) fibers and subsequent lipid infiltration, which translate into impairment of muscle power and a greatly increased risk of falls [4]. Several studies have shown that sarcopenic individuals are either three times more likely to fall or have an higher risk of death relative to non sarcopenic individuals [5], [6]. Moreover, sarcopenia itself is associated with disability and hospitalization [7].…”

Section: Introductionmentioning

confidence: 99%

Inflammation and sarcopenia: A systematic review and meta-analysis

et al. 2017

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Nicola.Inflammation and sarcopenia: A systematic review and meta-analysis.Maturitas http://dx.doi.org/10.1016/j.maturitas. 2016.11.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Sarcopenia is associated with functional impairment and adverse outcomes.  Highly inflammatory cytokines are negatively related to muscle strength and mass.  Sarcopenia is associated with higher serum inflammatory parameters.  Chronic inflammation could play a role in sarcopenia. AbstractInflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analysed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; p<0.0001; I 2 =96%) than controls. Conversely, serum IL6 levels were not significantly different (SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I 2 =97%) in people with sarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I 2 =97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship.

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Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study

Abstract: our results obtained from a representative sample of very old and frail subjects show that sarcopenia is associated with mortality, independently of age and other clinical and functional variables.

Cited by 521 publications

References 28 publications

Ageing well: a review of sarcopenia and frailty

Ageing well: a review of sarcopenia and frailty

Frailty and perioperative outcomes: a narrative review

Inflammation and sarcopenia: A systematic review and meta-analysis

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