Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study

Abstract

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

Risk Factors for Sarcopenia in the Elderly with Type 2 Diabetes Mellitus and the Effect of Metformin

“…We also studied the relationship between educational level and sarcopenia and found that the higher the educational level, the lower the prevalence of sarcopenia. This is consistent with some studies [ 43 , 44 ]. However, some other investigations disagreed with this conclusion [ 39 , 45 ], possibly because the composition of their study participants differed from ours.…”

Myostatin as a Biomarker of Muscle Wasting and other Pathologies-State of the Art and Knowledge Gaps

“…Some authors distinguish primary (or age-related sarcopenia), occurring in otherwise healthy, usually aged persons, from secondary sarcopenia, the result of chronic inflammatory statuses, diabetes, hormonal alterations, vascular disturbances, renal, respiratory and/or cardiac failure and immobilization [ 29 , 30 ]. Furthermore, sarcopenia remains intertwined and overlapping with other syndromes such as frailty [ 31 , 32 ] and cachexia [ 33 , 34 ], and its development significantly worsens the prognosis of various diseases such as heart failure [ 35 , 36 ], chronic kidney disease [ 37 ] and liver failure [ 38 ]. Muscle wasting in aging (sarcopenia) shares many common metabolic pathways and mediators with body wasting (cachexia) observed during cancer and other chronic diseases, such as multiple inflammatory organ-specific disease or cardiovascular disease [ 39 ].…”

The Cumulative Impact of Sarcopenia, Frailty, Malnutrition, and Cachexia on Other Geriatric Syndromes in Hospitalized Elderly

“…The coexistence of tissue loss syndromes was recently reported by Sousa-Santos et al, who found that one in every five Portuguese community-dwelling elderly had two or more of sarcopenia, physical frailty, undernutrition, and obesity [16]. Moreover, a recent meta-analysis reported a substantial association between frailty, sarcopenia and malnutrition in hospitalized elderly [17].…”

“…This indicates a considerable overlap between frailty and sarcopenia in different clinical settings. [35] Many previous studies documented their overlap [16,17,37,38].…”