exudates and Sarcopenia

This study aimed to determine the factors associated with exercise behavior based on the theory of planned behavior (TPB) among the sarcopenic elderly people in Cheras, Kuala Lumpur. A total of 65 subjects with mean ages of 67.5±5.2 (men) and 66.1±5.1 (women) years participated in this study. Subjects were divided into two groups: 1) exercise group (n=34; 25 men, nine women); and 2) the control group (n=31; 22 men, nine women). Structural equation modeling, based on TPB components, was applied to determine specific factors that most contribute to and predict actual behavior toward exercise. Based on the TPB's model, attitude (β=0.60) and perceived behavioral control (β=0.24) were the major predictors of intention to exercise among men at the baseline. Among women, the subjective norm (β=0.82) was the major predictor of intention to perform the exercise at the baseline. After 12 weeks, attitude (men's, β=0.68; women's, β=0.24) and subjective norm (men's, β=0.12; women's, β=0.87) were the predictors of the intention to perform the exercise. "Feels healthier with exercise" was the specific factor to improve the intention to perform and to maintain exercise behavior in men (β=0.36) and women (β=0.49). "Not motivated to perform exercise" was the main barrier among men's intention to exercise. The intention to perform the exercise was able to predict actual behavior regarding exercise at the baseline and at 12 weeks of an intervention program. As a conclusion, TPB is a useful model to determine and to predict maintenance of exercise in the sarcopenic elderly.

Topics: Aged; Exercise; Female; Focus Groups; Health Behavior; Humans; Intention; Malaysia; Male; Middle Aged; Motivation; Patient Compliance; Psychological Theory; Resistance Training; Sarcopenia; Sex Factors

Sarcopenia is an emerging public health problem worldwide, but very limited information exits concerning the influence of lifestyle factors and inflammation on sarcopenia among community-dwelling older populations in Asia, including Malaysia. A total of 230 apparently healthy community-dwelling middle-aged and older Chinese adults were included in the study. Validated questionnaires were used to assess dietary and lifestyle practices, while pro-inflammatory cytokine status was assessed by blood interleukin-6 concentrations (IL-6). Sarcopenia risk was assessed by the newly revised diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 12.5% with similar proportions of males and females. Multivariate logistic regression analysis showed that older age and higher concentrations of pro-inflammatory cytokine levels of IL-6 were significantly associated with a greater risk of sarcopenia, after adjustments for potential known biological and body composition factors. The present findings indicate that older adults aged 70 years and above with higher inflammation levels had a significantly increased risk of sarcopenia. Hence, effective dietary and lifestyle intervention strategies should emphasize reducing the inflammation associated with aging to prevent the rapid loss of muscle mass and strength that can lead to sarcopenia.

Topics: Aged; Cytokines; East Asian People; Female; Humans; Independent Living; Inflammation; Interleukin-6; Malaysia; Male; Sarcopenia

While the potential of physical performance tests as screening tools for sarcopenia is evident, limited information on relevant reference values for sarcopenia detection. In this study, we aimed to establish the prospective relationship between physical performance tests, including time up and go (TUG), functional reach (FR), gait speed (GS), and hand grip strength (HGS) with five-year sarcopenia risk and to determine suitable cut-off values for screening activities.. This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs.. Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia.. The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.

Topics: Aged; Female; Geriatric Assessment; Hand Strength; Humans; Malaysia; Male; Physical Functional Performance; Prospective Studies; Sarcopenia

Sarcopenia is a condition that is highly prevalent among older adults. This condition is linked to numerous adverse health outcomes, including cognitive impairment that impairs healthy ageing. While sarcopenia and cognitive impairment may share a common pathway, limited longitudinal studies exist to show the relationship between these two conditions. Therefore, this study aimed to examine the longitudinal association between sarcopenia and cognitive impairment. This is a cohort study among older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia. There were 2404 respondents at the baseline and 1946 respondents at one-year follow-up. Cognitive impairment was determined using Mini-mental State Examination scores. Sarcopenia was identified using the Asian Working Group for Sarcopenia 2019 criteria, gait speed was measured using a 4-meter gait test, handgrip strength was assessed using Jamar handheld dynamometer, and appendicular skeletal muscle mass was measured using bioelectrical impedance analysis. Generalized estimating equation (GEE) was used to determine the longitudinal association between sarcopenia and cognitive impairment, presented as relative risk (RR) and its 95% confidence interval. The prevalence of sarcopenia was 5.0% (95% CI 4.00-5.90), and severe sarcopenia was 3.60% (95% CI 2.84-4.31). Upon adjusting for covariates, older adults with sarcopenia have an 80 per cent increased risk of cognitive impairment compared to those without (RR 1.80; 95% CI 1.18-2.75). Similarly, severe sarcopenia was found to significantly increase the risk of cognitive impairment by 101 per cent in the adjusted model (RR 2.01; 95% CI 1.24-3.27). Our study showed that sarcopenia, severe sarcopenia, low physical activity, depressive symptoms, hearing impairment and chronic pain were associated with a higher risk of cognitive impairment among community-dwelling older adults. Therefore, early intervention to prevent sarcopenia, depressive symptoms, hearing impairment, chronic pain, and higher physical activity among older adults is recommended.

Topics: Aged; Chronic Pain; Cognitive Dysfunction; Cohort Studies; Hand Strength; Humans; Malaysia; Prevalence; Sarcopenia

Sarcopenia is a recognised geriatric syndrome but few studies address its associated factors among elderly with type 2 diabetes mellitus (T2DM) in South East Asia. This study aimed to determine the prevalence of sarcopenia and its associated factors among the elderly with T2DM in public primary care clinics in Malaysia. This study utilised data from a longitudinal study of 506 adults with T2DM aged ≥60 years. Data on socio-demography, clinical and functional status, diet and levels of physical activity (PA) were collected. Sarcopenia was defined using Asian Working Group for Sarcopenia criteria and its associated factors were analysed using multiple logistic regression. The proportion of elderly with T2DM with sarcopenia was 28.5%. Those aged ≥70 years (β = 0.73;OR = 2.07; 95%CI = 1.24, 3.48; p = 0.006), men (β = 0.61; OR = 1.84; 95%CI = 1.12, 3.02; p = 0.017), with ≥10 years duration of diabetes (β = 0.62; OR = 1.85; 95%CI = 1.11, 3.09; p = 0.018), not using insulin sensitizers (β = -1.44; OR = 0.24; 95%CI = 0.08, 0.71; p = 0.010), using less than 5 medications (β = 0.68; OR = 1.98; 95%CI = 1.17, 3.36; p = 0.011), low body mass index (BMI) (β = -2.43; OR = 0.09; 95%CI = 0.05, 0.17; p<0.001), and engaging in low (β = 0.77; OR = 2.15; 95%CI = 1.07, 4.35; p = 0.032) and moderate physical activities (β = 0.80; OR = 2.23; 95%CI = 1.07, 4.66; p = 0.033) were associated with sarcopenia. Factors that predicts sarcopenia such as level of physical activity and body mass index were among the modifiable factors that could be used in developing future strategies to prevent or delay the progression of sarcopenia among elderly with T2DM to improve their health status.

Topics: Age Factors; Aged; Aged, 80 and over; Body Mass Index; Diabetes Mellitus, Type 2; Exercise; Female; Humans; Independent Living; Malaysia; Male; Middle Aged; Prevalence; Primary Health Care; Risk Factors; Sarcopenia

Studies have been carried out on the association between frailty and malnutrition, but the similarities and divergence of the relationship remain debatable. This study aimed to explore the prevalence of malnutrition risk and frailty as well as the overlapping constructs. The associations that emerged were assessed independently of other risk factors. A total of 301 community-dwelling older adults with a mean age of 66.91 ± 5.59 years old were randomly recruited. Fried Criteria and Mini Nutritional Assessment-Short Form (MNA-SF) were used to assess frailty status and malnutrition, respectively. Other related nutritional assessments were assessed (body mass index (BMI), circumference measures, body fat % and skeletal muscle mass). The prevalence of frailty was 14.6% and prefrail was 59.7%; 29.6% were at risk of malnutrition, and 3.3% were malnourished. Malnutrition risk was significantly associated with a higher number of chronic diseases, BMI, circumference of mid-upper arm (MUAC), and calf, (CC)and skeletal muscle mass (SMM) and frailty, whereas frailty was significantly associated with higher number of chronic diseases, SMM and malnutrition. Frailty syndrome can be predicted with increasing age, body fat, lower skeletal muscle and malnutrition. Those who were frail were found to be five times more likely to be at risk of malnutrition. Results suggested that frailty and malnutrition shared considerable overlap, which emphasised the interrelated but discrete concepts. Therefore, the assessment of malnutrition is imperative and could be used as a practical implication in assessing frailty syndrome.

Topics: Age Factors; Aged; Body Composition; Body Constitution; Female; Forecasting; Frailty; Humans; Independent Living; Malaysia; Male; Malnutrition; Middle Aged; Nutrition Assessment; Prevalence; Risk; Risk Factors; Sarcopenia

Sarcopenia, characterized as muscle loss that occurs with aging, is a major health problem in an aging population, due to its implications on mobility, quality of life, and fall risk. Protein supplementation could improve the physical fitness by increasing protein anabolism, and exercise has a documented evidence of positive effect on functional status among the elderly. However, the combined effect of both protein supplementation and exercise has not been investigated among sarcopenic elderly in the Asian population. Thus, this study aimed to determine the effectiveness of exercise intervention and protein supplementation either alone or in combination for 12 weeks, on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia. Sixty five sarcopenic elderly Malays aged 60-74 years were assigned to the control group, exercise group (ExG), protein supplementation group (PrG), or the combination of exercise and protein supplementation group. A significant interaction effect between body weight and body mass index (BMI) was observed, with the PrG (-2.1% body weight, -1.8% BMI) showing the highest reductions. Further, there was a decrease in % body fat (-4.5%) and an increase in fat-free mass (kg) (+5.7%) in the ExG after 12 weeks (P < 0.05). The highest increments in lower and upper body strength were observed in the PrG (73.2%) and ExG (47.6%), respectively. In addition, the ExG showed a reduction in superoxide dismutase (SOD) levels, and both interventions did not alter either lipid or protein oxidation. In conclusion, the exercise program was found to improve muscle strength and body composition, while protein supplementation reduced body weight and increased upper body strength, among sarcopenic elderly in Malaysia.

Topics: Aged; Anthropometry; Body Composition; Dietary Proteins; Exercise; Female; Humans; Malaysia; Male; Middle Aged; Oxidative Stress; Physical Fitness; Sarcopenia