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Geriatrics
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Frailty and Sarcopenia in Old Age
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Frailty and Sarcopenia in Old Age

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 November 2016) | Viewed by 48189

Special Issue Editor

Prof. Dr. Joseph S.K. Kwan

E-Mail Website
Guest Editor
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Interests: dementia; frailty; sarcopenia; heart–brain–muscle connection; stroke; exercise and nutrition

Special Issue Information

Dear Colleagues,

Frailty and sarcopenia are now recognized as the new geriatric giants. Frailty represents a reversible state of vulnerability to poor physical and cognitive outcome following a stressor event, predicting future decline in disability, morbidity, and mortality. Sarcopenia is the age-related loss of muscle mass and function, which contribute significantly to the burden of frailty. There has been a great advance in the basic and clinical research on frailty and sarcopenia in recent years, and many novel treatments and prevention strategies are being tested.

This Special Issue will focus on a wide range of essential topics relevant to frailty and sarcopenia in old age, including epidemiology, basic science, clinical studies, pharmacological and non-pharmacological interventions, as well as cognitive and psycho-social elements.

High quality original research and review articles in any of these areas will be considered. We are particularly keen on highlighting the novel and innovative approaches in the assessment, prevention, management, and rehabilitation of older people with frailty and sarcopenia.

Prof. Dr. Joseph S.K. Kwan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Frailty
  • Cognitive frailty
  • Sarcopenia
  • Muscle
  • Assessment
  • Prevention
  • Management
  • Rehabilitation
  • Disability
  • Exercise
  • Nutrition
  • Prognosis
  • Psycho-social
  • Nursing home

Published Papers (6 papers)

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Research

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320 KiB  
Article
Muscle Strength and Functional Ability in Recreational Female Golfers and Less Active Non-Golfers over the Age of 80 Years
by Alison Stockdale, Nicholas Webb, Jessica Wootton, Jonathan Drennan, Simon Brown and Maria Stokes
Geriatrics 2017, 2(1), 12; https://doi.org/10.3390/geriatrics2010012 - 04 Mar 2017
Cited by 4 | Viewed by 7335
Abstract
Muscle strength and functional ability decline with age. Physical activity can slow the decline but whether recreational golf is associated with slower decline is unknown. This cross-sectional, observational study aimed to examine the feasibility of testing muscle strength and functional ability in older [...] Read more.
Muscle strength and functional ability decline with age. Physical activity can slow the decline but whether recreational golf is associated with slower decline is unknown. This cross-sectional, observational study aimed to examine the feasibility of testing muscle strength and functional ability in older female golfers and non-golfers in community settings. Thirty-one females over aged 80, living independently (golfers n = 21, mean age 83, standard deviation (±) 2.1 years); non-golfers, n = 10 (80.8 ± 1.03 years) were studied. Maximal isometric contractions of handgrip and quadriceps were tested on the dominant side. Functional ability was assessed using the Timed Up and Go (TUG) and health-related quality of life using the Short Form-36 questionnaire. Grip strength, normalised to body mass, was greater in golfers (0.33 ± 0.06 kgF/kg) than non-golfers (0.29 ± 0.06), however, the difference was not statistically significant (p = 0.051). Quadriceps strength did not differ (golfers 2.78 ± 0.74 N/kg; non-golfers 2.69 ± 0.83; p = 0.774). TUG times were significantly faster (p = 0.027) in golfers (10.4 ± 1.9 s) than non-golfers (12.6 ± 3.21 s; within sarcopenic category). Quality of life was significantly higher in golfers for the physical categories (Physical Function p < 0.001; Physical p = 0.033; Bodily pain p = 0.028; Vitality p = 0.047) but psychosocial categories did not differ. These findings indicated that the assessment techniques were feasible in both groups and sensitive enough to detect some differences between groups. The indication that golf was associated with better physical function than non-golfers in females over 80 needs to be examined by prospective randomised controlled trials to determine whether golf can help to achieve the recommended guidelines for strengthening exercise to protect against sarcopenia. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
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980 KiB  
Article
Intramuscular Adipose Tissue and the Functional Components of Sarcopenia in Hospitalized Geriatric Patients
by Stany Perkisas, Anne-Marie De Cock, Veronique Verhoeven and Maurits Vandewoude
Geriatrics 2017, 2(1), 11; https://doi.org/10.3390/geriatrics2010011 - 22 Feb 2017
Cited by 26 | Viewed by 7825
Abstract
Intramuscular adipose tissue (IMAT) could be an important missing value in the assessment of sarcopenia. This study tries to determine the relation between IMAT, muscle strength, functionality and mortality. In addition, the relation with nutritional status is screened. For six months, all patients [...] Read more.
Intramuscular adipose tissue (IMAT) could be an important missing value in the assessment of sarcopenia. This study tries to determine the relation between IMAT, muscle strength, functionality and mortality. In addition, the relation with nutritional status is screened. For six months, all patients admitted to the University Geriatric Center of Antwerp were evaluated for strength (hand grip), functionality (short physical performance battery—SPPB) and nutritional status. After one year, patients/relatives were contacted to obtain a current health status (mortality). A total of 303 patients were included at a mean age of 83.0 ± 6.4 years. The mean percentage of IMAT was 29.2% ± 13.0% (range 3.2%–86.2%). There was a negative correlation between IMAT and both grip strength and SPPB. SPPB was positively correlated with both grip strength and muscle mass. There was a positive correlation between IMAT and mortality. There was a negative correlation between grip strength, SPPB and mortality. IMAT did not have a clear relation with nutritional status. IMAT should be addressed in the work-up of sarcopenia, as it is correlated with muscle strength, functionality and mortality. In this cohort of hospitalized geriatric patients, there is a mean of about one-third of measured muscle volume that appears to be adipose tissue. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
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1203 KiB  
Article
Anterior Thigh Tissue Thickness Measured Using Ultrasound Imaging in Older Recreational Female Golfers and Sedentary Controls
by Isabel Herrick, Simon Brown, Sandra Agyapong-Badu, Martin Warner, Sean Ewings, Dinesh Samuel and Maria Stokes
Geriatrics 2017, 2(1), 10; https://doi.org/10.3390/geriatrics2010010 - 07 Feb 2017
Cited by 11 | Viewed by 8969
Abstract
Physical activity is vital for the prevention of sarcopenia and frailty. The training effects of recreational golf on muscle function in older people are unknown. The present study examined quadriceps muscle and subcutaneous fat thickness in 66 older females. Thirty-one golfers (mean age [...] Read more.
Physical activity is vital for the prevention of sarcopenia and frailty. The training effects of recreational golf on muscle function in older people are unknown. The present study examined quadriceps muscle and subcutaneous fat thickness in 66 older females. Thirty-one golfers (mean age 69.1 years, standard deviation ±3.4) were compared with 35 less active non-golfers (73.4 ± 4.2 years). Images of the dominant anterior thigh were obtained using real-time B-mode ultrasound imaging. Thickness of muscle (rectus femoris, vastus intermedius, and intermuscular fascia) and subcutaneous tissue (fat and perimuscular fascia) was measured, and percentage contributions calculated. Muscle thickness was significantly greater (p < 0.001) in golfers (mean 2.78 cm ± 0.73 cm) than non-golfers (2.18 cm ± 0.55 cm). Mean percentage contribution of muscle and non-contractile tissue was 64% ± 9% and 36% ± 9%, respectively, in golfers, compared to 58% ± 8% and 42% ± 8% in non-golfers (p = 0.013). Multiple linear regression analysis, controlling for age and BMI, showed that golfers still had higher total anterior thigh thickness (regression parameter for non-golfers B = −0.984, p = 0.004) and higher muscle thickness (B = −0.619, p = 0.002). This study indicates an association between recreational golf and greater relative thigh muscle thickness and lower subcutaneous fat than in less active controls. Training effects need to be examined in prospective controlled trials in males and females in different age groups. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
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225 KiB  
Article
Psychosocial Correlates of Frailty in Older Adults
by Simone Freitag and Silke Schmidt
Geriatrics 2016, 1(4), 26; https://doi.org/10.3390/geriatrics1040026 - 01 Nov 2016
Cited by 33 | Viewed by 7484
Abstract
Background: The aim of this study was to investigate psychosocial variables associated with frailty status. Moreover, gender differences in the psychosocial variables associated with frailty were examined. Methods: This cross-sectional study examined a community-dwelling sample of N = 210 older adults (M [...] Read more.
Background: The aim of this study was to investigate psychosocial variables associated with frailty status. Moreover, gender differences in the psychosocial variables associated with frailty were examined. Methods: This cross-sectional study examined a community-dwelling sample of N = 210 older adults (M = 75.31 years). Frailty was measured with the Tilburg Frailty Indicator. Quality of life, depression, resilience, social support, self-efficacy, traumata experienced, and trauma severity were assessed as psychosocial variables. Logistic regression analyses were performed. Results: In total, 41.4% of the participants were frail (49.6% women, 27.8% men). Main correlates of frailty were depressive symptoms, quality of life, and resilience. Gender differences for frailty correlates were found. Depressive symptoms and perceived social support were mainly associated with frailty in women. Furthermore, age was only significantly associated with frailty in women. Quality of life was significantly associated with frailty being a protective factor in both women and men. Trauma count and trauma severity were associated with an elevated risk for frailty in men. Conclusions: The results show that the psychosocial variables depressive symptoms, quality of life, and resilience are associated with frailty. Gender-specific differences in psychosocial correlates of frailty were revealed. Results suggest that gender-specific assessments and interventions should be developed to prevent frailty in late life. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
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Review

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185 KiB  
Review
Response to Pulmonary Rehabilitation in Older People with Physical Frailty, Sarcopenia and Chronic Lung Disease
by Luke Attwell and Michael Vassallo
Geriatrics 2017, 2(1), 9; https://doi.org/10.3390/geriatrics2010009 - 22 Jan 2017
Cited by 11 | Viewed by 7543
Abstract
Frailty and sarcopenia are two important clinical syndromes associated with the ageing process, with a high risk of morbidity and mortality. Patients with chronic disease have been shown to have an accelerated decline into a frail state, with patients with both chronic lung [...] Read more.
Frailty and sarcopenia are two important clinical syndromes associated with the ageing process, with a high risk of morbidity and mortality. Patients with chronic disease have been shown to have an accelerated decline into a frail state, with patients with both chronic lung disease and frailty having a higher mortality than those with frailty alone. Pulmonary rehabilitation has been found to be an effective intervention in patients with chronic obstructive pulmonary disease (COPD), yet the effect of frailty on this as intervention remains unclear. A narrative literature search of PubMed, Medline complete and the Cochrane library was performed by the reviewers using predefined criteria. Only 3 studies met the selection criteria and were reviewed. These studies highlighted that, although completion rates are lower in patients with both COPD and frailty, pulmonary rehabilitation remains effective as an intervention in this subgroup of patients, with up to 61% of frail patients no longer meeting frailty criteria after completion of a pulmonary rehabilitation programme. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
263 KiB  
Review
Systemic Inflammation in the Genesis of Frailty and Sarcopenia: An Overview of the Preventative and Therapeutic Role of Exercise and the Potential for Drug Treatments
by Stephen C. Allen
Geriatrics 2017, 2(1), 6; https://doi.org/10.3390/geriatrics2010006 - 17 Jan 2017
Cited by 15 | Viewed by 8140
Abstract
The clinical, pathological and biological characteristics of frailty and sarcopenia are becoming better understood and defined, including the role of systemic inflammation. It is increasingly apparent that in older adults there is a tendency for the innate immune network to shift toward a [...] Read more.
The clinical, pathological and biological characteristics of frailty and sarcopenia are becoming better understood and defined, including the role of systemic inflammation. It is increasingly apparent that in older adults there is a tendency for the innate immune network to shift toward a pro-inflammatory setting, often due to the presence of chronic inflammatory diseases but also associated with age alone in some individuals. Furthermore, acute inflammation tends to resolve more slowly and less completely in many elderly people. Inflammation contributes to the pathogenesis of sarcopenia and other components of the frailty syndrome. Blood levels of inflammatory cytokines and acute phase proteins, are reduced by exercise, and there is a growing body of epidemiological, observational and intervention research that indicates that regular moderate exercise improves strength, function, morbidity and mortality in middle-aged and elderly adults. There is also an increasing awareness of the potential role of drugs to ameliorate inflammation in the context of frail old age, which might be particularly useful for people who are unable to take part in exercise programs, or as adjunctive treatment for those who can. Drugs that shift the innate immune biochemical network toward an anti-inflammatory setting, such as methyl-xanthines and 4-amino quinolones, could be of value. For example, theophylline has been shown to induce a 20 percent fall in pro-inflammatory tumor necrosis factor (TNF) and 180 percent rise in anti-inflammatory interleukin-10 production by peripheral blood monocytes, and a fall of 45 percent in interferon-gamma (IF-gamma) release. Such properties could be of therapeutic benefit, particularly to re-establish a less inflamed baseline after acute episodes such as sepsis and trauma. Full article
(This article belongs to the Special Issue Frailty and Sarcopenia in Old Age)
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