There is no doubt that sarcopenia is one of the most defining characteristics of aging that negatively impacts the people's health and quality of life. The condition is characterized by the progressive and generalized loss of muscle mass and strength, affecting physical performance. It is part of aging but can be exacerbated by pathophysiological conditions like cancer and several factors such as a sedentary lifestyle, poor nutrition, chronic diseases, falls and immobilization. Numerous cellular mechanisms have been implicated in its pathogenesis, including hormonal changes, mitochondrial dysfunctions, altered apoptotic and autophagic signaling, muscle fiber composition, and inflammatory pathways. To prevent sarcopenia, exercise is one of the most effective strategies as it has a strong influence on both anabolic and catabolic muscle pathways and helps improve skeletal muscle function. A well-rounded, multicomponent exercise program that targets muscle strength, aerobic capacity, and balance is recommended for optimal results. While nutrition is essential for muscle maintenance, relying solely on dietary interventions is unlikely to fully address sarcopenia. Therefore, a combination of adequate nutrition and regular exercise is recommended to promote muscle health and function. The purpose of this study is to review sarcopenia from an aging viewpoint and discuss the role of exercise and nutrition as prevention and management options.

Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, significantly impacts the people, leading to increased frailty and mortality. The atherogenic index of plasma (AIP), a biomarker for lipid imbalance, may be linked to sarcopenia due to shared pathways of inflammation and metabolic dysregulation. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 cycles were analyzed. The AIP was calculated as the logarithm of the ratio of triglycerides to High density lipoprotein cholesterol. Sarcopenia was defined using the appendicular skeletal muscle mass index (ASMBMI) adjusted for body mass index (BMI). Multivariable linear regression and logistic regression models were employed to assess the association between AIP and ASMBMI, as well as sarcopenia. Restrictive cubic spline curves were utilized to analyze potential nonlinear associations between AIP and outcome indicators. Additionally, subgroup analyses and intergroup interaction tests were performed. Elevated AIP levels were associated with decreased ASMBMI and an increased risk of sarcopenia. After adjusting for confounding factors, the association between AIP and ASMBMI remained significant (Beta [95% CI] = -0.02 [-0.03, -0.01], P < 0.001). AIP was significantly associated with sarcopenia (OR [95% CI] = 2.6 [1.78, 3.81], P = < 0.001). AIP is significantly associated with reduced muscle mass and potentially with sarcopenia, suggesting that lipid metabolism plays a critical role in muscle health. Identifying AIP as a modifiable risk factor could have important public health implications for managing sarcopenia.

Loss of skeletal muscle mass and strength can result from various factors, including malnutrition, glucocorticoid usage, and diseases. The mealworm (Tenebrio molitor larvae) is an edible insect gaining popularity as an alternative protein-rich diet. Mealworms are expected to help alleviate muscle atrophy based on their rich, high-quality protein and peptide content, but it remains unclear whether mealworms ameliorate muscle loss. This study aimed to investigate the potential of mealworm hydrolysate (MH) in mitigating dexamethasone (DEX)-induced muscle atrophy and to elucidate the underlying mechanisms. MH ameliorates muscle atrophy by activating sirtuin 1 (SIRT1) and Akt, reducing muscle-specific RING finger protein-1 and atrogin-1 expression, and inhibiting apoptosis in DEX-treated C2C12 cells. Additionally, MH significantly increased the muscle mass, grip strength, and muscle fiber cross-sectional area by activating SIRT1 and Akt in DEX-treated rats. These findings suggest that MH has the potential in alleviating dexamethasone-induced muscle atrophy.

This quasi-experimental study aimed to evaluate the effects of a 3-month exercise intervention program on diagnostic parameters of sarcopenia in community-dwelling older adults with dementia. Eighty participants were recruited: the intervention group (n = 40) engaged in integrated exercise sessions three times per week; the control group (n = 40) received usual care. Pre-test, only the physical performance parameter differed between groups, which was better for the intervention group (p < .05). Compared with controls, the intervention group had significantly better post-test parameters of muscle strength, and physical performance; fewer participants were categorized as having sarcopenia (p = .012). However, sarcopenia distribution pre-test vs. post-test within the intervention group was not significant. These findings suggest that a 3-month exercise intervention can effectively improve diagnostic parameters of sarcopenia in community-dwelling older adults with dementia. This intervention positively affected diagnostic parameters of sarcopenia however further modifications will be required to reduce sarcopenia.

The increasing global aging population has brought greater focus to age-related diseases, particularly muscle-brain comorbidities such as sarcopenia and late-life depression. Sarcopenia, defined by the gradual loss of muscle mass and function, is notably prevalent among older individuals, while late-life depression profoundly affects their mental health and overall well-being. Epidemiological evidence suggests a high co-occurrence of these two conditions, although the precise biological mechanisms linking them remain inadequately understood. This review synthesizes the existing body of literature on sarcopenia and late-life depression, examining their definitions, prevalence, clinical presentations, and available treatments. The goal is to clarify the potential connections between these comorbidities and offer a theoretical framework for the development of future preventive and therapeutic strategies.

Background/Objectives: Sarcopenia and malnutrition are common in post-stroke patients, impairing recovery. Medium-chain triglycerides (MCT) may support muscle metabolism, while chair-stand exercises improve strength and mobility. However, their combined effects remain unclear. This study evaluated the synergistic effects of MCT supplementation and high-frequency chair-stand exercise on physical function and muscle health in post-stroke patients. Methods: A retrospective cohort study included 1080 post-stroke patients categorized into three groups: (1) MCT supplementation alone, (2) chair-stand exercise alone, and (3) both combined. MCT supplementation consisted of ~40 g/day MCT oil or powder. Functional outcomes were assessed using the Functional Independence Measure (FIM-motor), while muscle health was evaluated by handgrip strength (HGS) and skeletal muscle index (SMI). Multiple linear regression analyses were performed, adjusting for confounders. Results: The combined intervention group showed significantly greater improvements in FIM-motor scores at discharge (B = 8.79, 95% CI: 5.64-11.95, β = 0.32, p < 0.001) and FIM-motor gain (B = 6.02, 95% CI: 3.42-8.62, β = 0.29, p < 0.001) compared to the control. Increases in HGS (B = 2.441, 95% CI: 0.483-4.398, β = 0.18, p = 0.015) and SMI (B = 0.194, 95% CI: 0.102-0.419, β = 0.12, p = 0.039) were also observed. Chair-stand exercise was performed a median of 62 times/day and independently improved outcomes, while MCT alone had limited effects. Conclusions: MCT supplementation combined with chair-stand exercise enhances functional recovery and muscle health in post-stroke patients, supporting its role in rehabilitation. Further research is needed to evaluate long-term effects and to examine the pharmacokinetics of MCTs, including blood concentrations, in broader populations.

BACKGROUND. CT muscle metrics hold promise for opportunistic sarcopenia screening and individualized clinical risk stratification, but reference values applicable across broad populations are lacking. OBJECTIVE. To estimate reference cutoff values for CT skeletal muscle metrics using data from populations of healthy young adults. EVIDENCE ACQUISITION. The PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched through January 1, 2025 for studies reporting skeletal muscle index (SMI) and/or skeletal muscle density (SMD) on CT at the L3 vertebral level in healthy young adults (age range, 18-45 years). For SMI and SMD in both men and women, a random effects meta-analysis was used to estimate interstudy SD (as a measure of variance among studies) and mean values for a theoretic global population of healthy young adults. Presence of significant heterogeneity among individual study means was assessed using the Q statistic. Cutoff values for the theoretic global population corresponding with a T-score of -2 (i.e., values ≥ 2 SDs below the population's mean value) were calculated, incorporating the meta-analysis results and pooled intrastudy variance. EVIDENCE SYNTHESIS. The meta-analysis included 14 studies (16,958 individuals; 11,819 men, 5139 women) reporting SMI, of which seven studies (11,175 individuals; 8372 men, 2803 women) also reported SMD. The estimated global mean value for SMI was 54.6 in men and 42.4 in women and for SMD was 47.4 HU in men and 43.6 HU in women. The interstudy SD for SMI was 5.4 in men and 4.3 in women and for SMD was 1.9 in men versus 3.2 in women; significant heterogeneity was present among individual study means for both SMI and SMD in both men and women (all p<.001). The cutoff value corresponding with a T-score of -2 for SMI was 36.3 in men and 27.5 in women and for SMD was 36.4 HU in men and 28.1 HU in women. CONCLUSION. This meta-analysis of studies performed in healthy young adults provides reference mean values and standardized cutoffs analogous to a T-score of -2 for SMI and SMD at the L3 level on abdominal CT. CLINICAL IMPACT. These results can aid opportunistic screening for sarcopenia.

Although physical activity (PA) is known to improve physical function (PF), and functional decline impacts the capacity to engage in PA, the reciprocal relationship between PA and PF remains unclear.

Data were from participants in the 1921-1926 cohort of the Australian Longitudinal Study on Women's Health (N = 8 238). PA and PF were assessed at 3-year intervals from 1999 (73-78 y) to 2011 (85-90 y). Group-based trajectory modeling was used to identify PA and PF trajectories, and associations between PA and PF were examined using mixed-effects models and restricted cubic spline modeling.

Three trajectories for PA and PF were identified: Low, Moderate, and High. Women in the High PA group maintained high PF and did not reach the starting PF level of the Low PA group (at age 73) until they were 87. Similarly, women in the High PF group maintained higher PA than those in the other groups. Women in the Low PF group never met PA guidelines and had PF scores below the disability threshold throughout the study. Restricted cubic splines showed that higher PA was associated with better PF 3 years later, and vice versa, indicating that PA and PF influence each other.

There are reciprocal relationships between PF and PA; higher levels of PA promote better PF, and higher PF may help slow the decline in PA. Although rates of decline in PF show little variation with PA in women during their 80s, habitually high PA confers considerable benefits, contributing to additional years of healthy life.

Cognitive impairment, dementia and sarcopenia significantly reduce the quality of life in middle-aged and older adults by impairing daily functioning, making cognitive decline a major concern for healthcare professionals.

To estimate the prevalence of sarcopenia and probable sarcopenia in middle-aged and older adults with cognitive impairment.

Six databases-Embase, Ovid MEDLINE, PubMed, CINAHL, Scopus and Web of Science was conducted through February 2025. Cohort and cross-sectional studies included, and a random-effects model was used for pooled prevalence analysis. Cognitive impairment is a decline in cognitive functions, including memory, attention and executive function, covering mild cognitive impairment and dementia. Sarcopenia is decreased skeletal muscle mass and function, assessed by muscle strength or physical performance.

A total of 67 studies involving 23 532 participants revealed a pooled sarcopenia prevalence of 30.1% and a probable sarcopenia prevalence of 40.5%. Additionally, amongst adults aged 65 and older, the prevalence of sarcopenia was 32.7%. The prevalence of sarcopenia varied by setting: 25.3% in community-dwelling populations, 35.5% in hospitals and 41.5% in institutional settings. Moderating factors included age, female, body mass index, comorbidities and risk factors such as depression, diabetes, hypertension, malnutrition, osteoarthritis, alcohol consumption and smoking.

Approximately one-third of middle-aged and older adults with cognitive impairment demonstrate to have sarcopenia. Early detection and tailored interventions by public health professionals are crucial, particularly for individuals with mild cognitive impairment and dementia. Enhanced preventive strategies are essential to improving outcomes and reducing healthcare costs.

Objective: To investigate the cross-sectional association between skeletal muscle mass and lifestyles including exercise, mealtime, and sleep habits in adult men aged under 64. Materials and Methods: A total of 101 Japanese men aged under 64 who underwent "Anti-aging Health Checkups" were enrolled in the study. Cross-sectional analyses were conducted using the subjects' data such as body mass index, skeletal muscle mass index (SMI), and self-reported lifestyle information. The physical activity (PA) value of habitual exercise per week (metabolic equivalent hr/week) was categorized into three groups. Mealtime combination of breakfast and dinner time was categorized into five groups. A multiple regression analysis demonstrated how each PA group has an association with SMI. Moreover, an analysis of covariance was performed to investigate the association between "mealtime combined with PA" and SMI levels by comparison and to investigate the association between "sleep duration or satisfaction combined with PA" and SMI levels, respectively. Results: The subjects with "breakfast before 8 a.m." had a significant positive association between SMI and PA levels; in addition, among the subjects from the "dinner before 8 p.m." group, as the PA level was higher, the SMI level increased. Consequently, the SMI level increased as the PA level was higher among the subjects who had "breakfast before 8 a.m. and dinner before 8 p.m." Furthermore, sufficient sleep such as more than 6 hr and satisfied sleep had positive associations with SMI as PA levels increased. Conclusion: These findings suggest a potential benefit of habitual exercise with breakfast before 8 a.m., dinner before 8 p.m., and sufficient sleep for maintaining skeletal muscle mass among middle-aged men.

Handgrip strength is a key indicator of overall health in older adults, and its decline is linked to various adverse health outcomes. Despite numerous studies on factors influencing handgrip strength, few attempts have integrated multiple factors into a practical clinical tool. This study aims to develop and validate a nomogram based on a logistic regression model to predict the risk of low handgrip strength in older adults. Using data from the China Health and Retirement Longitudinal Study (CHARLS), 1138 participants were included. Firth-adjusted logistic regression identified predictors of low handgrip strength, with variable selection based on the Bayesian Information Criterion (BIC). Model performance was assessed using calibration curves, ROC curves, and decision curve analysis (DCA). Internal validation was performed with 10-fold cross-validation and bootstrapping, determining the optimal risk threshold. Key predictors identified included age, chronic disease history, marital status, lifestyle, education, BMI, activities of daily living, and glycated hemoglobin. The simplified model exhibited good discriminatory ability (AUC = 0.78) and calibration performance. The optimal threshold (0.40) yielded sensitivity of 72.5% and specificity of 69.8%. Decision curve analysis confirmed significant net benefit within the clinically relevant threshold range. The nomogram provides a practical tool for identifying at-risk individuals and guiding intervention, integrating modifiable and non-modifiable factors for personalized risk assessment and early intervention.

Muscle health helps maintain locomotor capacity, a key component of intrinsic capacity, which is required for healthy ageing. Sarcopenia is characterized by the age-related decline in muscle mass and strength leading to impaired physical performance, and has been described as a biological substrate of physical frailty. Both sarcopenia and physical frailty share phenotypic features of weakness and slowness, lead to common adverse outcomes, and have potential for reversal through early identification and intervention. The purpose of this review is to present recent evidence for the impact of lifestyle interventions across the life course on sarcopenia and physical frailty.

Resistance exercise alone or combined with balance and aerobic training as part of a multicomponent exercise program and high-quality diets incorporating adequate protein remain the mainstay of treatment for sarcopenia and physical frailty. Reducing sedentary time and increasing physical activity, adherence to Mediterranean diet, increasing vegetable and caffeinated beverage intake, cardiovascular risk factor modification, improving sleep hygiene and depressive symptoms may also contribute to slowing down age-related decline in muscle health.

Lifestyle interventions such as physical activity, diet, sleep and mental health are effective against sarcopenia and physical frailty. Targeting lifestyle modifications in early to midlife may retard further decline in locomotor capacity and optimize intrinsic capacity of older persons, reducing the risk of sarcopenia, physical frailty and their attendant negative health outcomes.

The aim of this study is to evaluate fall trends, risk factors, and interventions aimed at reducing falls in older adult trauma patients in the healthcare & community settings in the United States.

A review was conducted utilizing PubMed, ProQuest, Cochrane, and Google Scholar search databases to identify relevant articles published prior to July 7, 2024. Studies were included if they assessed falls among the older adult population aged 55 years and older.

A total of 29 studies assessed met the inclusion criteria. Despite decreasing fall incidence in the community and hospital setting, fall-associated injuries, hospitalizations, and mortality in older adults have increased. Common predisposing factors for falls among older adults in the community and healthcare settings include advanced age, history of falls, recent hospitalization, and comorbid conditions affecting cognition, gait, and visual acuity. Interventions including strengthening exercise programs and individualized multifactorial plans reduced falls and fall-associated injuries in most studies.

Recent years demonstrated an increase in fall-associated injuries, hospitalizations, and mortality which underscores the urgent need for targeted multifactorial interventions.

Skeletal muscle health and function deteriorate with age, ultimately leading to impaired mobility and disability. Exercise is among the most effective interventions to mitigate muscle dysfunction in aging and reverse deficits. However, low attrition and an impaired capacity to exercise may limit its utility in improving muscle function in aged persons. Therefore, it is crucial to advance our mechanistic understanding of the molecular transducers of exercise to identify new and innovative drug targets to improve muscle health. Transcriptomic profiling of the human response to exercise has revealed that the nuclear receptor NR4A3 (NOR-1) is among the most responsive genes to acute exercise. Previously, we observed that in vitro knockdown of NOR-1 alters metabolic signaling in C2C12 myotubes. Specifically, we found that expression of PERM1, CKMT2, myoglobin, and mTORC1 signaling were perturbed during the knockdown of NOR-1. Herein, we extend these findings and observe that a NOR-1-PERM1-myoglobin axis regulates myoglobin expression in vitro. Furthermore, we found that aging is associated with reduced skeletal muscle NOR-1 expression. Although it is well known that exercise improves aged muscle function, whether overexpression of the exercise-responsive gene NOR-1 can confer benefits and improve muscle function in an aged context has not been evaluated. We found that the overexpression of NOR-1 in aged muscle results in enhanced muscle endurance, mitochondrial respiration, and elevated expression of NOR-1 responsive genes that we previously identified in loss of function studies. However, we also observed that overexpression of NOR-1 did not improve maximal muscle torque production and resulted in a small but significant loss of muscle wet weight that was concomitant with elevated autophagy signaling. Our data suggest that NOR-1 expression may reduce muscle fatigability and that NOR-1 drives myoglobin expression in a PERM1-dependent manner.

Strength development through physical exercise enhances neuromodulator production, neural connectivity, and motor unit efficiency. Beyond physical benefits, understanding individuals' perceptions, opinions, and knowledge can optimize engagement in exercise. However, existing literature lacks studies examining these factors alongside strength development. This study aimed to investigate whether the effectiveness of strength training protocols is associated with individuals' perceptions, opinions, and knowledge, thereby establishing a link between performance enhancement and awareness of the physiological demands of exercise. The findings seek to highlight the educational potential of physical exercise in promoting psychophysical well-being. A total of 24 participants (14 males, 10 females), aged 35-55 years with varying occupational backgrounds and sedentary levels, were recruited. A strength development protocol was administered, and the participants completed perception-based questionnaires at three time points. Statistical analyses, including repeated-measures ANOVA, Friedman's test, and post hoc comparisons, were conducted. Significant strength improvements were observed, specifically in the Hand Grip Test (p < 0.01). An increase, but non-significant, emerged in the Isometric Mid-Thigh Pull from 1850 ± 210 N to 2270 ± 190 N. The participants also reported a 35% increase in motivation to engage in exercise and a 42% reduction in sedentary behavior. Additionally, 78% of the participants demonstrated greater awareness of exercise benefits, correlating positively with physical improvements. The findings indicate that strength development is associated with increased awareness of the benefits of physical exercise, supporting its use as an educational tool to enhance engagement and adherence to exercise protocols.

This review summarises the latest evidence on effects of exercise on falls prevention, bone mineral density (BMD) and fragility fracture risk in postmenopausal women, explores hypotheses underpinning exercise-mediated effects on BMD and sheds light on innovative concepts to better understand and harness the skeletal benefits of exercise.

Multimodal exercise programs incorporating challenging balance exercises can prevent falls. Emerging clinical trial evidence indicates supervised progressive high-intensity resistance and impact training (HiRIT) is efficacious in increasing lumbar spine BMD and is safe and well-tolerated in postmenopausal women with osteoporosis/osteopenia. There remains uncertainty regarding durability of this load-induced osteogenic response and safety in patients with recent fractures. Muscle-derived myokines and small circulating extracellular vesicles have emerged as potential sources of exercise-induced muscle-bone crosstalk but require validation in postmenopausal women. Exercise has the potential for multi-modal skeletal benefits with i) HiRIT to build bone, and ii) challenging balance exercises to prevent falls, and ultimately fractures. The therapeutic effect of such exercise in combination with osteoporosis pharmacotherapy should be considered in future trials.

To estimate the share of the Medicare fee-for-service population with sarcopenia compared with osteoporosis, an associated age-related disease, using claims data and to assess abdominal CT use in the diagnosis of sarcopenia compared with dual-energy x-ray absorptiometry for the diagnosis of osteoporosis.

This retrospective study used a nationally representative 5% sample of Medicare fee-for-service beneficiaries from CMS (2017-2022). Diagnostic trends for sarcopenia and osteoporosis were compared. Nonlinear regression was used to assess the temporal association of the number of beneficiaries with an abdominal CT and a sarcopenia diagnosis (compared with dual-energy x-ray absorptiometry and osteoporosis diagnosis). Multivariable logistic regression models controlling for gender, age, race or ethnicity, urbanicity, area deprivation, and comorbidities assessed the likelihood of imaging associated with the diagnosis.

For 11,801,012 beneficiary years, there were 2,849,547 unique beneficiaries (53.2% female). Beneficiaries diagnosed with sarcopenia increased 480% from 0.01% in 2017 to 0.07% in 2022. From 90 days before the diagnosis date, the number of beneficiaries with an abdominal CT scan increased from the baseline rate at an exponential rate. After the diagnosis, the number of beneficiaries with abdominal CT scans was also elevated and returned to the baseline rate by 90 days after the diagnosis. These nonlinear patterns are statistically different from the null hypothesis of a flat line, which is indicative of no temporal association.

Although the diagnostic rate for sarcopenia increased nearly 5-fold from 2017 to 2022, it remains underdiagnosed. The results provide evidence that abdominal CT (used opportunistically or intentionally) may contribute to diagnosing sarcopenia.

Sarcopenia, defined as a progressive loss of skeletal muscle mass, strength, and function, is a leading contributor to disability, dependence, and reduced quality of life (HRQoL) in older adults. This study aimed to evaluate the impact of a personalized six-month rehabilitation program, centered on tailored kinetic therapy, on physical performance and HRQoL in older women with primary sarcopenia.

This prospective controlled study included 80 women aged ≥65 years, allocated into a Study Group (SG, n = 40), who followed a supervised personalized kinetic program, and a control group (CG, n = 40), who received general advice regarding physical activity and nutrition. Physical performance was measured using the short physical performance battery (SPPB), while HRQoL was assessed with the disease-specific SarQoL questionnaire. Evaluations were conducted at baseline and after six months.

At baseline, both groups had comparable scores (SPPB: SG = 5.75 ± 0.86 vs. CG = 5.8 ± 0.88, p = 0.798; SarQoL: SG = 54.42 ± 8.76 vs. CG = 55.59 ± 4.61, p = 0.457). After six months, the SG showed significant improvements (SPPB = 8.05 ± 0.90, p < 0.001; SarQoL = 62.55 ± 7.00, p < 0.001). Significant gains were observed in domains related to physical and mental health, locomotion, functionality, and leisure activities (p < 0.05). In contrast, the CG showed only minor, non-significant changes (SPPB = 6.17 ± 0.78; SarQoL = 56.51 ± 5.51).

A structured, personalized kinetic program significantly improves physical performance and HRQoL in older women with primary sarcopenia. These results support the need for individualized, supervised rehabilitation programs in optimizing functional recovery and enhancing patient-centered outcomes in sarcopenia management.

Sarcopenic obesity (SO) in older adults is associated with certain adverse outcomes, including falls, fractures, and disability, all of which affect patient quality of life, represent an economic burden, and potentially enhance the risk of death. Although a number studies have examined the effects of exercise, nutrition, and combined exercise and nutritional interventions on older adults with SO, the optimal therapeutic approach has yet to be sufficiently established. In this systematic review and network meta-analysis (NMA) protocol for SO in older adults, we aim to compare the combined effects of exercise and nutrition with those of exercise or nutritional interventions alone on the body composition and physical performance of older adults with SO.

The PubMed, Web of Science, Embase, OVID, CINAHL, CNKI, Wanfang Data, and VIP databases will be used to systematically search for randomized controlled trials published from the time of database inception to December 2024. Outcomes will include body composition and physical performance, and data will be extracted independently by two researchers. In cases of disagreement, a consensus will be reached by consulting a third researcher. The Cochrane risk-of-bias tool will be used to assess randomized controlled trials, and data analysis will be performed using Stata 15.0 and R software, based on homogeneity, sensitivity, transitivity, consistency, and publication bias tests.

By comprehensively assessing the relative efficacies of exercise, nutrition, and combined interventions in older adults with SO, we aim in this systematic review and NMA to fill an important gap in the existing literature. These findings will provide a reference for healthcare providers and policymakers and facilitate the development of evidence-based guidelines that will contribute to optimizing SO management and gaining more favorable outcomes for this vulnerable population.

CRD42024504706.

Weight loss achieved via energy restriction leads to significant losses in muscle and bone mass, potentially increasing risk for sarcopenia and osteoporosis. High-intensity resistance and impact training (HiRIT) might attenuate weight loss-induced musculoskeletal declines. Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).

Sixty older adults (aged ≥ 60 years) with obesity (dual-energy x-ray absorptiometry determined body fat percentage ≥ 30% in men and ≥ 40% in women) and a mobility limitation (Short Physical Performance Battery [SPPB] score ≤ 11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT or self-directed, home-based AT while consuming a hypocaloric diet (750-1000 kcal/day reduction in energy intake). Changes in physical function (primary outcome: gait speed) and body composition were compared between groups.

A total of 49/60 randomised participants (mean age: 69.6 ± 6 years; 58% women; mean BMI: 32.9 ± 4.1 kg/m2) completed the trial. Gait speed increased following HiRIT compared with AT (mean difference: 0.07 m/s [95% CI: 0.01, 0.13]). Chair stand times decreased in both groups (HiRIT: -1.3 s [95% CI: -2.1, -0.4] vs. AT: -0.8 s [95% CI: -1.6, -0.04]) and HiRIT, but not AT, increased handgrip strength (HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI: -0.9, 2.3]) and SPPB scores (HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI: -0.04, 0.8]). Similar decreases in total body mass (HiRIT: -5.1 kg [95% CI: -6.7, -3.4] vs. AT: -4.9 kg [95% CI: -6.5, -3.3]), fat mass (HiRIT: -3.6 kg [95% CI: -5.0, -2.2] vs. AT: -3.3 kg [95% CI: -4.7, -2.0]), visceral fat (HiRIT: -32.1 cm2 [95% CI: -47.4, -16.8] vs. AT: -31.4 cm2 [95% CI: -46.1, -16.8]) and appendicular lean mass (HiRIT: -0.8 kg [95% CI: -1.4, -0.2] vs. AT: -1.2 kg [95% CI: -1.8, -0.6]) were observed. HiRIT was well tolerated with only seven minor adverse events compared with five reported in those who completed AT.

HiRIT appears to be safe and more effective than AT for improving gait speed in older adults with obesity undertaking dietary weight loss. Additional trials with larger sample sizes and longer durations are warranted to explore whether HiRIT can attenuate weight loss-related muscle and bone mass declines.

Australian New Zealand Clinical Trials: ACTRN12618001146280.

Cellular antioxidant activity and oxidative stress are assumed to be critical factors in the aging process. This study aims to investigate the effects of resistance training (RT) on endogenous antioxidants in healthy older individuals.

The records were identified through searches in 5 electronic databases (PubMed, Bireme, Scopus, SPORTDiscus, and Web of Science) in June 2024 for eligible randomized controlled trials that observed older individuals subjected to RT programs that reported endogenous antioxidant outcomes. The Tool for the assEssment of Study qualiTy and reporting in EXercise (ranging from 0 to 15) was used to verify the methodological quality of the studies.

Fourteen randomized controlled trials involving 676 healthy older individuals were included in the systematic review. Of these, 10 articles were included in the meta-analysis. The meta-analysis indicated that RT interventions did not have significant effects on improving catalase levels (standardized mean difference = 0.84; 95% CI, -0.61 to 2.29) or antioxidant activity (standardized mean difference = 0.28; 95% CI, -0.41 to 0.98). However, RT was associated with a significant reduction in superoxide dismutase (mean difference = -0.16; 95% CI, -0.29 to -0.04) and glutathione peroxidase increased (standardized mean difference = 0.57; 95% CI, 0.13 to 1.01).

Based on available evidence, the meta-analysis suggests potential improvement in glutathione peroxidase gene expression and reduction in gene expression of superoxide dismutase after the intervention physical activity intervention in healthy older individuals.

Sarcopenia, generally defined by the loss of skeletal mass and function, may disproportionately affect elderly individuals and heavily influence spinal disease. Muscle atrophy is associated with myriad clinical problems, including thoracic kyphosis, increased sagittal vertical axis (SVA), spinal implant failures, and postoperative complications. As such, the aim of this narrative review is to synthesize pertinent literature detailing the intersection between sarcopenia and the impact of sarcopenia on the management of spine disease. Specifically, we focus on the domains of etiology, diagnosis and assessment, impact on the cervical and lumbar spine, spinal augmentation procedures, neoplastic disease, whiplash injury, and recovery/prevention. A narrative review was conducted by searching the PubMed and Google Scholar databases from inception to July 12, 2024, for any cohort studies, systematic reviews, or randomized controlled trials. Case studies and conference abstracts were excluded. Diagnosis of sarcopenia relies on the assessment of muscle strength and quantity/quality. Strength may be assessed using clinical tools such as gait speed, timed up and go (TUG) test, or hand grip strength, whereas muscle quantity/quality may be assessed via computed tomography (CT scan), magnetic resonance imaging (MRI), and dual-energy X-ray absorptiometry (DXA scan). Sarcopenia has a generally negative impact on the clinical course of those undergoing cervical and lumbar surgery, and may be predictive of mortality in those with neoplastic spinal disease. In addition, severe acceleration-deceleration (whiplash) injuries may result in cervical extensor muscle atrophy. Intervention and recovery measures include nutrition or exercise therapy, although the evidence for nutritional intervention is lacking. Sarcopenia is a widely prevalent pathology in the advanced-age population, in which the diagnostic criteria, impact on spinal pathology, and recovery/prevention measures remain understudied. However, further understanding of this therapeutically challenging pathology is paramount, as surgical outcome may be heavily influenced by sarcopenia status.

Low skeletal muscle mass (SMM) is a predictive factor for complications in patients undergoing major head and neck cancer surgery. This study aims to identify the predictive value of low SMM for postoperative complications in patients who underwent free forearm flap (FAFF) reconstructions after oral cancer resections.

A retrospective study was performed with all patients who underwent FFAF between 2003 and 2020 for an oral cavity reconstruction after cancer ablation. Free flap related, any postoperative complications and hospital stay were investigated.

Low SMM was associated with an increased risk of free flap associated complications (OR 2.14; 95% CI 1.02-4.39, p = 0.029). Low SMM was associated with severe complications (Clavien-Dindo ≥ III) (OR 1.46; 95% CI 1.20-2.09, p = 0.02).

Low SMM is a strong predictive factor for free flap related surgical complications in patients undergoing FAFF reconstruction after resection of oral cancer.

Despite advances in research on training and nutritional supplementation, it is largely unknown how micronutrient intake modulates the response to training in older adults. This study investigates the relationship between nutrient intake and response to training in older women at risk of sarcopenia.

A randomized clinical trial with two parallel groups (high-speed resistance training (H-RT) and multicomponent training (MT)) was conducted over a 32-week intervention involving 80 older women at risk of sarcopenia (mean age: 77.36 ± 6.71 years). A food frequency questionnaire was administered to assess whether nutrient intake influenced strength outcomes measured by the Five Times Sit-to-Stand Test (5STS) and other functional variables.

Significant improvements in the five times sit to stand test (5STS) were observed in both groups post-intervention (p < 0.001), with no significant differences between them (p = 0.127), suggesting comparable effectiveness. In both groups, lower levels of vitamin B12 (H-RT: rp = -0.52; MT: rp = -0.50) and vitamin D (H-RT: rp = -0.55; MT: rp = -0.69) were associated with worse 5STS performance. Additionally, in the H-RT group, lower levels of vitamin E (rp = -0.36), magnesium (rp = -0.48), iron (rp = -0.43), and potassium (rp = -0.47) were also correlated with poorer performance.

The results indicate that improvements in strength are related to micronutrient sufficiency rather than macronutrient sufficiency. Deficiencies in vitamin D and B12 negatively impacted muscle strength gains in both H-RT and MT, while vitamin E, potassium, magnesium, and iron influenced H-RT outcomes. The lesser effect of micronutrient deficiencies on MT suggests it may be more suitable for individuals with mild deficiencies, as it requires fewer specific nutrients for muscle strength.

The study is registered at ClinicalTrials.gov under the identifier NCT05870046.

G protein-coupled receptor 40 (GPR40) acts as a modulator of various physiological functions, including glycaemic lowering, anti-inflammation and antioxidative stress, in several tissues. However, the role of GPR40 in skeletal muscles remains unclear.

To investigate the roles of muscle GPR40, C2C12 myoblasts and myotubes were stimulated with palmitate and HD6277, a GPR40 agonist. Muscle strength and myofiber thickness were measured in obese and aged mice fed HD6277.

In C2C12 myoblasts, the addition of HD6277 induced phosphorylated Akt levels and expression of the myogenic factors, myogenin (MyoG), myocyte enhancer factor 2C (Mef2c) and myosin heavy chain (MyHC, p < 0.05). These changes resulted in accelerated muscle differentiation from myoblasts to myotubes (MyHC-positive area +56.52%; myotube width +34.08% vs. Veh, p < 0.05). In C2C12 myotubes, a palmitate-mediated decrease in the phosphorylation of forkhead box protein O1A (FOXO1A) and increase in the expression of E3 ubiquitin ligases, atrogin-1 and muscle RING-finger protein 1 (MuRF1) were reversed by HD6277 (p < 0.05). Additionally, HD6277 inhibited palmitate-induced apoptotic events such as the Bcl-2 (Bcl2)-associated X protein (Bax)/Bcl-2 ratio, caspase 3 cleavage and nuclear fragmentation in C2C12 myoblasts and myotubes (p < 0.05). These beneficial HD6277-mediated actions disappeared after the addition of an Akt inhibitor (p < 0.05). Similar to in vitro studies, HD6277 administration in obese and aged mice increased myogenic factors and decreased E3 ubiquitin ligase expression and apoptotic events (p < 0.05). HD6277 increased muscle strength (+9.88% vs. Aged, p < 0.05) and myofiber thickness (+29.01% vs. Aged, p < 0.05) in aging mice but only improved myofiber thickness (+11.84% vs. HFD, p < 0.05) in obese mice.

HD6277 can increase myogenic factors and reduce E3 ligase-mediated proteolysis to inhibit muscle atrophy in aged mice. Our results suggest that GPR40 agonists may have potential as therapeutic agents for sarcopenia.

Renin angiotensin system (RAS) alters various mechanisms related to muscle wasting. The RAS system consists of classical and non-classical pathways, which mostly function differently. Classical RAS pathway, operates through angiotensin II (AngII) and angiotensin type 1 receptors, is associated with muscle wasting and sarcopenia. On the other hand, the non-classical RAS pathway, which operates through angiotensin 1-7 and Mas receptor, is protective against sarcopenia. The classical RAS pathway might induce muscle wasting by variety of mechanisms. AngII reduces body weight, via reduction in food intake, possibly by decreasing hypothalamic expression of orexin and neuropeptide Y, insulin like growth factor-1 (IGF-1) and mammalian target of rapamycin (mTOR), signaling, AngII increases skeletal muscle proteolysis by forkhead box transcription factors (FOXO), caspase activation and muscle RING-finger protein-1 transcription. Furthermore, AngII infusion in skeletal muscle reduces phospho-Bad (Ser136) expression and induces apoptosis through increased cytochrome c release and DNA fragmentation. Additionally, Renin angiotensin system activation through AT1R and AngII stimulates tumor necrosis factor-α, and interleukin-6 which induces muscle wasting, Last but not least classical RAS pathway, induce oxidative stress, disturb mitochondrial energy metabolism, and muscle satellite cells which all lead to muscle wasting and decrease muscle regeneration. On the contrary, the non-classical RAS pathway functions oppositely to mitigate these mechanisms and protects against muscle wasting. In this review, we summarize the mechanisms of RAS-induced muscle wasting and putative implications for clinical practice. We also emphasize the areas of uncertainties and suggest potential research areas.

Cisplatin is a widely used chemotherapeutic agent for treating solid tumours. Still, it induces severe side effects, including muscle atrophy. Understanding the mechanisms of cisplatin-induced muscle loss and exploring potential therapeutic strategies are essential. Parvalbumin (PV) interneurons in the striatum play a crucial role in motor control, and recent studies suggest that their activation may alleviate motor deficits. This study investigates the effects of chemogenetic activation of PV interneurons on cisplatin-induced muscle atrophy and motor dysfunction in mice.

Wild-type C57BL/6 mice and transgenic hM3Dq mice were used in this study. Cisplatin (3 mg/kg) was administered intraperitoneally for 7 days to induce muscle atrophy. Mice were then treated with clozapine-n-oxide (CNO) to activate PV interneurons. Muscle strength and endurance were assessed using grip strength measurements, the inverted grid test and the wire hang test. Neuromuscular junction (NMJ) integrity was examined via histological analysis. Exercise intervention was also included, using a treadmill with a 15° incline for 60 min at varying speeds during seven consecutively days.

Cisplatin treatment significantly reduced body weight (p < 0.001), grip strength (forelimb strength: p < 0.001, four-limb strength: p < 0.001), endurance (inverted grid test: p = 0.047, wire hang test: p = 0.014) and NMJ integrity (partially innervated NMJs: p = 0.0383). PV interneuron activation with CNO improved spontaneous motor activity in cisplatin-treated mice, as evidenced by a significant increase in total travel distance (p = 0.049) in the open-field test. Histological analysis showed a reduced ratio of partially innervated NMJs in the PV-cre group compared to the control virus group (p = 0.0441). Muscle strength also improved significantly, with forelimb grip strength increased (p < 0.001) and four-limb grip strength increased (p = 0.018). Muscle wet-weight ratios were significantly higher in the PV-cre group (quadriceps: p = 0.030). Exercise intervention significantly improved grip strength (forelimb: p < 0.001, four-limb: p = 0.002), muscle endurance (four-limb hang test: p = 0.048) and muscle weight (quadriceps: p = 0.015, gastrocnemius: p = 0.022), with an increase in muscle fibre cross-sectional area (p = 0.0018).

Activation of PV interneurons significantly alleviates cisplatin-induced motor deficits and muscle atrophy by improving spontaneous motor activity, NMJ integrity and muscle function. It has a similar effect to short-term exercise and may offer a promising therapeutic strategy for mitigating chemotherapy-induced muscle atrophy.

While there is some evidence of the association between sedentary behavior and sarcopenia risk, it remains unclear whether systematic inflammation index (SII), 25(OH)D, and testosterone can mediate this association. This study aims to investigate whether sedentary behavior is associated with the prevalence of sarcopenia in the US population and further examine its potential mediators which have not been thoroughly explored, thereby presenting a novel approach to understanding the mechanism between sedentary behavior and sarcopenia.

We conducted a cross-sectional study involving a representative sample of the US national population of 9902 adults aged 18 years or older from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. The participants with sarcopenia were identified by Dual-energy X-ray (DXA) absorptiometry. Weighted multivariable logistic regressions based on the complex survey designs were used to explore the associations between a sedentary lifestyle and the risk of sarcopenia and restricted cubic spline (RCS) regression was used to examine the non-linear association. Causal mediation analysis using the quasi-Bayesian Monte Carlo method was applied to identify the mediating role of SII, 25(OH)D, and testosterone as potential mediators.

A total of 358 participants (3.6 %) had sarcopenia. Compared to those in the lowest quartile of sedentary time, participants in the highest quartile had a hazard ratio of 1.631 (95 % CI: 1.162 to 2.289) for the prevalence of sarcopenia. A non-linear relationship (P for non-linearity <0.001) between sedentary time and the risk of sarcopenia was observed using the RCS method. The odds ratio for sarcopenia was highest (OR = 3.427) when the sedentary time was 1080 min daily. Furthermore, SII, 25(OH)D, and testosterone showed a significant mediation in the association between sedentary time and sarcopenia risk, with a mediation effect of 3.39 %, 10.3 %, and 8.56 %, respectively.

This study demonstrated novel findings of the association between sedentary behavior and sarcopenia in the US population. Our study found that sedentary time was associated with the prevalence of sarcopenia. Vitamin D, SII, and testosterone served as mediating factors in the association of sedentary time with the risk of sarcopenia.

This study aims to analyze the effect of whey protein (WP) supplementation on glycemic control, muscle strength, quality of life, and body composition in older adults with non-insulin-dependent diabetes undergoing a resistance training program.

A double-blind, placebo-controlled, randomized study was carried out with older adults with Type 2 diabetes. Body composition, food intake, muscle strength, glycemic profile, markers of renal function, cardiopulmonary capacity, and quality of life were evaluated. Older adults were randomized into a supplementation group with 33 g of WP consumed twice a week on days of resistance training for 12 weeks supplemented group and a placebo group.

In total, 39 older adults were randomized into two groups, 19 in the supplement group and 20 in the placebo group. Both groups showed improvement in muscle strength, with the WP group failing to exceed that of the control group. WP supplementation slightly increased blood urea compared with the placebo group (p = .05), but values remained within normal limits. The group that used WP showed a small improvement in mental health, according to the 12-Item Short-Form Health Survey questionnaire, but without clinically important improvements.

Both groups showed improvements in muscle strength and mass, regardless of supplementation, showing that resistance exercises performed twice a week can contribute to the nonprogression of sarcopenia in older adults with Type 2 diabetes. More studies are needed to determine the safe and effective amount of supplementation to improve muscle strength without renal impairment in older adults with diabetes.

Exercise is a highly recommended nonpharmacological intervention for older adults with sarcopenia. Poor exercise adherence is a main factor affecting treatment efficacy. However, evidence for overall adherence to exercise and intervention characteristics affecting adherence in this population remains unknown.

To determine whether community-dwelling older adults with sarcopenia adhere to exercise programmes, what intervention components are used to improve adherence and how adherence relates to intervention characteristics and efficacy.

Seven electronic databases and relevant systematic reviews were searched to identify randomised controlled trials (RCTs). The capability, opportunity, motivation and behaviour model with behaviour change techniques (BCTs) were used to categorise adherence intervention components. Random-effects meta-analysis and meta-regression analyses were employed.

Seventeen RCTs with 2975 participants were included in this review. The pooled estimate of adherence rates for exercise interventions amongst older adults with sarcopenia was 85% (95% CI: 0.79-0.89, range: 71%-100%). Nine BCTs were identified from the included studies. Exercise with programme durations (<24 weeks) (P = 0.01) might be associated with higher adherence rates compared with programme durations (≥24 weeks). However, exercise adherence was not associated with intervention efficacy.

Adherence to exercise interventions in community-dwelling older adults with sarcopenia is relatively high and may be affected by programme duration. Most studies incorporated only a small number of BCTs into their exercise interventions. Such an approach may be insufficient to enhance adherence in this population effectively. Future studies with theory-informed interventions to improve adherence in the field of exercise for older people with sarcopenia are needed.

Sarcopenia is the age-related loss of skeletal muscle mass and function. Recently, research has focused on defining diagnostic criteria for this condition, now recognized as a muscle disease with a specific identifying code (ICD-10: M62.84). The diagnostic process for sarcopenia involves several stages, including the use of dedicated questionnaires and objective measurements of muscle strength and mass. According to international guidelines, therapeutic exercise is recommended to improve muscle mass, muscle strength, and physical performance. However, much of the supporting evidence comes from studies on non-sarcopenic elderly patients. Among types of therapeutic exercise, guidelines mainly emphasize muscle strengthening. The prescription of therapeutic exercise must consider the clinical and functional conditions of the patient (e.g., the presence of severe sarcopenia) and patient preferences. Muscle strengthening should target large muscle groups and include low-intensity resistance exercise for strength improvement, or high-intensity resistance exercise for additional benefits in muscle mass and function. Evidence suggests that an ideal therapeutic exercise program for sarcopenic patients should be multimodal, incorporating muscle strengthening, aerobic exercise, and balance control programs. This approach could enhance patient adherence by offering variety. Although multimodal therapeutic exercise improves muscle mass and function, these benefits can be lost during prolonged physical inactivity. Therefore, the exercise prescription must define intensity, volume (repetitions and sets), frequency, rest intervals, and duration, tailored to the type of exercise. Aerobic training programs improve endurance and optimize mitochondrial function. Balance training, important for reducing the risk of falls, should be done at least three times a week. Muscle strengthening should be done at least two days a week, starting at 50%-60% of 1 repetition maximum (RM) and progressing to 60%-80% of 1 RM, with approximately 10 exercises per session. Adopting comprehensive prescription protocols, such as those proposed in this paper, can significantly aid in the functional recovery and well-being of patients with sarcopenia.

Sarcopenia is prevalent among individuals undergoing maintenance hemodialysis (MHD) and is influenced by sedentary lifestyles. Although leisure-time physical activities have been shown to prevent sarcopenia in patients undergoing MHD, the impact of nonleisure-time physical activities on sarcopenia has not yet been examined in prospective studies.

This prospective cohort study, conducted in 2020 with a 12-month follow-up, included stable MHD patients without baseline sarcopenia. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria. Physical activity was assessed using the International Physical Activity Questionnaire. Additionally, demographic, dietary, nutritional, and laboratory data were collected. Modified Poisson regression analysis was employed to evaluate the impact of physical activity on the risk of developing sarcopenia.

Among the 196 MHD patients who completed the 1-year follow-up, 29 (14.8%) developed sarcopenia. The average total physical activity was 1,268 METs/week, with leisure-time activity averaging 300 METs/week and nonleisure-time activity averaging 724 METs/week. Adjusted analyses indicate that leisure-time physical activities do not significantly affect the risk of sarcopenia (RR = 0.920, 95% CI = 0.477-1.951; P > 0.05), whereas nonleisure-time physical activities are significantly associated with a reduced risk of sarcopenia (RR = 0.449, 95% CI = 0.248-0.814).

Actively participating in physical activities (nonleisure-time physical activities) can reduce the incidence of sarcopenia in patients undergoing MHD. Promoting such activities may be an effective strategy to enhance physical fitness and mitigate sarcopenia risk among this population.

The burden of sarcopenia in India continues to be of significant concern. Its diagnosis is challenging due to the lack of standardized cutoffs for assessing muscle strength, quantity, and function among Indians. This consensus aims to identify features of sarcopenia in Indians and provide culturally relevant recommendations for its management. An expert panel from diverse medical specialties across India arrived at a consensus using the modified Delphi method. The panel recommended that a baseline handgrip strength (HGS) cutoff value of <27.5 kg in males and 18.0 kg in females be defined as low muscle strength for the Indian population. All patients with comorbidities should be screened for sarcopenia. In people with sarcopenia, resistance exercise and nutrition with specialized nutrients such as protein, beta-hydroxy-beta-methylbutyrate (HMB), and micronutrients for at least 3 months were recommended as key interventions.

Scapulohumeral periarthritis (SP) is a disease caused by chronic inflammation of the shoulder soft tissue area, which is characterized by shoulder pain and limited mobility. Due to the long course of disease, it often has a great impact on the life and work of patients.

The purpose of this study was to systematically evaluate the effect of proprioceptive neuromuscular facilitation (PNF) stretching technique in the treatment of SP.

A systematic search of 10 databases such as China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database, Weipu, Wanfang, PubMed, Embase, Web of Science, Cochrane Library, Clinical Trials, and China Clinical Trial Registry Platform was performed. The retrieval time was from inception to January 2024. Two researchers screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality.Revman5.3 software was used for meta-analysis, and only descriptive analysis was performed on the outcome indicators of the number of literature ≤ 2.

A total of 12 articles were included, including 968 patients. The results of Meta-analysis showed that PNF technique could reduce pain intensity ((Visual analog scale (VAS) score (SMD = -0.67, 95% CI [-1.18, -0.15], P = 0.03), Japanese Orthopaedic Association (JOA) score (subjective pain score standard) (SMD = 0.79, 95% CI [0.23,1.35], P < 0.01)), improve the shoulder function of patients (SMD = 1.13, 95% CI [0.96,1.31], P < 0.01), and improve the patient's daily living ability (SMD = 1.06, 95% CI [0.77,1.34], P < 0.01). The results of descriptive analysis showed that the PNF technique could improve the psychological state of patients with scapulohumeral periarthritis to a certain extent.

The PNF technique can help patients with scapulohumeral periarthritis to relieve pain, improve shoulder function, and strengthen daily living ability. In addition, a good psychological state is conducive to better recovery of patients ' health. In clinical work, medical staff should pay attention to the psychological state of patients with SP.

Not applicable.

Background and Objectives: This study examined the prevalence and risk factors of dynapenia, pre-sarcopenia, and sarcopenia among Korean adults using nationally representative data. Materials and Methods: A cross-sectional analysis was conducted using the 2022-2023 Korea National Health and Nutrition Examination Survey (KNHANES). Participants aged 20 years and older with available muscle strength and body composition measurements were included. Handgrip strength and skeletal muscle mass (measured via bioelectrical impedance analysis) were used to classify participants based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Logistic regression analysis identified associated risk factors. Results: The prevalence of pre-sarcopenia, dynapenia, and sarcopenia was 9.6%, 3.4%, and 1.6%, respectively. Pre-sarcopenia was most common across all age groups, while sarcopenia was primarily observed in older adults (p < 0.001). Age was a key predictor for all three conditions (p < 0.001), with sex differences-men had a higher prevalence of pre-sarcopenia (p = 0.014), whereas women showed higher rates of dynapenia (p = 0.003) and sarcopenia (p = 0.008). Low physical activity (p < 0.001), high stress (p = 0.021), and smoking (p = 0.012) were also significant risk factors. Conclusions: These findings highlight the importance of early identification and targeted interventions to prevent muscle deterioration. Public health strategies focusing on lifestyle modifications and sex-specific approaches may help mitigate the burden of sarcopenia and its related health complications in aging populations.

The Global Leadership Initiative in Sarcopenia (GLIS) aims to standardize the definition and diagnostic criteria for sarcopenia into one unifying, common classification. Among other actions to achieve this objective, the GLIS has organized three different working groups (WGs), with the WG on outcomes of sarcopenia focusing on reporting its health outcomes to be measured in clinical practice once a diagnosis has been established. This includes sarcopenia definitions that better predict health outcomes, the preferred tools for measuring these outcomes, and the cutoffs defining normal and abnormal values. The present article synthesizes discussions and conclusions from this WG, composed of 13 key opinion leaders from different continents worldwide. Results rely on systematic reviews, meta-analyses, and relevant cohort studies in the field. With a high level of evidence, sarcopenia is significantly associated with a reduced quality of life, a higher risk of falls and fractures and a higher risk of mortality. Sarcopenia has been moderately associated with a higher risk of reduced instrumental activities of daily living (IADL). However, the GLIS WG found only inconclusive level of evidence to support associations between sarcopenia and higher risks of hospitalization, nursing home admission, mobility impairments, and reduced basic activities of daily living (ADL). This limitation underscores the scarcity of longitudinal studies, highlighting a barrier to understanding its progression and implications over time.

Understanding sarcopenia is becoming increasingly important as society ages. This comprehensive review covers the definition, epidemiology, causes, pathogenesis, diagnosis, prevention, management, and future directions for the management of sarcopenia, and the major issues related to sarcopenia in the knee joint.

Sarcopenia, a condition related to aging, is characterized by decreased muscle mass and strength, which significantly affects physical function. Its prevalence may vary by region and age, with reports of up to 50% prevalence in the elderly population. The potential causes of sarcopenia include neurodegeneration, poor nutrition, changes in hormonal effects, elevated levels of proinflammatory cytokines, and reduced activation of muscle satellite cells. Various pathogeneses, such as apoptosis, proteolysis, and inhibition of the signaling for increasing muscle mass, contribute to the development of sarcopenia. Generally, the diagnostic criteria for sarcopenia are based on reduced muscle mass, reduced muscle strength, and decreased physical performance, and can be assessed using various equipment and clinical tests. A healthy lifestyle consisting of a balanced diet, sufficient protein intake, and regular exercise is recommended to prevent sarcopenia. The management of sarcopenia involves resistance exercise, proper nutrition, and deprescribing from polypharmacy. In the future, pharmacological treatment and personalized nutrition may become alternative management options for sarcopenia. Finally, since sarcopenia can be associated with knee osteoarthritis and poor outcomes after total knee arthroplasty, appropriate management of sarcopenia is important for physicians treating knee-related conditions.

Sarcopenia is a significant pathological condition that needs to be recognized, especially in the older population. Although sarcopenia is common as aging occurs, it can be prevented by a healthy lifestyle. Currently, there are no approved drugs for sarcopenia; however, resistance exercise and proper nutritional supplementation are essential methods for managing sarcopenic conditions. Given its diverse causes, a personalized approach may be necessary to effectively manage sarcopenia. Finally, appropriate management of sarcopenia can contribute to the prevention and effective treatment of knee osteoarthritis.

Aging brings with it many health issues that can make life challenging. As much of the attention is given to non-communicable diseases, there are others which are slowly becoming a matter of great concern. One such issue is cognitive frailty, which is a high risk factor for dementia, falls, fractures and hospitalization. Though not yet declared a public health concern, it deserves early detection and prevention strategies. As it is reversible if treated on time, there is a need to look into its prevention and cure. Physical activity has proven to be very effective in the treatment of cognitive frailty. This scoping review thus aims to study the impact of physical activity through social participation on cognitive frailty. The authors recommend that focussing on one's muscular fitness through participation in sports and elements of Indian classical dance form like Kathak in groups/ communities can be a very effective way of combating cognitive frailty among older adults.