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Background A specific self‐administrated health‐related quality of life questionnaire for sarcopenia, the Sarcopenia and Quality Of Life (SarQoL®), has been recently developed. This questionnaire is composed of 55 items translated into 22 questions and organized into seven domains of quality of life. The objective of the present work is to evaluate the psychometric properties (discriminative power, validity, reliability, floor and ceiling effects) of the SarQoL® questionnaire. Methods Sarcopenic subjects were recruited in an outpatient clinic in Liège, Belgium and were diagnosed according to the algorithm developed by the European Working Group on Sarcopenia in Older People. We compared the score of the SarQoL® between sarcopenic and non‐sarcopenic subjects using a logistic regression after adjustment for potential confounding variables. Internal consistency reliability was determined using Cronbach's alpha coefficient; construct validity was assessed using convergent and divergent validities. Test–retest reliability was verified after a two‐week interval using the intra‐class correlation coefficient (ICC). At last, floor and ceiling effects were also tested. Results A total of 296 subjects with a median age of 73.3 (68.9–78.6) years were recruited for this study. Among them, 43 were diagnosed sarcopenic. After adjustment for potential confounding factors, the total score and the scores of the different dimensions of the SarQoL® questionnaire were significantly lower for sarcopenic than for non‐sarcopenic subjects (54.7 (45.9–66.3) for sarcopenic vs. 67.8 (57.3 – 79.0) for non sarcopenic, OR 0.93 (95%CI 0.90–0.96)). Regarding internal consistency, the Cronbach's alpha coefficient was 0.87. The SarQoL® questionnaire data showed good correlation with some domains of the Short‐Form 36 (SF‐36) and the EuroQoL 5‐dimension (EQ‐5D) questionnaires and with the mobility test. An excellent agreement between the test and the retest was found with an ICC of 0.91 (95% CI 0.82–0.95). At last, neither floor nor ceiling effects were detected. Conclusions The SarQoL® questionnaire is valid, consistent, and reliable and can therefore be recommended for clinical and research purposes. However, its sensitivity to change needs to be assessed in future longitudinal studies.

Frailty is a major health condition associated with ageing. Although the concept is almost universally accepted, its operational definition remains controversial. Anyway, this geriatric condition represents a huge potential public health issue at both the patient and the societal levels because of its multiple clinical, societal consequences and its dynamic nature. Here, we review existing definitions and assessment tools for frailty, we highlight consequences of this geriatric condition and we discuss the importance of its screening and prevention to limit its public health burden.

Background The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality. Methods Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups [0–3, 4–6, 7–9, 10–12]) were retrieved from the articles and/or obtained by the study authors. The odds ratio (OR) and/or hazard ratio (HR) was obtained for all-cause mortality according to SPPB category (with SPPB scores 10–12 considered as reference) with adjustment for age, sex, and body mass index. Results Standardized data were obtained for 17 studies ( n  = 16,534, mean age 76 ± 3 years). As compared to SPPB scores 10–12, values of 0–3 (OR 3.25, 95%CI 2.86–3.79), 4–6 (OR 2.14, 95%CI 1.92–2.39), and 7–9 (OR 1.50, 95%CI 1.32–1.71) were each associated with an increased risk of all-cause mortality. The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length, subsets of participants, geographic area, and age of the population. Random effects meta-regression showed that OR for all-cause mortality with SPPB values 7–9 was higher in the younger population, diabetics, and men. Conclusions An SPPB score lower than 10 is predictive of all-cause mortality. The systematic implementation of the SPPB in clinical practice settings may provide useful prognostic information about the risk of all-cause mortality. Moreover, the SPPB could be used as a surrogate endpoint of all-cause mortality in trials needing to quantify benefit and health improvements of specific treatments or rehabilitation programs. The study protocol was published on PROSPERO (CRD42015024916).

Since 1989 and the first use of the term sarcopenia during a meeting about the epidemiology of ageing in Albuquerque, New Mexico (1), the search for an unequivocal conceptual and operational definition of sarcopenia has continue to animate the research community. The Journal of Nutrition Health and Aging publishes a remarkable study this month, which looks at the prevalence of sarcopenia according to the various definitions proposed to date (2). Applying 12 operational definitions diagnose sarcopenia, Stuck et al. obtained the prevalence of sarcopenia in the European population of the large DO-HEALTH trial, a community-based population with high levels of physical activity, good physical performance (median SPPB of 12) and low rates of multimorbidity. The definitions used are those published over 30 years of clinical research by Baumgartner, Delmonico, the Foundation for the National Institutes of Health (FNIH1), the Asian Working Group on Sarcopenia (AWGS1, AWGS2), the European Working Group on Sarcopenia in the Elderly (EWGSOP1, EWGSOP2, EWGSOP2-lower extremities), the FNIH2, the SARC-F, the International Working Group on Sarcopenia in the Elderly (IWGS), and more recently the Sarcopenia Definitions and Outcomes Consortium (SDOC). The prevalence of sarcopenia, according to these definitions, in this primarily healthy population, ranges from 0.7% for the AWGS2 definition to 16.8% for the Delmonico definition. At first reading, the considerable variation in prevalence suggests that sarcopenia is sometimes rare pathology, sometimes a very common condition, depending on the definition applied. Above all, this result suggests that we still disagree on how to reliably identify a sarcopenic patient. As such, the authors suggest that «the concept of sarcopenia may need to be rethought to reliably identify people with impaired muscle health. « What other reading can we do on the advances that have been made in diagnosing sarcopenia and on the steps that remain to be done?[...]

Purpose Sarcopenia is an age-related muscle condition which is frequently a precursor of frailty, mobility disability and premature death. It has a high prevalence in older populations and presents a considerable social and economic burden. Potential treatments are under development but, as yet, no guidelines support regulatory studies for new drugs to manage sarcopenia. The objective of this position paper is therefore to suggest a set of potential endpoints and target population definitions to stimulate debate and progress within the medico-scientific and regulatory communities. Methods A multidisciplinary expert working group was hosted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, which reviewed and discussed the recent literature from a perspective of clinical experience and guideline development. Relevant parallels were drawn from the development of definition of osteoporosis as a disease and clinical assessment of pharmaceutical treatments for that indication. Results A case-finding decision tree is briefly reviewed with a discussion of recent prevalence estimations of different relevant threshold values. The selection criteria for patients in regulatory studies are discussed according to the aims of the investigation (sarcopenia prevention or treatment) and the stage of project development. The possible endpoints of such studies are reviewed and a plea is made for the establishment of a core outcome set to be used in all clinical trials of sarcopenia. Conclusions The current lack of guidelines for the assessment of new therapeutic treatments for sarcopenia could potentially hinder the delivery of effective medicines to patients at risk.

Geroscience is becoming a major hope for preventing age-related diseases and loss of function by targeting biological mechanisms of aging. This unprecedented paradigm shift requires optimizing the design of future clinical studies related to aging in humans. Researchers will face a number of challenges, including ideal populations to study, which lifestyle and Gerotherapeutic interventions to test initially, selecting key primary and secondary outcomes of such clinical trials, and which age-related biomarkers are most valuable for both selecting interventions and predicting or monitoring clinical responses (“Gerodiagnostics”). This article reports the main results of a Task Force of experts in Geroscience. Geroscience is becoming a major hope for preventing age-related diseases and loss of function by targeting biological mechanisms of aging. This article reports a discussion of a research Task Force on the challenges posed by the clinical research in Geroscience so that future gerotherapeutic clinical trials can be conducted successfully.

In response to the challenge of maintaining COVID-19 vaccination coverage amidst the pandemic, VillageReach, in collaboration with the Ministry of Public Health Prevention and Hygiene in Kinshasa, DRC, integrated COVID-19 vaccination with routine immunization services at two primary healthcare facilities. This initiative, launched in July 2022, represented the first of its kind in the DRC, aiming to assess the effectiveness and scalability of a multimodal vaccination approach. Through a rapid appraisal involving key informant interviews and analysis of pre- and post-integration service delivery data, this case study explores the operational dynamics and outcomes of integrating COVID-19 and routine immunizations. Results demonstrated that the integrated approach not only maintained COVID-19 vaccine coverage but also significantly enhanced routine immunization uptake, particularly among under-immunized and zero-dose children. Overall, the vaccination sites, outreach, and integrated health facilities administered 229,983 (33 %) of COVID-19 vaccines in Kinshasa, of which 53 % were referred by community health workers. Additionally, 998 under-immunized children received routine immunizations, of whom 126 were zero-dose children. Key success factors included sustained community health worker engagement, neighborhood-specific strategies, accessible vaccination points, and robust data management. The findings suggest that such integrative strategies can effectively bolster immunization coverage in urban poor communities, offering valuable insights for similar initiatives in the DRC and beyond. This study advocates for sustained investment in innovative immunization models to strengthen primary healthcare systems post-pandemic. •Integrating COVID-19 vaccination with routine immunization reinforced both services•Targeted demand generation by community health workers drove immunization success•Strategies tailored to the unique needs of each neighborhood improved vaccination access•Comprehensive data collection and data-driven decision-making optimized service delivery

Although it is well-admitted that cardiovascular health affects cognition, the association between orthostatic hypotension (OH) and cognition remains unclear. The objectives of the present study were i) to determine among the EPIDOS cohort (EPIdémiologie de l'OStéoporose) whether OH was cross-sectionally associated with cognitive impairment at baseline, and ii) whether baseline OH could predict incident cognitive decline after 7 years of follow-up. Systolic and Diastolic Blood Pressure (SBP and DBP) changes while standing (ie, ΔSBP and ΔDBP, in %) were measured at baseline among 2,715 community-dwelling older women aged 75 years and older using no antihypertensive drugs from the French EPIDOS cohort. OH was defined as a decrease in SBP ≥20 mmHg and/or a decrease in DBP ≥10 mmHg within 3 min after standing. Cognitive impairment was defined as a Short Portable Mental Status Questionnaire (SPMSQ) score <8 (/10). Among those without cognitive impairment at baseline, a possible incident onset of cognitive decline was then sought after 7 years of follow-up among 257 participants. Baseline ΔSBP was associated with baseline cognitive impairment (adjusted OR = 1.01, p = 0.047), but not with incident onset of cognitive decline after 7 years (adjusted OR = 0.98, p = 0.371). Neither baseline OH nor baseline ΔDBP were associated with cognitive impairment neither at baseline (p = 0.426 and p = 0.325 respectively) nor after 7 years (p = 0.180 and p = 0.345 respectively). SBP drop while standing, but neither OH per se nor DBP drop while standing, was associated with baseline cognitive impairment in older women. The relationship between OH and cognitive impairment appears more complex than previously expected.

To the Editor: Lundgren et al. (May 6 issue) 1 showed that a combination of high-intensity exercise and treatment with liraglutide for 1 year had clinically meaningful positive effects on several health outcomes, particularly those related to metabolism, in middle-aged adults with obesity. These findings add major evidence for the treatment of obesity and may have positive public health implications. Nevertheless, can these results be maintained in the long term? A 1-year trial is a medium-to-long–term study, yet represents only a short interval from a life-course perspective. For how long should participants continue to follow a somewhat constraining treatment protocol to . . .