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(1) Background/Objectives: The relationship between body mass index (BMI) and probable sarcopenia, a precursor to sarcopenia diagnosis, is unclear. While low BMI has been associated with sarcopenia risk, some evidence suggests that obesity may confer protection. We aimed to investigate the association between probable sarcopenia and BMI and, furthermore, to explore associations with waist circumference (WC). (2) Methods: This cross-sectional study included 5783 community-dwelling adults (mean age 70.4 ± 7.5 years) from Wave 6 of the English Longitudinal Study of Ageing (ELSA). Probable sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria for low hand grip strength and/or slow chair rise. Associations between BMI and probable sarcopenia were examined using multivariable regression analysis and were similarly performed for WC. (3) Results: Our overall findings show that an underweight BMI was significantly associated with an increased likelihood of probable sarcopenia [OR (CI) 2.25 (1.17, 4.33), p = 0.015]. For higher BMI categories, the findings were conflicting. Overweight and obesity were associated with an increased likelihood of probable sarcopenia when defined by lower limb strength alone, [OR (CI), 2.32 (1.15, 4.70), p = 0.019; 1.23 (1.02, 1.49), p = 0.35, and 1.49 (1.21, 1.83), p < 0.001, respectively]. In contrast, overweight and obesity appeared protective when probable sarcopenia was assessed by low hand grip strength alone [OR (CI) 0.72 (0.60, 0.88), p = 0.001, and 0.64 (0.52, 0.79), p < 0.001, respectively]. WC was not significantly associated with probable sarcopenia on multivariable regression analysis. (4) Conclusion: This study supports the evidence that low BMI is associated with an increased likelihood of probable sarcopenia, highlighting an important at-risk group. The findings for overweight and obesity were inconsistent and may be measurement dependent. It seems prudent that all older adults at risk of probable sarcopenia, including those with overweight/obesity, are assessed to prevent underdetection of probable sarcopenia alone or with the double burden of obesity.

The objective of this research was to identify the factors contributing to the decline in handgrip strength among middle-aged and elderly individuals with this condition. In addition, an algorithmic model for the detection of probable sarcopenia will be developed. This research encompassed the collection and evaluation of fundamental data, laboratory indicators, body composition metrics, and lifestyle factors. Patients were diagnosed with handgrip strength loss according to the diagnostic criteria established by the Asian Working Group for Sarcopenia in 2019, specifically for “probable sarcopenia”. A multifactorial logistic regression model was employed to discern the independent variables that significantly influence the occurrence of handgrip strength reduction among patients suffering from coronary artery disease. An internal validation of this model was conducted using the bootstrap repetitive sampling technique. The predictive efficacy of the model was assessed through comparisons of the area under the receiver operating characteristic curve, the calibration curve, and the decision curve for the subjects. High gait speed (OR 0.015; 95%CI 0.001–0.232), high calf circumference (OR 0.650; 95%CI 0.503–0.839), and high albumin level (OR 0.714; 95%CI 0.572–0.891) were significantly and negatively associated with reduced handgrip strength, which were protective factors for the development of probable sarcopenia. (all p  < 0.05). Gait speed, calf circumference, and serum albumin levels were independent factors that influenced the likelihood of developing probable sarcopenia. The nomogram model based on these factors has a certain predictive value of probable sarcopenia, which can guide the development of disease prevention strategies.

Parkinson’s disease (PD) and probable sarcopenia (PS) frequently coexist in older adults, yet the relationship between PS, non-motor symptoms, and functional outcomes remains unclear. This study aimed to evaluate the association between PS and non-motor symptoms in patients with PD and to examine how PS relates to mobility and falls. Ninety-three participants aged ≥ 65 years were evaluated (50 PD; 43 controls). PS was defined according to EWGSOP2 based on handgrip strength. Frailty, nutritional status, functional performance, gait speed, fall history, and depressive symptoms were assessed in all participants, while PD patients additionally completed the Non-Motor Symptoms Questionnaire and Falls Efficacy Scale. The prevalence of PS in PD was 60%. Patients with PS demonstrated higher non-motor symptom scores, poorer nutritional status, greater frailty, reduced mobility, and more frequent dysphagia and orthostatic symptoms than those without PS. In univariable analyses, age, non-motor symptom burden, and orthostatic symptoms were associated with PS. In multivariable logistic regression, the Clinical Frailty Scale (OR 2.50, 95% CI 1.06–5.87) and the Mini Nutritional Assessment–Short Form (OR 0.64, 95% CI 0.42–0.97) remained independently associated with PS. Probable sarcopenia is common in PD and is strongly linked to frailty, nutritional status, non-motor symptoms, and mobility limitations. Early identification of PS may help detect individuals at increased risk of functional decline and falls.

In 2018 EWGSOP2 has suggested low muscle strength as the primary parameter of sarcopenia. The consensus has recommended SARC-F questionnaire as a screening test to find cases with low muscle strength which has been designated as probable sarcopenia. We aimed to study the ability of SARC-F to find probable sarcopenia cases in older patients. Retrospective, cross-sectional. Istanbul University Istanbul Faculty of Medicine A total of 456 older adults (71.1% female, mean age: 74.6±6.6 years) We diagnosed probable sarcopenia by EWGSOP 2 criteria, i.e., presence of low handgrip strength (HGS). SARC-F questionnaire was performed by all participants. We used a receiver operating characteristics curve to obtain SARC-F cut-off values to detect probable sarcopenia and calculated the area under the curve and 95% confidence interval (CI). We included 456 participants (71.1% female; mean age: 74.6 ± 6.6 years). Probable sarcopenia was present in 58 (12.7%). SARC-F cut-off ≥ 2 presented the best balance between sensitivity and specificity (sensitivity: 64.9% vs specificity: 67.9%) to detect probable sarcopenia [the area under the receiver operating characteristics curve (AUC) = 0.710; 95% Cl: 0.660–0.752, p< 0.001]. SARC-F with a cutoff point ≥ 1 had sensitivity 84.2% and specificity 40.5% and SARC-F ≥ 4 had high specificity 88.2% with 40.3% sensitivity. SARC-F is a good screening tool for sarcopenia in practice. Our findings suggest SARC-F ≥ 1 cut-off point to be used as the probable sarcopenia screening tool regarding its high sensitivity. Consequently, SARC-F ≥ 4 cut-off is better to be used if one prefers to exclude probable sarcopenia.

To evaluate the prevalence of probable, confirmed, and severe sarcopenia in spondyloarthritis (SpA), according to the European Working Group on Sarcopenia in Older People 2019 (EWGSOP2) definition. A total of 103 patients (51% women) with SpA, mean age 47.1 ± 13.7 years, were included and compared to 103 age- and sex-matched controls. Grip strength was measured by dynamometry. Body composition was assessed by whole-body densitometry. In SpA patients gait speed was measured by the 4-m-distance walk test and quality of life was evaluated with a specific health-related questionnaire for sarcopenia (SaRQoL®). Twenty-two SpA patients (21%) versus 7 controls (7%) had a low grip strength, i.e., probable sarcopenia (p < 0.01), 15 SpA (15%) patients and 7 controls (7%) had low Skeletal Muscle mass Index (SMI) (ns), respectively, and 5 and 2% of SpA patients and controls had low grip strength and low SMI, i.e., confirmed sarcopenia (ns). All the sarcopenic SpA patients had a low gait speed, i.e., severe sarcopenia. Finally, probable sarcopenic SpA patients had significantly higher C-Reactive Protein (CRP, p < 0.001) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI score, p < 0.01), lower gait speed (p < 0.001), and SarQoL® score (p < 0.001) than SpA patients with normal grip strength. According to EWGSOP2 definition, the prevalence of probable sarcopenia was significantly higher in SpA patients compared to controls. Probable sarcopenia was associated with higher inflammation and disease activity, impaired muscle performance, and quality of life. These results suggest that muscle strength may be a salient hallmark in SpA.

Background and Objectives Sarcopenia in cirrhosis is associated with poor survival and adverse pre and post-transplant outcomes. The study aimed at determining the prevalence of sarcopenia and its association with the severity, complications and etiology of liver disease. Methods As many as 416 cirrhotic patients who met the inclusion criteria underwent muscle strength testing using a dynamometer. As many as 109 probable sarcopenia patients underwent computed tomography (CT) scan to measure skeletal muscle index (SMI) at the L3 vertebral level and gait-speed testing. The gender-specific cut-offs used to define sarcopenia were an SMI of 36.54 cm 2 /m 2 in males and 30.21 cm 2 /m 2 in females. A gait speed ≤ 0.8 m/s was taken as a cut-off to define severe sarcopenia in both genders. Results The mean age was 54.7 ± 9.51 years and male:female ratio was 2.2:1.The mean body mass index (BMI) was 24.2 ± 1.34 kg/m 2 . Alcohol and non-alcoholic steatohepatitis (NASH) were the two most common etiologies (45.9% and 31.2%). The proportion of patients belonging to Child-Pugh class A, B and C was 26.6%, 48.6% and 24.8%, respectively. Forty out of 109 (36.7%) patients had a model for end-stage liver disease (MELD) > 14. Ascites, upper gastrointestinal bleeding and hepatic encephalopathy (HE) were present in 59 (54.1%), 60 (55.0%) and 24 (22.0%) patients, respectively. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was found to be 26.20%, 10.09% and 6.73%, respectively. Sarcopenia and severe sarcopenia were associated with Child-Pugh class ( p  < 0.001, p  < 0.001), MELD ( p  = 0.007, 0.002), upper gastrointestinal bleed ( p  = 0.007, 0.004), ascites ( p  = 0.038, 0.025) and HE (0.001, < 0.001). Conclusion The prevalence of sarcopenia and severe sarcopenia was found to be 10.09% and 6.73%, respectively. Sarcopenia and severe sarcopenia had a significant association with the severity and complications of cirrhosis. However, no association was observed with etiology of liver disease. Graphical abstract

Objectives The aim of this study was to assess the associations between ultrasonographic masseter muscle thickness, sarcopenia and Eichner Index in outpatients over 60 years of age. Methods Participants who admitted to a geriatric outpatient clinic of a university hospital were included in this study. Comprehensive geriatric assessments were recorded. The European Working Group of Sarcopenia in Older People 2 criteria were used to evaluate sarcopenia and probable sarcopenia. Masseter muscle thickness (MMT) was measured bilaterally by ultrasonography. The sum of the mean MMT values for the right and left sides was divided into two equal parts, and the average of these two parts was recorded as the average MMT (AMMT). Masseter muscle was grouped into 3 types according to band appearances. State of dentition was evaluated according to the Eichner index. Results >Fourty-six participants whose median age was 73 were included in the study (19.6% probable sarcopenic, 30.4% sarcopenic). AMMT was significantly lower in those with high SARC-F scores compared to low SARC-F score group (p=0.041). AMMT, the distribution of Eichner groups, right and left masseter muscle fibriller types were similar in probable sarcopenia, sarcopenia and non-sarcopenic groups (p˃0.05). AMMT was significantly correlated with handgrip strength, appendicular skeletal muscle mass, calf circumference. Left-sided functional tooth units correlated positively with left MMT, whereas the Eichner index was not independently associated with sarcopenia. Conclusions Decreased MMT might be useful as a predictor of low appendicular skeletal muscle mass.

Milk is a source of several nutrients which may be beneficial for skeletal muscle. Evidence that links lower milk intake with declines in muscle strength from midlife to old age is lacking. We used data from the Medical Research Council National Survey of Health and Development to test sex-specific associations between milk consumption from age 36 to 60–64 years, low grip strength (GS) or probable sarcopenia, and GS decline from age 53 to 69 years. We included 1340 men and 1383 women with at least one measure of both milk intake and GS. Milk intake was recorded in 5-d food diaries (aged 36, 43, 53 and 60–64 years), and grand mean of total, reduced-fat and full-fat milk each categorised in thirds (T1 (lowest) to T3 (highest), g/d). GS was assessed at ages 53, 60–64, and 69 years, and probable sarcopenia classified at the age of 69 years. We employed logistic regression to examine the odds of probable sarcopenia and multilevel models to investigate decline in GS in relation to milk intake thirds. Compared with T1, only T2 (58·76–145·25 g/d) of reduced-fat milk was associated with lower odds of sex-specific low GS at the age of 69 years (OR (95 % CI): 0·59 (0·37, 0·94), P = 0·03). In multilevel models, only T3 of total milk (≥ 237·52 g/d) was associated with stronger GS in midlife in men (β (95 % CI) = 1·82 (0·18, 3·45) kg, P = 0·03) compared with T1 (≤ 152·0 g/d), but not with GS decline over time. A higher milk intake across adulthood may promote muscle strength in midlife in men. Its role in muscle health in late life needs further examination.

Background Probable sarcopenia is a condition related to low muscle strength which increases the risk of sarcopenia. Both probable sarcopenia and sarcopenia increases the risk of dementia. The aim of this study is to investigate the factors associated with dementia among probable sarcopenia and sarcopenia older adults. It was hypothesized that comorbidities among probable sarcopenia and sarcopenia subjects may elevate the risk of dementia. Methodology This study involved 194 older adults with probable sarcopenia and sarcopenia aged 60 years and above. Sarcopenia was assessed using the Asian Working Group of Sarcopenia (AWGS) 2019. Among the parameters investigated in this study were sociodemographic, medical history, anthropometry, body composition, physical fitness, subjective cognitive decline, depressive symptoms, cognitive function and functional status. Dementia risk was assessed using the Montreal Cognitive Assessment (MoCA) tool. Adjusted binary logistic regression was employed to identify the factors associated with dementia among probable sarcopenia and sarcopenia older adults. Results Probable sarcopenia subjects with dementia were older (68.5(7.8) years old) as compared to those without dementia (66.0(6.0) years old). Among the probable sarcopenia, 66.1% of the subjects with dementia had hypertension, while 64.3% of the sarcopenia subjects had hypertension. Fat mass was significantly higher among dementia subjects with probable sarcopenia (33.0(6.5) %) as compared to non-dementia subjects (30.4(6.8) %). Multivariate analysis revealed that hypertension (OR: 4.049; 95% CI: 1.510; 10.855, p  = 0.005) was the only factor associated with dementia risk among older adults with probable sarcopenia and sarcopenia. Conclusion Hypertension is the only factors associated with risk of dementia after adjusting for potential confounders among older adults with probable sarcopenia and sarcopenia. Good control of blood pressure is essential among sarcopenia patients for lowering risk of dementia. Well-designed clinical trials are essential to investigate optimizing blood pressure level to reduce risk of dementia among patients with sarcopenia and probable sarcopenia.

Background The European Working Group on Sarcopenia in Older People has recently defined new criteria for identifying “(probable) sarcopenia” (EWGSOP2). However, the prevalence of probable sarcopenia, defined by these guidelines, has not been determined extensively, especially in the oldest old. This study aims to determine the prevalence of probable sarcopenia in older, community-living people and its association with strength-related determinants. Methods Handgrip strength and reported determinants (age, height, weight, osteoarthritis of hands, medications, fall history, physical activity, activities of daily living (ADL) and global cognitive function) were collected in a cross-sectional study of 219 community-living Swiss people (75 years and over). Probable sarcopenia was estimated based on cut-off values for handgrip strength as recommended by EWGSOP2. Spearman correlations, binary-regression analyses and contingency tables were used to explore relationships between variables. Results The prevalence of probable sarcopenia in women ( n  = 137, age 84.1 ± 5.7 years) and men ( n  = 82, age 82.6 ± 5.2 years) was 26.3 and 28.0%, respectively. In women, probable sarcopenia correlated positively with age and falls (r s range 0.332–0.195, p  < .05), and negatively with weight, cognition, physical activity, using stairs regularly, participating in sports activities and ADL performance (r s range = − 0.141 - -0.409, p  < .05). The only significant predictor of probable sarcopenia at the multivariate level was ADL performance (Wald(1) = 5.51, p  = .019). In men, probable sarcopenia was positively correlated with age (r s  = 0.33, p  < .05) and negatively with physical activity, participation in sports and ADL performance (r s range − 0.221 – − 0.353, p  < .05). ADL performance and age (Wald(1) = 4.46, p  = .035 and Wald(1) = 6.30, p  = .012) were the only significant predictors at the multivariate level. Men and women with probable sarcopenia were 2.8 times more likely to be dependent in ADL than those without. Conclusion Probable sarcopenia affected one in every four community-living, oldest old people and was independently associated with impaired ADL performance in both sexes. This highlights the importance of detection of handgrip strength in this age group in clinical practice. Although prospective studies are required, independence in ADL might help to protect against probable sarcopenia.