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Anorexia is Independently Associated with Decreased Muscle Mass and Strength in Community Dwelling Older Adults

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The journal of nutrition, health & aging

Abstract

Objectives

We aimed to investigate the association between anorexia and sarcopenia in community dwelling older adults.

Method

Anorexia was assessed by Simplified Nutritional Appetite Questionnaire (SNAQ) and sarcopenia defined by EWSGOP criteria. Study participants consisted of 442 patients from Turkish validation study of the SNAQ. Study is designed as cross-sectional in community dwelling outpatients.

Measurements

Muscle mass was determined by using bioimpedance analysis. Skeletal muscle mass index (SMMI) was calculated as SMM (kg)/height (m)2. Muscle strength was evaluated by hand grip strength (HGS) with Jamar hydraulic hand dynamometer. Gait speed (GS) was assessed by usual 4 meters speed. Depression and quality of life were assessed by using Geriatric Depression Scale (GDS) and Euro-Quality of Life-5D(EQ-5D). Univariate analysis and multivariate regression analysis were run to evaluate the association between poor appetite and components of sarcopenia.

Results

Prevalences of low HGS, low gait speed and sarcopenia were higher in group with poor appetite (p=0.001, p<0.0001, p=0.036, respectively). Depression and constipation were more prevalent in participants with poor appetite (p<0.0001, p=0.033, respectively). SNAQ was correlated with SMMI and EQ-5D. Regression analysis showed that lower muscle mass, lower SMMI, and lower HGS were independently associated with poor appetite after adjustment for confounders. Neither gait speed nor diagnosis of sarcopenia was associated with poor appetite in regression analysis models.

Conclusion

We observed poor appetite has independent association with lower skeletal muscle mass and decreased muscle strength. Prospective studies are needed to evaluate exact relationship between poor appetite and sarcopenia.

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References

  1. Schilp J, Wijnhoven HAH, Deeg DJH et al. Early determinants for the development of undernutrition in an older general population: Longitudinal aging study Amsterdam. Br J Nutr 2011;106:708–717.

    Article  CAS  PubMed  Google Scholar 

  2. Castel H, Shahar D, Harman-Boehm I. Gender differences in factors associated with nutritional status of older medical patients. J Am CollNutr 2006;25:128–134.

    Google Scholar 

  3. Landi F, Calvani R, Tosato M, et al. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments. Nutrients. 2016;8(2):69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, Diebold MR, Morley JE. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J ClinNutr. 2005 Nov;82(5):1074–81.

    CAS  Google Scholar 

  5. Ilhan, B., Bahat, G., Oren, M.M. et al. J Nutr Health Aging (2018). https://doi.org/10.1007/s12603-018-1051-3

    Google Scholar 

  6. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010 Jul;39(4):412–23.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Morley JE, Abbatecola AM, Argiles JM, et al; Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011 Jul;12(6):403–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Calvani, R.; Martone, A.M.; Marzetti, E.; Onder, G.; Savera, G.; Lorenzi, M.; Serafini, E.; Bernabei, R.; Landi, F. Pre-hospital dietary intake correlates with muscle mass at the time of fracture in older hip-fractured patients. Front. Aging Neurosci. 2014, 6,269.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Barillaro C, CapoluongoE, Bernabei R, Onder G. Association of anorexia with sarcopenia in acommunitydwelling elderly population: results from the ilSIRENTE study. Eur JNutr. 2013 Apr;52(3):1261–8.

    Article  Google Scholar 

  10. Mohamad HA Jr, Suzana S, Noor Ibrahim MS, Norshafarina S. Relationship between Appetite, Food Intake and Body Composition among Elderly Malays from an Urban Residential Area in Kuala Lumpur, Malaysia. Malays J Nutr. 2010 Dec;16(3):339–48. Epub 2010 Dec15.

    PubMed  Google Scholar 

  11. Nakatsu N, Sawa R, Misu S, Ueda Y, Ono R. Reliability and validity of the Japanese version of the simplified nutritional appetite questionnaire in community-dwelling older adults. Geriatr Gerontol Int. 2015 Dec;15(12):1264–9.

    Article  PubMed  Google Scholar 

  12. Dent E, Chapman I, Piantadosi C, Visvanathan R. Nutritional screening tools and anthropometric measures associate with hospital discharge outcomes in older people. Australas J Ageing. 2015 Mar;34(1):E1–6. doi: 10.1111/ajag.12130. Epub 2014 Jan21.

    Article  PubMed  Google Scholar 

  13. Pilgrim AL, Baylis D, Jameson KA, Cooper C, Sayer AA, Robinson SM, Roberts HC. Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes. J Nutr Health Aging. 2016 Jan;20(1):3–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Muscaritoli M, Anker SD, Argiles J, Aversa Z, Bauer JM, Biolo G, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr. 2010 Apr;29(2):154–9.

    Article  CAS  PubMed  Google Scholar 

  15. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011 May;12(4):249–56.

    Google Scholar 

  16. Dam TT, Peters KW, Fragala M, Cawthon PM, Harris TB, McLean R, et al. An evidence-based comparison of operational criteria for the presence of sarcopenia. J Gerontol A Biol Sci Med Sci. 2014 May;69(5):584–90.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, Erten N, Karan MA, Cruz-Jentoft AJ. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. ClinNutr. 2016 Dec;35(6):1557–1563.

    Google Scholar 

  18. Deurenberg P, Pietrobelli A, Wang ZM, Heymsfield SB. Prediction of total body skeletal muscle mass from fat-free mass or intra-cellular water. Int J Body Compos Res. 2004;2:107e13.

    Google Scholar 

  19. Baumgartner RN, Koehler KM, Gallagher D et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;15;147(8):755–63

    Article  CAS  PubMed  Google Scholar 

  20. Fess EE (1992) Grip strength. In: Clinical assessment recommendations. 2 nd edn. Edited by Casanova JS. Chicago: American Society of Hand Therapists, pp 41–45.

    Google Scholar 

  21. Massy-Westropp NM, Gill TK, Taylor AW et al. Hand Grip Strength: age and gender stratified normative data in a population-based study. BMC Res Notes. 2011 Apr14;4:127.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Durmaz B., Soysal P., Ellidokuz H., Isik A. T. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. North Clin Istanb 2018.

    Google Scholar 

  23. EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208.

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Correspondence to Birkan İlhan.

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İlhan, B., Bahat, G., Erdoğan, T. et al. Anorexia is Independently Associated with Decreased Muscle Mass and Strength in Community Dwelling Older Adults. J Nutr Health Aging 23, 202–206 (2019). https://doi.org/10.1007/s12603-018-1119-0

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  • DOI: https://doi.org/10.1007/s12603-018-1119-0

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