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      Prevalence of sarcopenia in community-dwelling older adults using the updated EWGSOP2 definition according to kidney function and albuminuria : The Screening for CKD among Older People across Europe (SCOPE) study

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          Abstract

          Background

          Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR).

          Methods

          A cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines.

          Results

          Median age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, ( p = 0.019).

          Conclusions

          Sarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of eGFR; as well as among those with higher albuminuria categories.

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          Most cited references 21

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          Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology—update 2014

          Sarcopenia is now defined as a decline in walking speed or grip strength associated with low muscle mass. Sarcopenia leads to loss of mobility and function, falls, and mortality. Sarcopenia is a major cause of frailty, but either condition can occur without the other being present. Sarcopenia is present in about 5 to 10 % of persons over 65 years of age. It has multiple causes including disease, decreased caloric intake, poor blood flow to muscle, mitochondrial dysfunction, a decline in anabolic hormones, and an increase in proinflammatory cytokines. Basic therapy includes resistance exercise and protein and vitamin D supplementation. There is now a simple screening test available for sarcopenia—SARC-F. All persons 60 years and older should be screened for sarcopenia and treated when appropriate.
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            Geriatric depression scale (GDS): recent evidence and development of a shorter version

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              An estimated glomerular filtration rate equation for the full age spectrum.

              Glomerular filtration rate (GFR) is accepted as the best indicator of kidney function and is commonly estimated from serum creatinine (SCr)-based equations. Separate equations have been developed for children (Schwartz equation), younger and middle-age adults [Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation] and older adults [Berlin Initiative Study 1 (BIS1) equation], and these equations lack continuity with ageing. We developed and validated an equation for estimating the glomerular filtration rate that can be used across the full age spectrum (FAS).
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                Author and article information

                Contributors
                rafamg86@hotmail.com
                xcorbella@bellvitgehospital.cat
                f.mattaceraso@erasmusmc.nl
                l.tap@erasmusmc.nl
                cornel.sieber@fau.de
                Ellen.Freiberger@fau.de
                tomasz.kostka@umed.lodz.pl
                agnieszka.guligowska@umed.lodz.pl
                itzikm@bgu.ac.il
                meltzer@bgu.ac.il
                axel.carlsson@ki.se
                johan.arnlov@ki.se
                regina.roller-wirnsberger@medunigraz.at
                gerhard.wirnsberger@medunigraz.at
                pgil@hcsc.insalud.es
                sara.lainez@salud.madrid.org
                P.FABBIETTI@inrca.it
                a.corsonello@inrca.it
                f.lattanzio@inrca.it
                fformiga@bellvitgehospital.cat
                Journal
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                2 October 2020
                2 October 2020
                2020
                : 20
                Issue : Suppl 1 Issue sponsor : SCOPE study and publication costs are funded by the European Union Horizon 2020 program. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.
                Affiliations
                [1 ]GRID grid.418284.3, ISNI 0000 0004 0427 2257, Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, , Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, ; Barcelona, Spain
                [2 ]Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Catalunya International University, Barcelona, Spain
                [3 ]GRID grid.5645.2, ISNI 000000040459992X, Department of Internal Medicine, Section of Geriatric Medicine, , Erasmus MC, University Medical Center Rotterdam, ; Rotterdam, The Netherlands
                [4 ]GRID grid.5330.5, ISNI 0000 0001 2107 3311, Department of Internal Medicine-Geriatrics, , Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, ; Nürnberg, Germany
                [5 ]GRID grid.8267.b, ISNI 0000 0001 2165 3025, Department of Geriatrics, Healthy Ageing Research Centre, , Medical University of Lodz, ; Lodz, Poland
                [6 ]GRID grid.7489.2, ISNI 0000 0004 1937 0511, Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, , Ben-Gurion University of the Negev, ; Beer-sheva, Israel
                [7 ]Maccabi Health Organization, Tel Aviv-Yafo, Israel
                [8 ]GRID grid.8993.b, ISNI 0000 0004 1936 9457, Department of Medical Sciences, , Uppsala University, ; Uppsala, Sweden
                [9 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, , Karolinska Institutet, ; Stockholm, Sweden
                [10 ]GRID grid.411953.b, ISNI 0000 0001 0304 6002, School of Health and Social Studies, , Dalarna University, ; Falun, Sweden
                [11 ]GRID grid.11598.34, ISNI 0000 0000 8988 2476, Department of Internal Medicine, , Medical University of Graz, ; Graz, Austria
                [12 ]GRID grid.411068.a, ISNI 0000 0001 0671 5785, Geriatric Department, , Hospital Clínico San Carlos, ; Martín Lagos S/N, 28040 Madrid, Spain
                [13 ]Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124 Ancona, Italy
                [14 ]Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
                Article
                1700
                10.1186/s12877-020-01700-x
                7531109
                33008317
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100010661, Horizon 2020 Framework Programme;
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
                Award ID: 634869
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