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Volume 4, Issue 4, December 2019

Original Article JFSF, Vol 4, No 4, December 2019, p.91-101
Osteosarcopenic obesity, the coexistence of osteoporosis, sarcopenia and obesity and consequences in the quality of life in older adults ≥65 years-old in Greece
Konstantia Keramidaki, Amalia Tsagari, Mina Hiona, Grigoris Risvas
Keywords: Sarcopenic obesity, Osteopenic obesity, Obesity, Frailty, Quality of life
Objective: We investigated the coexistence of sarcopenia and obesity in older adults≥65 years diagnosed with osteoporosis and the association with Quality of Life (QoL). Methods: A Cross-sectional survey has been performed on a randomized sample of 50 diagnosed osteoporotic elderly people from both sexes (Men=16; Women=34). Measurements: Quantitative ultrasound was conducted to identify osteoporosis and defined with a T score ≤2.5. Validated anthropometric equations were used in order to estimate body fat percentage and skeletal muscle mass so as to detect the reallocation of body fat and lean muscle. 10m gait speed and hand grip strength was measured in order to diagnose sarcopenia according to European Society for Clinical Nutrition and Metabolism (ESPEN) algorithm. The evaluation of QoL was conducted using a QoL questionnaire specific to osteoporosis. The data were analyzed with descriptive statistics and a chi-square test was performed to examine if Osteosarcopenic Obesity (OSO) is sex related and the correlation between OSO and QoL. Results: From the 50 participants, 40%(n=19) were classified as people with OSO and 60%(n=31) without OSO. From n=19 people that experienced OSO women represent 20% (n=9) and men 18% (n=9); with the latter had a greater decline in muscle mass than women, while women had lower BMD than men according to the z score. OSO is not related with sex (p>.05) and there is no significant association between OSO and QoL (p>.05 for all the domains of QoL questionnaire). Conclusion: Osteoporosis in the elderly often coexists with reduced muscle mass and muscle strength as well as an increase in adiposity and was independently associated with QoL. People that experience OSO presenting lower functionality that increases the risk for falls and bone fractures originated from the decline in bone and muscle mass, and increased adiposity. Increased awareness of OSO may help develop efficient interventions and public health policies for healthier and more active elderly people.
Original Article JFSF, Vol 4, No 4, December 2019, p.102-110
Changes in physical activity predict changes in a comprehensive model of balance in older communitydwelling adults. A longitudinal analysis of the TILDA study
Ilona I. McMullan, Brendan P. Bunting, Suzanne M. McDonough, Mark A. Tully, Karen Casson
Keywords: Falls, Low-intensity physical activity, TILDA
Objective: Falls due to poor balance can cause injury, disability, and death in older adults. The relationship between free-living physical activity (PA) and balance over time is poorly understood. The aim of this study is to explore the association between PA and balance in older adults over time. Methods: Using two waves of data from the TILDA study (n=8,504 participants) a structural equation model was used to identify a composite measure of balance that incorporated measures of Timed Up and Go; handgrip strength; Mini Mental State Exam; vision; hearing; and steadiness. The patterns of change in PA and balance were then compared over time (controlling for covariates). Results: The results showed that one extra metabolic equivalent of task (MET) minute of PA improves balance by 4% over one week (Est=-0.10, SE=0.12), and by 5% cumulatively over two years (Est=-0.13, SE=0.02). Medication, alcohol consumption, sex, age, fear of falling, education, pain, and problems performing activities of daily living (ADL) were risk factors for balance. Conclusion: This study provides a novel and robust model that should guide comprehensive balance assessment. PA promotion should engage older adults in more free-living PA that may be more relevant to them.
Opinion Article JFSF, Vol 4, No 4, December 2019, p.111-115
Implementing frailty assessment into a healthcare system: a clinical opinion paper
Eftychia Kyriakou, Dimitrios Tzefronis, Georgia Dagianta, Ioannis K. Triantafyllopoulos
Keywords: Screening, Frailty assessment, Frailty diagnosis, Frailty syndrome, Geriatric assessment instruments
Frailty is a multifactorial medical syndrome characterized by reduced endurance and decreased physiological ability. The aim of this narrative literature review is to present the frailty diagnostic instruments that are already used in most Western countries and provide recommendations for use in clinical practice. Among the numerous available frailty instruments identified in current literature, the Frailty Index and the Physical Frailty Phenotype are most commonly used. There are large differences in each instrument design, ease of use by healthcare teams and also significant heterogeneity in the design of the studies based on these instruments. Therefore, future studies should be designed to properly address the discrepancy in the comparison of the existent instruments and consider their validity and feasibility of implementation in different healthcare settings with different healthcare providers.
Original Article JFSF, Vol 4, No 4, December 2019, p.116-121
Evaluation of physical performance in musculoskeletal and rheumatic diseases with jumping mechanography
Yannis Dionyssiotis, Grigorios Skarantavos, Inga Kantaidou, Maria-Christina Papadatou, Panayiotis Papagelopoulos, Antonios Angoules, Jannis Papathanasiou, George P. Lyritis
Keywords: Sarcopenia, Jumping mechanography, Rheumatic diseases, Osteoporosis, Menopause
Objective: Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseases are related to increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and postmenopausal women and women with rheumatic diseases. Methods: Two hundred fifty seven women were included in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. Results: Height was decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical significance was found among POST HEALTH and POST OST women. Conclusions: Jumping mechanography can be proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.