Objectives:

Successful ART prolongs PLHIV survival, but metabolic complications like dyslipidemia and sarcopenia are rising. Research on these issues, particularly with newer integrase inhibitor-based regimens, remains limited.

Methods:

We evaluated 84 PLHIV on stable ART (> 2 years) for sarcopenia and metabolic abnormalities using functional assessments (HGS, SPPB), BIA, and detailed biochemical screening for dyslipidemia and insulin resistance.

Results:

Of 84 participants (71.4% male, mean age 38.97 ± 9.77 years), probable sarcopenia prevalence was 8.33% (using AWGS (Asian Working Group for Sarcopenia) criteria), while none had confirmed sarcopenia using BIA for measurement of muscle mass. Dysglycemia affected 33.0%, with 8.33% having diabetes. Dyslipidemia was observed in 76.19%. Metabolic syndrome prevalence was 16.6%. Compared to non-sarcopenic participants, those with probable sarcopenia had significantly lower median MUAC (23 vs. 26 cm, p=0.02 for both sides) and mid-thigh circumferences (Right: 41.5 vs. 45.5 cm, p=0.04; Left: 41 vs. 45 cm, p=0.05). Physical performance, measured by the SPPB score, was also significantly reduced (median 10 vs. 11; p=0.02).

Conclusion:

We identified probable sarcopenia and its correlates in stable PLHIV. Findings suggest current AWGS cutoffs require regional validation. High metabolic morbidity underscores significant cardiovascular risks, necessitating early intervention to optimize quality of life

Objectives:

Handgrip strength (HGS) is a key metric in cirrhosis. Multiple devices exist for HGS measurement, with gender specific cut-offs being established. However, the cut-offs do not account for potential differences between devices. We assessed the performance of the Camry EH101^® handgrip dynamometer against the gold-standard Jamar^® dynamometer in cirrhosis.

Methods:

This prospective observational study enrolled stable outpatients with cirrhosis (≥18 years). Baseline demographic and biochemical indices were assessed. HGS testing was performed by two dynamometers (Camry EH101^® and Jamar^®) and evaluated for correlation, systematic differences, and level of agreement.

Results:

76 stable outpatients [48.1±12.1 years, 50 (65.7%) were males, MASLD, 77.7%] were enrolled. The overall right HGS by Jamar^® and Camry EH101^® dynamometers in males was 31.3±6 Kg and 25.6±7.3Kg, respectively, while it was 19.4±4.7 and 15.0±3.4 in females. The correlation coefficient for right- and left-hand measurements was 0.82 (0.72-0.88) and 0.81 (0.72-0.88), respectively. Regression analysis showed no significant deviation from linearity. Bland-Altman plots for levels of agreement showed most values falling within the +/-1.96 SD range. However, there were outliers overall, representing a modest level of agreement.

Conclusion:

While the Jamar^® handgrip dynamometer remains the gold standard, alternatives like the Camry EH101^® dynamometer show good correlation and modest agreement.

Objectives:

This study aimed to evaluate phase angle (PhA) as a clinical marker of sarcopenia within the multidimensional Structure–Quality–Strength–Mobility (SQSM) framework and to compare its associations with muscle strength and physical performance against sarcopenia defined by appendicular skeletal muscle mass index (ASMI).

Methods:

A cross-sectional study was conducted on 87 older adults (mean age 68.8 years; 70.1% female) recruited into a structured exercise program. PhA and ASMI were measured via bioelectrical impedance analysis in the program’s final week. Muscle strength and physical performance were measured using the Asian Working Group for Sarcopenia definitions. The SQSM-operationalised definition(OD) of sarcopenia was classified as low PhA combined with either low handgrip strength (HGS) or gait speed(GS). Logistic regression assessed associations.

Results:

Phase angle ≤4.25° was associated with low HGS (OR=2.51, p=0.058), GS (OR=3.96, p=0.010), and falls (OR=4.20, p=0.024). SQSM-OD of sarcopenia showed higher prevalence and stronger association with falls (OR=5.77, p=0.008) than ASMI-defined sarcopenia.

Conclusion:

PhA was associated with low muscle strength, gait speed and falls supporting its role as a marker of muscle quality. SQSM-OD identified more at-risk individuals highlighting the utility of incorporating muscle quality into sarcopenia assessment.

Objectives:

Osteosarcopenia is characterized by the coexistence of sarcopenia and osteoporosis. This comorbid condition is thought to negatively affect functional outcomes. In this study, we investigated the negative impact of osteosarcopenia on the functional outcomes of older patients undergoing rehabilitation.

Methods:

This singlecenter retrospective cohort study was conducted at Hamamatsu City Rehabilitation Hospital in Japan and included 184 participants ≥65 years. Functional outcomes were assessed using the functional independence measure (FIM), the minimum clinically important difference (MCID) achieved on the FIM, and home discharge. Multiple linear and logistic regression analyses were conducted to assess the independent association of osteosarcopenia with FIM score at discharge and the FIM MCID. Additionally, the association between osteosarcopenia and home discharge was examined.

Results:

Osteosarcopenia was present in 30.4% of participants. Osteosarcopenia did not reach a statistically significant association with FIM at discharge (95% confidence interval [CI]: –2.518–8.489; β, 0.058), FIM MCID (odds ratio [OR]: 1.919; 95% CI: 0.698–5.277), or discharge to home (OR: 0.525; 95% CI: 0.126–2.189).

Conclusions:

Osteosarcopenia was prevalent among older patients undergoing rehabilitation, but its association with functional outcomes at discharge did not reach statistical significance. Intensive rehabilitation may have masked its adverse effects, warranting further longitudinal studies.

Objectives:

In patients receiving dialysis, the prevalence of frailty can be as high as 73%; however, systematic identification of frailty and the relation to disease burden is not standard practice. This study examined whether functional outcome measures would predict frailty and kidney disease burden among patients receiving dialysis, which would enable more efficient assessments.

Methods:

The study included twenty-eight patients receiving dialysis to analyze the number of falls in the past year, Timed Up and Go time, and 30-second sit-to-stand repetitions as predictors of the (a) Fried frailty score and (b) Kidney Disease Quality of Life burden of kidney disease subscale score.

Results:

The functional outcome measures were significant predictors of frailty score (R²=0.784, F=29.4, P<.001). The number of falls in the past year was a significant predictor of kidney disease burden (R²=0.22, F=7.20, P=.01).

Conclusions:

The results provide evidence for the use of higher Timed Up and Go times and fewer 30-second sit-to-stand repetitions as predictors of the Fried frailty score. An increased number of self-reported falls in the past year predicted a higher burden of kidney disease.

To examine whether self-selected hydrogen-rich water consumption was associated with 6-month changes in physical function among community-dwelling older adults attending community salons. This prospective observational study included 128 older adults in Hiroshima, Japan. Participants were classified as consumers or non-consumers at baseline and completed repeated assessments of the 30-second chair stand test, Timed Up and Go, usual gait speed, one-leg stance time, and grip strength. Primary analyses used analysis of covariance with robust standard errors, adjusting for baseline value, age, sex, fall history, and walking-aid use; mixed-effects and overlap-weighted models were sensitivity analyses. Compared with non-consumers, consumers had better adjusted 6-month chair-stand performance (1.85 repetitions, 95% confidence interval 1.11 to 2.59), gait speed (0.07 m/s, 0.04 to 0.10), one-leg stance time (1.78 s, 0.43 to 3.13), and grip strength (0.80 kg, 0.21 to 1.40). Timed Up and Go did not clearly differ (-0.39 s, -1.23 to 0.45). Self-selected hydrogen-rich water consumption was associated with better chair-stand performance and gait speed in this pragmatic community setting, but residual confounding remains possible.

Fear of falling is a common and distressing concern among people with multiple sclerosis due to the gait and balance impairments associated with the disease. Clinicians and researchers often assume that the degree of fear of falling, typically measured with the Falls Efficacy Scale International (FES-I), is proportional to activity restrictions or rehabilitation engagement. However, a low or high level of fear of falling alone does not indicate whether fear of falling influences individual’s performance of daily living activities. Fear of falling can either be adaptive (when aligned with functional capacity and actual fall risk) or maladaptive (when disproportionate to functional capacity and actual fall risk). In this personal viewpoint, I discuss the importance of contextualizing fear of falling assessment within the performance of daily living activities and propose that a function-focused assessment of fear of falling may enhance our understanding of whether it is adaptive or maladaptive. This approach may also provide targeted information to guide the development of interventions to address fear of falling in people with multiple sclerosis, help identify who requires intervention, and the type of intervention needed.