Sarcopenia Cut-points and Functionality in Older Adults

Study Overview
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Brief Summary
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This is a cross-sectional study conducted in older adults living in Valencia Province in order to establish the cut-off points of the multicriteria diagnostic of sarcopenia through functionality and frailty variables.

Detailed Description
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Sarcopenia is a geriatric syndrome that involves a gradual and generalized loss of the mass and strength of the skeletal muscles. Currently, there is an international debate about the criteria and reference values for the sarcopenia diagnosis, and the main scientific societies encourage improving research on this. The biggest problem lies in the assessment of the diagnostic criterion of muscle mass while the criterion of muscular strength seems safer and more robust. Experts point out the need to adjust the muscle mass indexes to the characteristics of the population studied, and the convenience of relating the three diagnostic criteria of sarcopenia (muscle mass and strength, and walking speed) with other variables that report about functionality and frailty in older adults. The main objective is to establish different cut-off points for the diagnostic criteria of sarcopenia and relate them with other instruments for assessing functionality in older population of Valencia Province. To this purpose, data will be collected through various tests and questionnaires about: clinical, demographic and anthropometric characteristics; muscle mass; muscle strength; walk speed; physical and cognitive function; nutritional status; self-perception of health; comorbidity and frailty. With this information it will be possible, as primary outcome, to determine a more sensitive, reliable and valid muscle mass index to predict sarcopenia, and, as a secondary outcome, to establish the relationship between the multicriteria diagnostic of sarcopenia with the functional and frailty variables.

Official Title
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Relationship Between the Sarcopenia Diagnostic Cut-points and Functionality in Older Adults

Conditions
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Sarcopenia, Diagnostic

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: People aged > 65 years Residents in Valencia Province (Living-Community, Day-Centers and institutionalized) Exclusion Criteria: Lobo Mini-exam cognoscitive < 18 score Any disorder that prevents from performing the assessment tests. Recent hospitalization or who are in a acute process of any illness (less one month).

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Older adults and Sarcopenia<br>Older adults with and without Sarcopenia living in Valencia Province. | Other: No intervention<br>* There is not intervention to be administered, only collection of data through various tests and questionnaires.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First criteria of sarcopenia diagnostic: hand grip strength | Muscle strength measured by the isometric hand grip strength (reference: Age and Aging. 2010;39:412-23). | The cohort group will be assessed in one day visit. | 
| First criteria of sarcopenia diagnostic: knew extension strength | Muscle strength measured by the isometric knew extension (reference: Phys Ther. 1996;76(3):248-59). | The cohort group will be assessed in one day visit. | 
| First criteria of sarcopenia diagnostic: elbow flexion strength | Muscle strength measured by the isometric elbow flexion (reference: Phys Ther. 1996;76(3):248-59). | The cohort group will be assessed in one day visit. | 
| Second criteria of sarcopenia diagnostic: muscle mass | Muscle mass estimated by Bioimpedance analysis (BIA) (reference: J Aging Phys Act. 2015;23(4):597-606). | The cohort group will be assessed in one day visit. | 
| Third criteria of sarcopenia diagnostic: walk speed | Walk speed measured by the Short Physical Performance Balance test (SPPB) (reference: J Gerontol A Biol Sci Med Sc 2000; 55(4):M221-31. | The cohort group will be assessed in one day visit. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functionality: Modified Baecke Questionnaire | Functionality measured by the Modified Baecke Questionnaire (reference: Med Clin.2007;129:326-32). The Modified Baecke Questionnaire results in a score to classify people as high, moderate, or low in daily physical activity, based on tertiles. Work Index = 0 1 +12 + 13 + 14 + 15 + 16 + 17 + I8)/8 Sport Index = 0 9 + 110 + II1 + I12)/4 Leisure Time Index = 0 ' 3 + 114 + 115 + 116 + 117 + 118 + I19V7 Total Index = work index + sports index + leisure time index. | The cohort group will be assessed in one day visit. | 
| Functionality: Barthel Index | Functionality measured by the Barthel Index (reference: Rev Esp Geriatr Gerontol.1993;28:32-40). Range from 0 to 100 score. High score of 100 means total independent. | The cohort group will be assessed in one day visit. | 
| Functionality: Lawton and Brody Questionnaire | Functionality measured by the Lawton and Brody Questionnaire (reference: Gerontologist.1969;9:179-86).Range from 0 to 8 score. High score of 8 means total independent to perform daily activities. | The cohort group will be assessed in one day visit. | 
| Frailty: Fried Scale | Frailty measured by the Fried Scale (reference: J Gerontol A Biol Sci Med Sc. 2001;56(3):M146-56). It is a scale with 5 domains: weight loss, self-reported exhaustion, physical activity, walking speed, and weakness. It has a total score ≥ 5 points. A frail person is who scores 3 to 5; is prefrail when scores is 1 to 2, and robust if scores is 0. | The cohort group will be assessed in one day visit. | 
| Frailty:Frail Scale | Frailty measured by the Frail Scale (reference: J Nutr Health Aging. 2012;16(7):601-8). It has a total score of 5 points. The more score the more frailty. As in Fried scale, participants with scores 3 to 5 is frail person; with scores 1 to 2 is prefrail, and robust if scores is 0. | The cohort group will be assessed in one day visit. | 
| Frailty: Kihon Check List (KCL) | Frailty measured by the Kihon Check List (reference: Geriatr Gerontol Int. 2016;16(6):709-15). The KCL is a simple self-reporting yes/no survey consisting of 25 questions structured into seven domains /dimensions. A total score ≥ 10 points allow to identify a frail person and each domain can identify the specific need. | The cohort group will be assessed in one day visit. | 
| Comorbidity | Comorbidity measured by Abbreviated Charslon Index (reference: J Chron Dis.1987;40:373-83). Range from 0 to 10 score. High score of 10 means high comorbidity; 0 means absence of comorbidity. | The cohort group will be assessed in one day visit. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Older adult, Sarcopenia, Frailty, Functionality, Muscle strength, Muscle mass, Walk speed