Biomarkers of Sarcopenia and Frailty in Geriatric Patients

Study Overview
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Brief Summary
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During the last decades there has been an increase in the relative proportion and life expectancy of elderly people. Hence, the number of elderly with diseases and disabilities related to aging will increase and consequently, age-related losses in skeletal muscle mass and physical function represents an important current and future public health issue. Sarcopenia is a progressive and generalized skeletal muscle disorder that is considered central to the development of physical deconditioning and untreated sarcopenia is linked to falls, morbidity, and mortality. The underlying mechanisms behind the progressive loss of muscle mass and function associated with aging are yet unknown but seems to be multifactorial. A decrease in physical activity level and an altered central and peripheral nervous system innervation have been identified as some of the contributing factors. Furthermore, chronic low-grade inflammation has been proposed as a central contributor to sarcopenia and thus physical frailty. However, it is not yet clear whether the elevated markers of inflammation seen in the elderly are due to aging, chronic illness, or inactivity. But overall, it seems that inflammation plays an important role in the development of muscle loss, and is related to increased risk of falls, fragility, and early death.

Official Title
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Biomarkers of Sarcopenia and Frailty in Geriatric Patients

Conditions
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Sarcopenia, Muscle Loss, Fall Patients

Intervention / Treatment
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* Other: Assessing sarcopenia and potential biomarkers of sarcopenia in fall patients


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Geriatric patients referred to out-patient clinic for fall assessments equal to or over the age of 65 Exclusion Criteria: age under 65 years participants who do not understand Danish severe communicative problems moderate to severe dementia or cognitive deficits no independent walking

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 |
| --- | --- |
| Home-dwelling geriatric outpatients<br>Home-dwelling geriatric outpatients from the Falls Clinic at Gentofte Hospital . Clinical assesment: Blood test, body composition (BIA and/or DXA), balance tests (sway), handgrip strength, isometric knee extension strength, chair-rise test, gait-speed, thickness of the thigh muscles, screening for sarcopenia (SARC-F), screening for malnutrition (SNAQ), screening for depression (GDS-15), screening for self-rated health (EQ-5D-5L), frailty (CSHA Frailty Scale) | Other: Assessing sarcopenia and potential biomarkers of sarcopenia in fall patients<br>* Blood test, body composition (BIA and/or DXA), balance tests (sway), handgrip strength, isometric knee extension strength, chair-rise test, gait-speed, thickness of the thigh muscles (ultrasound), screening for sarcopenia (SARC-F), screening for malnutrition (SNAQ), screening for depression (GDS-15), screening for self-rated health (EQ-5D-5L), frailty (CSHA Frailty Scale)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Skeletal muscle mass | Determination of skeletal muscle mass measured by Bioelectrical Impedance analysis (BIA Inbody770) | Baseline | 
| Appendicular lean muscle mass | Determination of appendicular lean muscle mass (The sum of the lean tissue is the arms and legs) measured by Bioelectrical Impedance analysis (BIA Inbody770) | Baseline | 
| Skeletal muscle mass index (SMI) | Determination of skeletal muscle mass index (The sum of the lean tissue is the arms and legs scaled to height squared (ALM/height(2)) measured by Bioelectrical Impedance analysis (BIA Inbody770) | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle Thickness | Determination of muscle thickness of the vastus laterals og rectus femoris assessed by ultrasound | Baseline | 
| Muscle strength (upper body) | Determination of muscle strength measured by a handgrip dynamometer | Baseline | 
| Muscle strength (lower body) | Determination of maximal isometric quadriceps muscle strength measured by a handheld dynamometer | Baseline | 
| Physical Activity (Chair rise) | Determination of physical activity assessed by 30 s sit-to-stand chair rise test and five times sit-to-stand test | Baseline | 
| Physical Activity (Gait speed) | Determination of physical activity assessed by habitual and maximal 6 meters walking speed | Baseline | 
| Postural sway | Determination of postural sway will be evaluated with a HUR balance force plate. This device is a precision device that provides objectively measurable data. Thanks to its movable platform, it can measure in all directions. The patients will be performing three balance test; Romberg balance test, tandem test and 15 s one-leg-stand. | Baseline | 
| SARC-F (sarcopenia screening) | The SARC-F questionnaire is used as a screening tool to identify probable sarcopenia patients. The scores range from 0 to 10, with 0 to 2 points for each component. Studies suggested that a score equal to or greater than 4 is predictive of sarcopenia and poor outcomes. | Baseline | 
| Geriatric Depression Scale (GDS-15) | GDS-15 is used as a screening tool to facilitate assessment of depression. Scores of 0-4 are considered normal; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression. | Baseline | 
| SNAQ (malnutrition) | The Short Nutritional Assessment Questionnaire (SNAQ) is used as a screening tool to get an insight into patients' nutritional status. Patients with 2 points were classified as moderately malnourished and patients with 3 points or more are classified as severely malnourished. | Baseline |