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02/2019 journal articles

THE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS-2 (TREM-2) AS EXPRESSION OF THE RELATIONSHIP BETWEEN MICROGLIA AND ALZHEIMER’S DISEASE: A NOVEL MARKER FOR A PROMISING PATHWAY TO EXPLORE

C. Gussago, M. Casati, E. Ferri, B. Arosio

J Frailty Aging 2019;8(2):54-56

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Alzheimer’s disease (AD) is a common neurodegenerative disorder, strongly related with age. It has been reported that genetic variants of the Triggering Receptor Expressed on Myeloid Cells-2 (TREM2), a cell-surface receptor expressed in microglial cells, greatly increase the risk of AD, thus suggesting an involvement of the microglia in the AD pathogenesis. The aim of this report is to provide an overview of the TREM2 and of its possible implication in the pathogenesis of AD.

CITATION:
C. Gussago ; M. Casati ; E. Ferri ; B. Arosio (2018): The Triggering Receptor Expressed on Myeloid cells-2 (TREM-2) as expression of the relationship between microglia and Alzheimer’s disease: a novel marker for a promising pathway to explore. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2018.43

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LONGITUDINAL CHANGES IN MUSCLE MASS AND FUNCTION IN OLDER MEN AT INCREASED RISK FOR SARCOPENIA – THE FrOST-STUDY

W. Kemmler, S. von Stengel, D. Schoene

J Frailty Aging 2019;8(2):57-61

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Background: Declines in muscle mass and function are inevitable developments of the advanced aging process. Corresponding dimensions of longitudinal changes in at-risk populations are still scarce although clinically relevant. The present study monitored changes in morphologic and functional sarcopenia criteria related to sarcopenia in older men with low muscle mass over a period of 24 months. Objectives: The main objective of the present study was to determine whether changes in muscle mass and function were comparable across the body. Our hypothesis was that both (1) fat free mass (FFM) and (2) function decline at a significantly higher rate in the lower versus the upper extremities. Design: We conducted an observational study of 24 months. Setting: Community dwelling men living in the area of Northern Bavaria were initially included in the Franconian Sarcopenic Obesity (FranSO) study by the Institute of Medical Physics University of Erlangen-Nürnberg, Germany. Participants: One hundred and seventy-seven (177) men (77.5±4.5 years) within the lowest skeletal muscle mass index (SMI) quartile of the FranSO study were included in the present 24 month analysis. Measurements: Fat free mass (direct-segmental, multi-frequency Bio-Impedance-Analysis (DSM-BIA)), handgrip strength (hand-dynamometer) and 10-m habitual gait velocity (photo sensors) were assessed at baseline and 24-month follow-up. Results: Lower extremity fat free mass (LEFFM: -2.0±2.4%), handgrip strength (-12.8±11.0%) and gait velocity (-3.5±9.0%) declined significantly (p<.001) during the follow-up period, while upper extremity FFM was maintained unchanged (UEFFM: 0.1±3.1%). Changes in LEFFM were significantly higher (p<.001) compared with UEFFM, however contrary to our expectation the decline in handgrip strength representing upper extremity muscle function was 3.7-fold higher (p<.001) than the decline in gait velocity. Conclusion: Medical experts involved in diagnosis, monitoring and management of sarcopenia should consider that parameters constituting morphologic and functional sarcopenia criteria feature different rates of decline during the aging process.

CITATION:
W. Kemmler ; S. von Stengel ; D. Schoene (2019): Longitudinal changes in muscle mass and function in older men at increased risk for sarcopenia – the FrOST-study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.9

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THE ASSOCIATION OF APOE Ε4 STATUS WITH LOWER LIMB FUNCTION AND HANDGRIP STRENGTH IN OLDER ADULTS

M. Maltais, P. de Souto Barreto, Y. Rolland, B. Vellas, for the MAPT/DSA Study Group

J Frailty Aging 2019;8(2):62-66

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Background/Objectives: Apolipoprotein (ApoE ε4) status has been associated with various cardiovascular diseases and Alzheimer’s Disease. Some studies have found a possible relationship between the presence of an ApoE ε4 allele and the decrease of motor function in healthy older adults. The objective of this study was to measure the cross-sectional and prospective associations of ApoE ε4 status with lower limb function and handgrip strength in older adults. Design: Longitudinal observational study using data from a randomized controlled trial.Setting: Community-dwelling older adults. Participants: 1300 older adults (≥70 years old) with ApoE ε4 status from the Multidomain Alzheimer’s Preventive Trial (MAPT) were followed for three years. Measurements: Lower-limb function was measured with the Short Physical Performance Battery (SPPB) and muscle strength was measured with a handgrip strength dynamometer. ApoE ε4 status was assessed with a blood draw. Mixed-effect linear regressions were used to examine cross-sectional as well as prospective associations between ApoE ε4 status and the outcomes. Results: No significant cross-sectional or prospective associations were found between ApoE ε4 status, lower-limb function and handgrip strength in our study. Conclusions: ApoE ε4 status was not associated with motor function in older adults.

CITATION:
M. Maltais ; P. de Souto Barreto ; Y. Rolland ; B. Vellas ; for the MAPT/DSA Study Group (2019): The association of ApoE ε4 status with lower limb function and handgrip strength in older adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.7

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DEFINING FRAILTY IN RESEARCH ABSTRACTS: A SYSTEMATIC REVIEW AND RECOMMENDATIONS FOR STANDARDIZATION

E. Yaksic, V. Lecky, S. Sharnprapai, T. Tungkhar, K. Cho, J.A. Driver, A.R. Orkaby

J Frailty Aging 2019;8(2):67-71

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Multiple definitions of frailty are used. We sought to quantify the frequency that frailty is insufficiently defined in published abstracts. We conducted a systematic review of MEDLINE/PubMed for English abstracts of original research investigating frailty as an exposure or outcome in humans from 2015-2017. A complete definition of frailty included: 1) a named measure of frailty, including “frailty” alone, 2) details on variables included (e.g. grip strength), 3) number of variables included (e.g. 33-item frailty index), and 4) details on cutoffs or levels of frailty unless a definition was used continuously. Our search yielded 1,110 titles; 490 abstracts met review criteria, 348 abstracts had any definition of frailty and were included. Majority reported a single measure of frailty (n=313, 90%). The most commonly used measures were variations of Fried’s phenotype (n=167, 48%) and Rockwood’s cumulative deficit model (n=101, 29%). Only 56 abstracts had complete definitions (16%). In 123 abstracts (35%), a means of measuring frailty was named, but no additional details were given. When details of the frailty measure were described, they generally referred to cutoffs or levels rather than variables used in the measure. A minority of abstracts of original manuscripts related to frailty research had adequate definitions of frailty. We encourage scientists to adopt a standardized approach to defining the term for all abstracts related to frailty research to facilitate systematic reviews, meta-analysis, and accurate reporting of frailty science.

CITATION:
E. Yaksic ; V. Lecky ; S. Sharnprapai ; T. Tungkhar ; K. Cho ; J.A. Driver ; A.R. Orkaby (2019): Defining Frailty in Research Abstracts: A Systematic Review and Recommendations for Standardization. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.4

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PSOAS AND PARASPINOUS MUSCLE MEASUREMENTS ON COMPUTED TOMOGRAPHY PREDICT MORTALITY IN EUROPEAN AMERICANS WITH TYPE 2 DIABETES MELLITUS

B.M. Tucker, F.C. Hsu, T.C. Register, J. Xu, S.C. Smith, M. Murea, D.W. Bowden, B.I. Freedman, L. Lenchik

J Frailty Aging 2019;8(2):72-78

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Background: Appendicular skeletal muscle mass index and muscle attenuation (density) are negatively associated with mortality in European-derived populations. Objectives: The present analyses assessed association between axial skeletal muscle density and muscle index with mortality in European Americans with type 2 diabetes mellitus (T2D). Design: Single-center observational study. Setting: Diabetes Heart Study. Participants: 839 European Americans with T2D. Methods: Computed tomography-measured psoas and paraspinous muscle mass index (cross sectional area/height2) and radiographic density (Hounsfield Units) were assessed in all participants. A Cox proportional hazards model was computed. The fully-adjusted model included covariates age, sex, body mass index, smoking, alcohol use, diabetes duration, insulin use, hormone replacement therapy (women), prevalent cardiovascular disease (CVD), hypertension, and coronary artery calcified atherosclerotic plaque mass score. Deaths were recorded in the National Death Index data through December 31, 2015. Results: Participants included 428 women and 411 men with median (25th, 75th quartile) age 62.8 (56.1, 69.1) years and diabetes duration 8.0 (5.0, 14.0) years. After 11.9 (9.4, 13.3) years of follow-up, 314 (37.4%) of participants were deceased. In the fully-adjusted model, psoas muscle density (hazard ratio [HR] 0.81, p<0.001), psoas muscle index (HR 0.82, p=0.008), and paraspinous muscle density (HR 0.85, p=0.003) were inversely associated with mortality. Paraspinous muscle index was not significantly associated with mortality (HR 0.90, p=0.08). Results did not differ significantly between men and women. Conclusions: In addition to established risk factors for mortality and CVD, higher psoas muscle index, psoas muscle density, and paraspinous muscle density were significantly associated with lower all-cause mortality in European Americans with T2D.

CITATION:
B.M. Tucker ; F.C. Hsu ; T.C. Register ; J. Xu ; S.C. Smith ; M. Murea ; D.W. Bowden ; B.I. Freedman ; L. Lenchik (2019): Psoas and paraspinous muscle measurements on computed tomography predict mortality in European Americans with type 2 diabetes mellitus. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.5

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AN ULTRASOUND PREDICTION EQUATION TO ESTIMATE DXA-DERIVED BODY FATNESS FOR MIDDLE-AGED AND OLDER CAUCASIAN ADULTS

T. Abe, J.P. Loenneke, R.S. Thiebaud

J Frailty Aging 2019;8(2):79-84

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Background & Objectives: Currently, only one study has used dual-energy X-ray absorptiometry (DXA)-derived percent body fat (BF%) as the criterion measure to develop ultrasound prediction equations to estimate BF% in adults between the ages of 50 and 80 years. The aim of this study was to examine the relationship between BF% estimated from subcutaneous fat thickness using a previously published Japanese-based prediction equation and DXA-derived BF% in Caucasian middle-aged and older adults. A secondary aim was to develop a new prediction equation for Caucasian adults if the previously published equation did not predict BF% well in Caucasians. Design: Cross-sectional study. Participants & Measurements: One-hundred and two Caucasian adults aged 50-76 years (59 men and 43 women) had ultrasound fat thickness and DXA values measured. A new BF% prediction model was developed using ordinary least squares multiple linear regression. Results: There was a strong correlation between ultrasound predicted and DXA-derived BF% (r = 0.882, p<0.001). Bland-Altman analysis did not indicate a bias in the prediction of BF% for Caucasian adults (r = -0.092, p>0.05). However, the predicted BF% was significantly higher compared to DXA-derived BF% (approximately 4%). A newly developed nonlinear prediction model used to estimate BF% was significant [F(17,84) = 33.44, p<0.001] with an R2 of 0.871 and an adjusted R2 of 0.845. When examining the stability of the model, bootstrapping (n=1000) resulted in an optimism value of 0.1135 so that the corrected R2 was 0.758. After removing an outlier, the model was significant [F(17,83) = 34.82, p<0.001] and it’s R2 was 0.877 and adjusted R2 was 0.852. Conclusion: The developed equation was stable with a high degree of variance compared to results from previous studies. The results of this study also suggest that ethnicity should be considered when choosing which prediction equations should be used to estimate BF%.

CITATION:
T. Abe ; J.P. Loenneke ; R.S. Thiebaud (2019): An ultrasound prediction equation to estimate DXA-derived body fatness for middle-aged and older Caucasian adults. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.8

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PREDICTIVE ABILITY OF SEVEN DOMAINS OF THE KIHON CHECKLIST FOR INCIDENT DEPENDENCY AND MORTALITY

S. Satake, H. Shimokata, K. Senda, I. Kondo, H. Arai, K. Toba

J Frailty Aging 2019;8(2):85-87

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The Kihon Checklist (KCL) is a structured questionnaire consisting of 7 domains to assess seniors’ function in daily living. The aim of this study was to examine which domains of the KCL can predict incident dependency and mortality. The municipality sent a KCL questionnaire to independent seniors in Higashi-ura Town and collected the answers of the 5542 seniors who provided complete answers. Their incident dependency and mortality were followed-up for 2.5 years. A Cox proportional hazard model indicated that meeting any of the criteria in instrumental activities of daily living, physical, nutrition, and mood domains significantly predicted the risk of dependency, whereas meeting any of the criteria in physical, nutrition and socialization domains significantly predicted the risk of mortality. Category assessment by the KCL could be useful to predict incident dependency and all-cause mortality.

CITATION:
S. Satake ; H. Shimokata ; K. Senda ; I. Kondo ; H. Arai ; K. Toba (2019): Predictive ability of seven domains of the Kihon Checklist for incident dependency and mortality. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.3

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AGE OF HIV ACQUISITION AFFECTS THE RISK OF MULTI-MORBIDITY AFTER 25 YEARS OF INFECTION EXPOSURE

G. Guaraldi, A. Malagoli, J. Milic, I. Pintassilgo, E. Rossi, N. Riva, I. Franconi, A. Santoro, P. Sorin, A. Streinu-Cercel, M. De Rosa, C. Mussini

J Frailty Aging 2019;8(2):88-92

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Introduction: Understanding the intersection of HIV, aging and health is crucial due to the increasing number of people aging with HIV. Objective: The objective of the study was to assess the prevalence of, and risk factors for individual comorbidities and multi-morbidity in people living with HIV with similar duration of HIV infection, notwithstanding a 25-year difference at the time of HIV acquisition. Methods: In a cross-sectional multicentre retrospective study, we compared three match-control age groups. The “Young” were selected from Romania and included HIV-positive patients prenatally infected and assessed at the age of 25-30 years. The “Old” and the “Geriatric” were selected from Italy. These respectively included subjects infected with HIV at the age of 25 years and assessed at the age of 50-55 years, and those infected at the age of 50 years and assessed at the age of 75-80 years. Each group was sex and age matched in a 1:5 ratio with controls selected from the CINECA ARNO database from Italy. We described non-infectious comorbidities (NICM), including cardiovascular disease, hypertension, dyslipidaemia, diabetes, chronic kidney disease, and multi-morbidity (MM≥ 3 NICM). Results: MM prevalence in the “Young” group compared to controls was 6.2% vs 0%, while in the “Geriatric” was “68.2% vs 3.6%. Using “Young” as a reference, in multivariate analyses, predictors for MM were as follows: HIV serostatus (OR=47.75, IQR 14.78-154.25, p<0.01) and “Geriatric” vs “Young” (OR=30.32, IQR 5.89-155.98, p<0.01). Conclusion: These data suggest that age at acquisition of HIV should be considered as a risk factor for NICM and MM.

CITATION:
G. Guaraldi ; A. Malagoli ; J. Milic ; I. Pintassilgo ; E. Rossi ; N. Riva ; I. Franconi ; A. Santoro ; P. Sorin ; A. Streinu-Cercel ; M. De Rosa ; C. Mussini (2019): Age OF HIV acquisition affects the risk of multi-morbidity after 25 years of infection exposure. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.6

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ECONOMIC IMPACT OF HOSPITALIZATIONS IN US ADULTS WITH SARCOPENIA

S. Goates, K. Du, M.B. Arensberg, T. Gaillard, J. Guralnik, S.L. Pereira

J Frailty Aging 2019;8(2):93-99

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Background: Sarcopenia is characterized by progressive loss of muscle mass with corresponding decline in strength and/or physical function. The economic burden of sarcopenia-associated disability is considerable in the US. Objective: To estimate the cost of hospitalizations in US adults with sarcopenia categorized by age, sex, and race/ethnicity. Design, setting and participants: A retrospective, prevalence based, economic burden study, consisting of 4011 adults aged ≥40 years with and without sarcopenia. Methods: Data on prevalence of low lean mass, functional limitations, and hospitalizations were obtained from the National Health and Nutrition Examination Survey (1999-2004); cost of hospitalizations was obtained from the Healthcare Cost and Utilization Project - National Inpatient Sample (2014), and population estimates were obtained from the US Census (2014). Probability and cost of hospitalizations were estimated by multiple logistic regression and negative binomial regression models, respectively. Results: The total estimated cost of hospitalizations in individuals with sarcopenia was USD $40.4 billion with an average per person cost of USD $260. Within this category, average per person cost was highest for Hispanic women (USD $548) and lowest for Non-Hispanic Black women (USD $25); average per person cost was higher for older adults (≥65 years) (USD $375) than younger adults (40-64 years) (USD $204) with sarcopenia. The total cost of hospitalizations in individuals with sarcopenia (≥65 years) was USD $19.12 billion. Individuals with sarcopenia had greater odds of hospitalization (OR, 1.95; p<.001) compared to those without and had an annual marginal increase in cost of USD $2315.7 per person compared to individuals without sarcopenia. Conclusion: Sarcopenia places considerable economic burden on the US healthcare system. The ethnic disparity and economic burden associated with sarcopenia warrant further investigation.

CITATION:
S. Goates ; K. Du ; M.B. Arensberg ; T. Gaillard ; J. Guralnik ; S.L. Pereira (2019): Economic impact of hospitalizations in US adults with Sarcopenia. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.10

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LOSS OF POSTERIOR OCCLUDING TEETH AND ITS ASSOCIATION WITH PROTEIN-MICRONUTRIENTS INTAKE AND MUSCLE MASS AMONG THAI ELDERS: A PILOT STUDY

B. Treesattayakul, T. Winuprasith, B. Theeranuluk, D. Trachootham

J Frailty Aging 2019;8(2):100-103

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Contact between upper and lower posterior teeth is crucial for chewing. However, the influence of posterior occluding teeth loss on protein intake and muscle mass was unclear. This cross-sectional study compared consumption frequency of protein food, amount of protein and relevant micronutrient intakes and muscle mass indices among older adults with different Eichner indices (EI) of posterior occluding teeth loss. Ninety Thai healthy adults were divided into three groups (N=30 each) according EI with statistically comparable characters. Food frequency questionnaire, 4-days diet record, and bioelectrical impedance analysis were used for outcome measurement. Our findings suggested that loss of posterior occluding teeth on both sides was associated with less frequent consumption of meat, nut, egg, fish and dairy products, inadequate intakes of protein (< 0.8 g/kg body weight), iron and vitamin B12, and reduced muscle mass indices in older adults. Future large-scale cohort studies are warranted to confirm these findings.

CITATION:
B. Treesattayakul ; T. Winuprasith ; B. Theeranuluk ; D. Trachootham (2019): Loss of posterior occluding teeth and its association with protein-micronutrients intake and muscle mass among Thai elders: A pilot study. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2019.2

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