Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

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Sarcopenia: Revised European consensus on definition and diagnosis

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Dementia prevention, intervention, and care

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

Use of low-cost technologies could simplify assessment of balance in elderly. Objective Determine the usefulness of the Wii ™ pressure board in assessing balance in elderly. Methods We conducted a cross-sectional study in a group of elderly to test their balance with the pressure board compared to conventional tests used in geriatric practice. Community-dwelling adults over 60-years old were assessed. We compared the Short Physical Performance Battery scores with the Wii force platform results (average kinetic energy). Two blinded researchers classified each set of tests; and then a weighted kappa statistic was estimated. Results We assessed a total of 20 subjects, with a median age of 67.5 years (range 60-98), 75% women. The tests were concordant in 19 of the 20 subjects; with a resulting concordance of 0.6 (p=0.05). C onclusion The Wii pressure board has a good concordance with usual clinical assessment of balance in the elderly.

A Wii pressure platform to assess balance in the elderly

Clinical trials are considered to be one of the best methodologies in health research and they are used primarily to test interventions in medicine. Aging research is no exception for this goal, and clinical trials are used to test different interventions in older adults with a number of variations in this particular research. In addition to drugs, in older adult’s diverse non-pharmacological interventions are experimented for a wide-array of diseases and conditions that are particular for this age group. A careful design and sometimes adaptation of clinical trials methodology are necessary to have accurate results and translate them into actions in everyday clinical care of the older adult. Below, we provide a general and schematic review of the theoretical concept of clinical trials and their variants, followed by examples of interventions and specific outcomes in research on older adults.

Clinical Trials on Aging Research

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Sarcopenia is associated with physical and mental components of quality of life in older adults

Progresión del envejecimiento en México: Estudio Nacional de Salud y Envejecimiento en México (Enasem) 2012

Science never before faced such a complex, dynamic and time-dependent process as human aging. Longitudinal studies are a source of fundamental evidence of multi-factor changes over time, especially those that have contributed to understanding the aging process through research questions related to the course or prognosis of physical or cognitive functioning of older adults, exposure to comorbidity, health conditions, and biological, environmental, social or emotional negative or positive factors, as well as other questions related to aging.

Luis Miguel Gutiérrez-Robledo

Papers

A Wii pressure platform to assess balance in the elderly

Clinical Trials on Aging Research

Sarcopenia is associated with physical and mental components of quality of life in older adults

Progresión del envejecimiento en México: Estudio Nacional de Salud y Envejecimiento en México (Enasem) 2012

Longitudinal Studies and Older Adults Cohorts