الفهرس 
Sarcopenia
Lifestyle Lacking ExerciseOnly 14 pages are availabe for public view
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Abstract
Sarcopenia is a common clinical condition among elderly population. It is a syndrome characterized by progressive and generalized loss of skeletal muscle mass, strength, and muscle function. Sarcopenia is very often not noticeable in earlier phases but becomes apparent once a critical event or disability has occurred. It is better to prevent progressive loss of skeletal muscle mass, strength, and function rather than try to restore it at older ages. This study was conducted aiming to validate a simple screening tool for early detection of sarcopenia among hospitalized elderly patients. A pilot study was done at first to assess the sensitivity and specificity of different screening tools for sarcopenia. Aside from the standard methods detecting sarcopenia; our two tools were a questionnaire named (SARC-F Questionnaire) and an equation including (age, hand grip and calf circumference). A cross sectional study was done on127 elderly participants,60 years old and above, both men and women, who were admitted to Ain Shams University Hospitals at time of our study.
All individuals were subjected to medical history and physical examination. Comprehensive geriatric assessment was done including; cognitive function assessment by using mini-mental status examination, Screening for depression using patient health questionnaire 2, Functional assessment using activities of daily living (ADL) and Instrumental activities of daily living (IADL), Nutritional assessment using Mini-nutritional assessment and Assessment for fall risk by using Timed up and go test. They were also subjected to anthropometric measurements including body mass index and calf circumference measurement. SARC-F questionnaire and an equation including (age, hand grip and calf circumference) were the main goal of our work. Diagnosing sarcopenia using the standard methods including; muscle mass assessment by Bioelectrical Impedance Analysis (BIA), muscle strength by hand grip by Jamar hydraulic hand dynamometer and muscle performance by gait speed. Sarcopenia was highly prevalent among our participants; (47% in men versus 14% in women). Sarcopenic men and women were older and less educated. Number of comorbidities and comorbidity index had no statistical significance. Only anemia and chronic liver disease showed significance among men. Other demographic variables as smoking and alcohol didn‘t show any significant statistical difference.
Sarcopenic men and women had more functional decline with lower ADL and IADL scores, lower MNA scores with a higher risk of mal-nutrition, higher scores in TUG test indicating higher risk of fall. Although depression was common among sarcopenics, it didn‘t show any statistical significant difference. Lab results showed that sarcopenic men and women had lower total protein and albumin levels. Sarcopenic men and women recorded lesser hand grip, lesser BMI, lesser calf muscle circumference, lesser muscle mass with BIA, and lesser gait speed. Total score of SARC-F questionnaire and each of its five items and the equation showed to be statistically significant for both men and women. Assistance in walking, climbing stairs, and falls were significantly affected in sarcopenic women.
SARC-F questionnaire showed high specificity. It was more specific in men while more sensitive in women. The equation as well recorded high specificity. Among men, adding SARC-F to the equation raised the level of agreement. While among women, adding SARC-F questionnaire to the equation for screening of sarcopenia didn‘t significantly affect the level of agreement. While among women, adding calf circumference to SARC-F questionnaire, in screening for sarcopenia, raised its specificity.