Elsevier BV

This study aims to explore whether the current definitions of sarcopenia are applicable to the older Chinese population. Participants were 783 Chinese adults recruited from four regions in Mainland China: Jinan, Guangzhou, Xi’an, and Chengdu. Body composition was measured by dual energy x-ray absorptiometry. Handgrip strength, body weight, and height were measured by trained technicians, and demographic data were collected through questionnaires. Relative appendicular skeletal muscle, skeletal muscle index (SMI=100 × skeletal muscle mass/body mass) and residuals methods were applied to identify sarcopenia. Compared with young adults, no significant decrease was found in the relative appendicular skeletal muscle (ASM/height2) in older adults. If the criterion of two standard deviations below the mean value of ASM/height2 in young adults is used, none of older adults in this study could be diagnosed with sarcopenia. In addition, compared with the ASM/height2 and residuals methods, SMI shows higher discriminating power in the identifying persons with low handgrip strength. The data suggest that ASM/height2 method may not be appropriate for diagnosis of sarcopenia in Chinese population. However, whether SMI is a better choice remains inconclusive. Prospective studies are needed to clearly define sarcopenia in Chinese population.

Prodromal AD clinical trial methodology is advancing rapidly. It is now possible to more accurately identify MCI patients with underlying AD pathology at an earlier stage of the disease through the use of amyloid imaging and CSF biomarkers. Measurement of decline in these early stage clinical trials using continuous clinical and cognitive outcome measures is conceptually more appealing and adds greater efficiency compared to the classical outcome of “conversion” to dementia used in prior MCI clinical trials. Nevertheless, the fact that many prodromal AD patients who are likely to be recruited to these early stage studies are not taking acetylcholinesterase inhibitors at the time of enrollment, but are poised to start taking them over a multi-year period of follow-up, is a potential confound that needs to be addressed.

To determine the genetic correlates of physical frailty and sarcopenia, focusing on single nucleotide polymorphisms (SNPs) in genome-wide association studies (GWAS), and to explore the genetic overlap of frailty with cardiovascular disease (CVD) and its risk factors. PubMed was systematically searched for GWAS studies investigating the association between SNPs and objective measures of physical frailty or sarcopenia. SNPs were retained if they were associated with one of the phenotypes of interest by a p-value of 5.0×10−8 or less. Ten studies were included, with a total of 237 SNPs in 181 genes being associated with physical frailty or sarcopenia; as measured by handgrip strength or lean (muscle) mass. These genes were cross-referenced in the GWAS Catalog, and many of them were found to be associated with CVD or metabolic syndrome. Evidence from GWAS has shown that frailty is associated with common genetic polymorphisms. Many of these polymorphisms have been implicated in CVD, supporting the hypothesis of a shared pathophysiology between these entities. Future studies are eagerly anticipated to map out the mechanistic links and discover therapeutic targets and novel biomarkers for frailty.

Increasing evidences suggest that dietary Silicon (Si) intake, is positively correlated with bone homeostasis and regeneration, representing a potential and valid support for the prevention and improvement of bone diseases, like osteoporosis. This review, aims to provide the state of art of the studies performed until today, in order to investigate and clarify the beneficial properties and effects of silicates, on bone metabolism. We conducted a systematic literature search up to March 2013, using two medical databases (Pubmed and the Cochrane Library), to review the studies about Si consumption and bone metabolism. We found 45 articles, but 38 were specifically focused on Si studies. Results showed a positive relationship between dietary Si intake and bone regeneration.

Western research into dementia has focused on finding effective means of prevention, particularly through nutrition. To date, however, little is known about the relationship between diet and cognitive disorders in Africa, where the number of people with dementia is expected to increase most over the coming decades. The objective of the study was to investigate the relationship between diet and alcohol intake and cognitive disorders among elderly people in Central Africa. Between 2011 and 2012, a cross-sectional multicentre population-based study was carried out in rural and urban areas of the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 years were interviewed using the Community Screening Interview for Dementia (CSI-D). Elderly people who performed poorly (COGSCORE≤24.5/30) were clinically assessed by neurologists and underwent further psychometric testing. DSM-IV and Petersen criteria were required for a diagnosis of dementia or mild cognitive impairment (MCI), respectively. A food frequency questionnaire assessed the intakes of dairy products, fruit, vegetables, starches, legumes, oleaginous foods, meat or fish, eggs and sweet foods over the previous three days. We also collected data on alcohol intake. Sociodemographic, vascular, and psychological factors were documented. Multivariate multinomial logistic regression models were used to estimate the associations. In fully adjusted models, a lower consumption of oleaginous foods was associated with MCI (OR=3.7 [1.4−9.9]) and dementia (OR=2.8 [1.0−7.7]) in a rural area of CAR. Alcohol consumption was associated with reduced probability of dementia in CAR (OR=0.3 [0.1−0.8]). In ROC, food groups and alcohol intake were not associated with MCI or dementia. In conclusion, our study provides new data about the association between diet and cognitive disorders in Africa. Further studies should investigate the relationship between diet and cognitive disorders at the level of specific foods rather than food groups.

Judicious food choices are of prime importance during aging. This study was conducted to identify individual and collective attributes determining global diet quality (DQ). Participants were 1,793 adults (52% women) from the NuAge study on nutrition and successful aging. Subjects aged 67 to 84 years in relatively good health were recruited from the Québec Medicare Database. Sociodemographic, affective, and cognitive data, health conditions, perceived physical health and functional status, dietary habits and dietary attributes and community resources were obtained using questionnaires. Body weight and height were measured and body mass index (BMI) was calculated. Three non-consecutive 24-hour diet recalls were collected at recruitment. DQ, assessed using the Canadian Healthy Eating Index (C-HEI, /100), was computed on the mean intakes from the diet recalls. Analyses were stratified by gender. Variables significantly related to DQ in bivariate analyses (p<.05) were entered into backward stepwise multiple regression analyses. Among men, the final model showed higher education (β=0.23, p=.01), diet knowledge (β=0.96, p<.0001), number of daily meals (β=1.91, p=.02) and perceived physical health (β=0.06, p=.01) to be positive determinants of DQ, whereas alcohol consumption (β=−2.25, p=.05), wearing dentures (β=−2.31, p=.01) and eating regularly in restaurants (β=− 1.65, p=.03) were negative determinants of DQ (adjusted R2 = 13.7%). Among women, higher education (β=0.29, p=.002), diet knowledge (β=0.54, p=.002), number of daily meals (β=3.61, p<.0001), and hunger (β=0.61, p<.0001) were positive determinants of global DQ; greater BMI (β=−0.16, p=.03) and chewing problems (β=−0.48, p=.03) were negative determinants of DQ (adjusted R2 = 7.8%). These results point to several key factors influencing global DQ in older adults and also show gender-based differences. More research must be done to better understand how these factors change with aging and exert their impact on diet, particularly since variance in DQ was largely unexplained. As diet knowledge was an independent predictor for both genders, targeted, sustainable interventions are needed to ensure good diet quality as people age.

Research in preventive nutrition aims at elucidating mechanism by which our diet helps us to remain in good health through optimal physiological functions. However, despite decades of accumulated data in human nutrition and regular subsequent nutritional recommendations, obesity and type 2 diabetes epidemics continue to progress worldwide each year leading to a regular decrease of the Healthy Life Years, notably in Western countries. Such a paradox may be explained by the Nutrition Transition, the extreme application of the reductionist paradigm in nutrition research, the lack of nutritional education and a too strong focus on curative nutrition in at risk/ill subjects. In this position paper, we hypothesized that researchers should focus more on healthy subjects, from birth until maturity. Rather than exploring what differentiates healthy and at risk/ill subjects, we propose to thoroughly study what characterizes a healthy state and its underlying metabolism. We define it as the Healthy Core Metabolism which remains stable whatever energy inputs (diets) and outputs (exercise), genetic background and external/internal stress, e.g., temporary illnesses. As a basis for Healthy Core Metabolism investigation, we observed that main physiological and ubiquitous functions of human organism, i.e., the neuro-vasculo-sarco-osteoporotic system, tend to follow a concave curve with common phases of growth, optimum, and decline. Finally, we hypothesized that true primary preventive nutrition should focus on the growth phase to reach the maximum capital of a given physiological function so that — whatever the further decline —, Healthy Life Years may approach or coincide with theoretical Life Expectancy.

People involved with development of health care policy must be appreciative of the social and economic challenges that will likely develop as a result of the rise in Alzheimer’s disease (AD) as the 21st century progresses. Their attitudes, perceptions and understanding regarding AD were captured in the IMPACT survey, a 30-minute Web-based questionnaire. Fifty health policy managers and decision-makers (payors) were recruited, 10 each from 5 European countries—France, Germany, Italy, Spain and the United Kingdom. Most payors felt that AD was underdiagnosed and undertreated in their country (80% and 68%, respectively). Half of all payors felt that their government did not invest enough in treating AD, and 30% felt their government hindered access to drug therapy. Payors believed that treatment should be initiated as early as possible after a diagnosis of AD (82%), and that early treatment can delay progression of the disease (82%). Even more than caregivers, payors agreed that AD can have devastating effects on the family of the sufferer (90% vs 75%; P<0.05). Payors more often cited cancer, stroke and heart disease than AD as affecting their budgets, but cited AD more often than depression, diabetes, HIV/AIDs and arthritis. Cost savings were seen as the most important factor regarding policy decisions. These attitudes of the surveyed payors towards AD and the patients and caregivers affected by it suggest that they may advocate for national and international policies that will facilitate earlier diagnosis and improved access to treatment.

To use the item response theory (IRT) methods to examine the degree to which the four selected tools reflect sarcopenia and to arrange them according to their ability to estimate sarcopenia severity. A cross-sectional study aimed at verifying the possibilities of using diagnostic tools for sarcopenia. The study included residents living in an assisted living unit at the Senior Centre in Blansko (South Moravia, Czech Republic) (n=77). Sarcopenia was estimated according to the proposals of the European Working Group on Sarcopenia in Older People (EWGSOP) using calf circumference, the EWGSOP algorithm, hand grip strength, and the Short Physical Performance Battery (SPPB). The results from the IRT model showed that these four methods indicate strong unidimensionality so that they measure the same latent variable. The methods ranked according to the discrimination level ranging from high to low discrimination where the calf circumference was the most discriminatory (Hi = 0.86) and the SPPB together with hand grip strength were the least discriminatory (both Hi = 0.44). We are recommending to identify mild sarcopenia by SPPB or hand grip strength, moderate sarcopenia by the EWGSOP algorithm and severe sarcopenia by the calf circumference.