In view of the global demographic shift, a scientific symposium was organised by the European Society for Clinical Nutrition and Metabolism (ESPEN) to address nutrition-related challenges of the older population and provide an overview of the current state of knowledge. Eighteen nutrition-related issues of the ageing global society were presented by international experts during the symposium and summarised in this report. Anorexia of ageing, dysphagia, malnutrition, frailty, sarcopenia, sarcopenic obesity, and the metabolic syndrome were highlighted as major nutrition-related geriatric syndromes. Great progress has been made in recent years through standardised definitions of some but not all syndromes. Regarding malnutrition, the GLIM approach has shown to be suitable also in older adults, justifying its continuous implementation. For anorexia of ageing, a consensus definition is still required. Intervention approaches should be integrated and person-centered with the aim of optimizing intrinsic capacity and maintaining functional capacity. Landmark studies like EFFORT and FINGER have impressively documented the potential of individualised and multifactorial interventions for functional and health benefits. Combining nutritional intervention with physical training seems particularly important whereas restrictive diets and drug treatment should generally be used with caution because of undesirable risks. Obesity management in older adults should take into account the risk of promoting sarcopenia. In the future, even more individualised approaches like precision nutrition may enable better nutritional care. Meanwhile all stakeholders should focus on a better implementation of currently available strategies and work closely together to improve nutritional care for older adults.

Background & Aim: Muscle strength seems to be more relevant to the functionality than muscle mass in sarcopenia. Different diagnostic techniques are available for the evaluation of muscle mass. Ultrasonography (USG) seems to have some advantages compared to other techniques especially bioelectrical impedance analysis (BIA) including being not affected of the results by the factors like extreme body mass indexes (BMI) or hypervolemia. The aim of the study is to determine and compare the muscle strength prediction value of muscle mass measured by using USG or BIA and determine the cut-off values for the Turkish population. Methods: One hundred and thirty six patients admitted to geriatrics outpatient clinic for comprehensive geriatric assessment were included in the study. Body composition was determined by BIA and skeletal muscle mass ındex (SMI) was measured. Thickness of the gastrocnemius muscle was measured via USG. Diagnosis of sarcopenia was made according to the EWSGOP 2 diagnostic criteria. Results: The best cut-off value for gastrocnemius muscle thickness to predict low HGS was ≤13.8 mm (AUC:0.690,p 0.05). Comparison of AUCs for gastrocnemius muscle thickness and SMI showed that gastrocnemius muscle thickness had higher AUC (p=0.008). For predicting sarcopenia, the best cut-off value of gastrocnemius muscle thickness was found to be ≤12.3 mm in women (AUC: 0.862,p <0.001) and ≤12.3 mm in men (AUC:0.900, p < 0.001). Conclusions: In this study, we found that gastrocnemius thickness measured by USG seems to predict low HGS better than SMI measured by BIA.

Gastrointestinal (GI) system cancers are common among older adults and it is still difficult to predict which are at increased risk for postoperative complications. Frailty and sarcopenia are increasing problems of older population and may be associated with adverse outcomes. In this study we aimed to examine the impact of frailty and sarcopenia on postoperative complications in older patients undergoing surgery for GI cancers. A total of 49 patients admitted to general surgery clinic with the diagnosis of gastrointestinal system cancers were enrolled in this cross-sectional study. Frailty status was assessed using Edmonton Frail Scale (EFS). Sarcopenia was defined due to the EWGSOP2 criteria and ultrasonography was used to evaluate muscle mass. The median age of the patients was 70 (min-max: 65-87). Fourteen (28.6 %) patients were found to be sarcopenic and 16 (32. 7%) patients were frail, and 6 (37.5 %) of these patients were also severe sarcopenic (p=0.04). When the postoperative complications were assessed, time to oral intake, time to enough oral intake, length of hospital stay in the postoperative period were found to be longer in frail patients (p=0.02, p=0.03, p=0.04 respectively). Postoperative complications were not different due to the sarcopenia. Frailty, but not sarcopenia was associated with adverse outcomes in older adults undergoing GI cancer surgery. Comprehensive geriatric assessment before surgical intervention may help to identify patients who are at risk.