The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition. In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.

The present review describes and discusses the currently available definitions for sarcopenia from consensus studies. Different sarcopenia definitions have been proposed in these last years. Six main approaches to an operative definition of sarcopenia have been identified. Although the first definitions were solely based on the assessment of the amount of muscle mass, current definitions seem to consistently recognize a bi-dimensional nature of sarcopenia. So, these approaches imply the need of simultaneously assessing both age-related quantitative (i.e. amount of muscle mass) and qualitative (i.e. muscle strength and function) declines of skeletal muscle. Although current consensus exists about a bi-dimensional nature, the proposed approaches to measure sarcopenia are characterized by methodological differences. The majority of the operative definitions proposes to assess muscle mass as an index of appendicular muscle mass divided by squared height (evaluated by dual energy X-ray absorptiometry), assess strength using hand-held dynamometers, and assess function by evaluating gait speed at habitual pace over a short distance. Nevertheless, the clinically relevant thresholds and how to combine the three aspects in an operative definition in order to identify sarcopenia are heterogeneous. A main drawback is that supportive empirical data are missing for these conceptual definitions regarding the risk-assessment of different clinically significant adverse outcomes.

Background: Cognitive dysfunction and changes in body composition share common pathophysiological pathways. The aim of the present paper was to evaluate whether changes in appendicular muscle mass (AMM) and fat mass (FM) are associated factors with an increased risk of cognitive dysfunction in community‐dwelling older women.Methods: A nested case–control study was performed in 181 women aged 75 years and older from a subsample of the Epidemiologie de l'Osteoporose participants from Toulouse. Body composition parameters at inclusion and 7 years later (assessed by dual energy X‐ray absorptiometry), and the presence of cognitive dysfunction (dementia and mild cognitive impairment) at 7 years of follow‐up, assured by two memory experts based on best clinical practice and validated criteria, were obtained. Multivariate logistic regression models assessed the association of percent change in AMM and FM with risk of cognitive dysfunction.Results: At 7 years of follow‐up, 15 participants suffered from dementia, 6 suffered from mild cognitive impairment, and 160 were cognitively normal. Neither body composition changes nor gait speed was found to be statistically associated with cognitive dysfunction after controlling for potential confounders. Only age, over 85 years, was associated with an increased risk of subsequent cognitive impairment (odds ratio 3.10; 95 % confidence interval 1.07–8.87).Conclusions: No significant association could be evidenced between changes in body composition and cognitive dysfunction. Due to the small sample size, statistical power could be an issue. The study could also suggest the possibility that the risk of cognitive dysfunction is not mediated by changes in body composition.

Body mass index (BMI) determines general corpulence and health, whatever age, sex or clinical background. Normal BMI (18.5-24.9 kgm²) is defined as healthy, normal, weight leading to a false impression that no intervention is needed. Assess the prevalence of body impairments in the presence of normal BMI. Cross-sectional design. Bivariate and a multivariate regression analysis assessed the association of body composition with clinical parameters in the presence of normal BMI. Community dwelling older adults attending the Toulouse Frailty Clinic at the University Hospital, Toulouse. 876 community dwelling, autonomous older adults, 70 years and over. Dual X-ray Absorptiometry (DXA) assessment, and cognitive, physical, nutritional, and demographic evaluations were included in the present analysis. Of the initial sample, 347 (39.61 %) patients had normal BMI, and among them, 152 (43.80 %) had low lean mass, 144 (41.49 %) were osteoporotic and 2 (0.58 %) increased fat mass. A poor nutritional status (Mini-Nutritional Assessment score, MNA-score, <24) was the only independent variable associated with body impairments in the presence of normal BMI (Odd Ratio 2.83; 95 % Confidence Interval 1.64-4.89). Nearly 70 % of the adults with normal BMI had at least one impairment in body composition (low lean mass, osteoporosis, or obesity). In the light of the present study, older adults with normal BMI and an MNA-score under 24 should be assessed with DXA to identify the age-associated impairments in body composition in order to lead to specific interventions.

In the last few years several indices and tools, aimed at identifying frail subjects in various care settings have been developed. However, to date none of them has been incorporated into usual practice in the primary care setting. The purposes of this study are: 1) to evaluate the predictive capacity of the Tilburg Frailty Indicator (TFI), the Gérontopôle Frailty Screening Tool (GFST) and the KoS model together with two biomarker levels (SOX2 and p16INK4a) for adverse events related to frailty; 2) to determine differences in the use of healthcare services according to frailty. Prospective multicentre cohort study with a 2-year follow-up. The study will be performed in primary care centres of Gipuzkoa and Costa del Sol, both located in Spain. Autonomous, non-institutionalized individuals aged 70 and over that agree to participate in this study will constitute the study population. A total of 900 individuals will be randomly selected from the healthcare administrative data bases of the participating health services. Data will be collected at baseline and at 1 and 2 years. The main independent variables assessed at baseline will be TFI outcomes, GFST and the KoS model, together with the expression of SOX2 and p16INK4a levels. During follow-up, loss of autonomy, the occurrence of death and consumption of healthcare resources will be assessed. The main focus of this work is the identification and evaluation of several instruments constructed under different rationales to identify frail subjects in primary care settings. The resulting outcomes have potential for direct application to the primary care practice. Early identification of the onset of functional impairment of elderly is an essential, still unresolved aspect in the prevention of dependence in the scope of primary care.

Introduction: The aim of this study was to explore the predictors of decline in walking ability in patients with Alzheimer’s disease (AD). Methods: The prospective REseau surla maladie ALzheimer FRançais (REAL.FR) study enrolled six hundred eighty four community-dwelling AD subjects (71.20% women; mean age 77.84 Standard Deviation, SD, 6.82 years, Mini-Mental State Examination 20.02, SD 4.23). Decline in walking ability was defined as the first loss of 0.5 points or more in the walking ability item of the Activities of Daily Living scale (ADL), where higher score means greater independence, during the four-years of follow-up. Demographic characteristics, co-morbidities, and level of education were reported at baseline. Disability, caregiver burden, cognitive and nutritional status, body mass index, balance, behavioral and psychological symptoms of dementia, medication, hospitalization, institutionalization and death were reported every six months during the four years. Cox survival analyses were performed to assess the independent factors associated with decline in walking ability. Results: The mean incident decline in walking ability was 12.76% per year (95% Confidence Interval (CI) 10.86 to 14.66). After adjustment for confounders, the risk of decline in walking ability was independently associated with older age (Relative Risk, RR = 1.05 (95% CI 1.02 to 1.08)), time from diagnosis of dementia (RR = 1.16 (1.01 to 1.33)), painful osteoarthritis (RR = 1.84 (1.19 to 2.85)), hospitalization for fracture of the lower limb (RR = 6.35 (3.02 to 13.37)), higher baseline ADL score (RR = 0.49 (0.43 to 0.56)), and the use of acetylcholinesterase inhibitors (RR = 0.52 (0.28 to 0.96)). Conclusions: The risk of decline in walking ability is predicted by older age, increased dementia severity, poor functional score, and orthopedic factors and seems to be prevented by the use of acetylcholinesterase inhibitors medication.