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Iñaki Echeverria
Department of Physiology University of the Basque CountryUPV/EHU Leioa Spain

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Original paper
Published: 05 October 2020 in European Journal of Clinical Investigation
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Background People with frailty and/or sarcopenia have an increased risk of negative health outcomes. However, their diagnosis is often difficult. Considering the potential value of myostatin and follistatin as biomarkers of these conditions, we aimed to compare the association between both myokines and frailty and/or sarcopenia in post‐hospitalised older people. In addition, the capability of myostatin and follistatin for identifying frailty and sarcopenia was compared with physical tests. Materials And Methods Participants in this cross‐sectional study consisted of 84 post‐hospitalised patients immediately after discharge. Participants met the following inclusion criteria: aged ≥70 years, score of ≥20 on the Mini‐Mental State Examination, and able to stand up and walk independently for at least 4 metres. Serum myostatin and follistatin concentrations were measured by enzyme‐linked immunosorbent assay. Body measures and results from 4 physical tests (hand grip, chair stand, 8‐foot timed Up‐and‐Go (8TUG) and gait speed (GS)) were also recorded. Frailty was evaluated by the Fried index, and sarcopenia by the criteria of the European Working Group on Sarcopenia in Older People. Results Myostatin concentration was lower and follistatin concentration higher in people with frailty or sarcopenia. Receiver operating characteristic curves indicated that GS and 8TUG tests had the greatest capability for identifying frailty. Myostatin was the only variable capable of identifying sarcopenia. Conclusion Myostatin may be a useful biomarker for sarcopenia in post‐hospitalised older adults. However, it has a lower capability for identifying frailty than physical tests. Further studies using larger samples and these myokines together with other biomarkers are warranted.

ACS Style

Iñaki Echeverria; Ariadna Besga; Begoña Sanz; María Amasene; Gotzone Hervás; Julia Barroso; Ana Rodriguez‐Larrad; Jon Irazusta. Identification of frailty and sarcopenia in hospitalised older people. European Journal of Clinical Investigation 2020, 51, e13420 .

AMA Style

Iñaki Echeverria, Ariadna Besga, Begoña Sanz, María Amasene, Gotzone Hervás, Julia Barroso, Ana Rodriguez‐Larrad, Jon Irazusta. Identification of frailty and sarcopenia in hospitalised older people. European Journal of Clinical Investigation. 2020; 51 (4):e13420.

Chicago/Turabian Style

Iñaki Echeverria; Ariadna Besga; Begoña Sanz; María Amasene; Gotzone Hervás; Julia Barroso; Ana Rodriguez‐Larrad; Jon Irazusta. 2020. "Identification of frailty and sarcopenia in hospitalised older people." European Journal of Clinical Investigation 51, no. 4: e13420.

Original article
Published: 20 May 2020 in Supportive Care in Cancer
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Decreased health-related quality of life (HRQoL) is common in patients with cancer. We investigated the effects of dietary intervention and baseline nutritional status on worsening of HRQoL in older patients during chemotherapy. In this randomized control trial assessing the effect on mortality of dietary advice to increase dietary intake during chemotherapy, this post hoc analysis included 155 patients with cancer at risk of malnutrition. The effects of dietary intervention, baseline Mini Nutritional Assessment item scores, weight loss, and protein and energy intake before treatment on the worsening of HRQoL (physical functioning, fatigue) and secondary outcomes (Timed Up and Go test, one-leg stance time, depressive symptoms, basic (ADL), or instrumental (IADL) activities of daily living) were analyzed by multinomial regressions. Dietary intervention increased total energy and protein intake but had no effect on any examined outcomes. Worsening of fatigue and ADL was predicted by very low protein intake (< 0.8 g kg−1 day−1) before chemotherapy (OR 3.02, 95% CI 1.22–7.46, p = 0.018 and OR 5.21, 95% CI 1.18–22.73, p = 0.029 respectively). Increase in depressive symptomatology was predicted by 5.0–9.9% weight loss before chemotherapy (OR 2.68, 95% CI 1.10–6.80, p = 0.038). Nutritional intervention to prevent HRQoL decline during chemotherapy should focus on patients with very low protein intake along with those with weight loss.

ACS Style

Sophie C. Regueme; Iñaki Echeverria; Nicolas Monéger; Jessica Durrieu; Maïté Becerro-Hallard; Sophie Duc; Aurelie LaFargue; Cécile Mertens; Hamid Laksir; Joël Ceccaldi; Sandrine Lavau-Denes; Thierry Dantoine; Jon Irazusta; Isabelle Bourdel-Marchasson. Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer. Supportive Care in Cancer 2020, 29, 687 -696.

AMA Style

Sophie C. Regueme, Iñaki Echeverria, Nicolas Monéger, Jessica Durrieu, Maïté Becerro-Hallard, Sophie Duc, Aurelie LaFargue, Cécile Mertens, Hamid Laksir, Joël Ceccaldi, Sandrine Lavau-Denes, Thierry Dantoine, Jon Irazusta, Isabelle Bourdel-Marchasson. Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer. Supportive Care in Cancer. 2020; 29 (2):687-696.

Chicago/Turabian Style

Sophie C. Regueme; Iñaki Echeverria; Nicolas Monéger; Jessica Durrieu; Maïté Becerro-Hallard; Sophie Duc; Aurelie LaFargue; Cécile Mertens; Hamid Laksir; Joël Ceccaldi; Sandrine Lavau-Denes; Thierry Dantoine; Jon Irazusta; Isabelle Bourdel-Marchasson. 2020. "Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer." Supportive Care in Cancer 29, no. 2: 687-696.

Journal article
Published: 20 January 2020 in International Journal of Environmental Research and Public Health
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Multicomponent physical exercise is effective in curbing the effect of hospitalization in older adults. However, it is not well established which characteristics of the exercise interventions would optimize intervention sustainability and efficacy. This study compared the effects of two group-based multicomponent exercise interventions of different lengths in older adults after hospitalization. Fifty-five participants were randomly assigned to a short-term group-based branch (SGB, n = 27) or to a long-term group-based branch (LGB, n = 28). The SGB participated in a six-week multicomponent group-based exercise-training program followed by 18 weeks of home-based exercise. The LGB completed 12 weeks of each phase. Physical function, physical activity, quality of life, anthropometrics, and nutritional status were assessed at baseline, after 12 weeks, and after 24 weeks of intervention. Both groups improved physical function and nutritional status and increased physical activity after 12 weeks of intervention (paired student’s t-test, p < 0.01), and maintained the positive effects during the following 12 weeks. No group-by-time interaction was observed in any of the studied variables using mixed-model ANOVA. Based on these findings, we determined that 6 weeks of a group-based exercise intervention caused similar functional and nutritional benefits to a longer group-based intervention of 12 weeks when both are continued at home until 24 weeks.

ACS Style

Iñaki Echeverria; Maria Amasene; Miriam Urquiza; Idoia Labayen; Pilar Anaut; Ana Rodriguez-Larrad; Jon Irazusta; Ariadna Besga. Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions. International Journal of Environmental Research and Public Health 2020, 17, 666 .

AMA Style

Iñaki Echeverria, Maria Amasene, Miriam Urquiza, Idoia Labayen, Pilar Anaut, Ana Rodriguez-Larrad, Jon Irazusta, Ariadna Besga. Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions. International Journal of Environmental Research and Public Health. 2020; 17 (2):666.

Chicago/Turabian Style

Iñaki Echeverria; Maria Amasene; Miriam Urquiza; Idoia Labayen; Pilar Anaut; Ana Rodriguez-Larrad; Jon Irazusta; Ariadna Besga. 2020. "Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions." International Journal of Environmental Research and Public Health 17, no. 2: 666.

Randomized controlled trial
Published: 01 October 2019 in Nutrients
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Age-related strength and muscle mass loss is further increased after acute periods of inactivity. To avoid this, resistance training has been proposed as an effective countermeasure, but the additional effect of a protein supplement is not so clear. The aim of this study was to examine the effect of a whey protein supplement enriched with leucine after resistance training on muscle mass and strength gains in a post-hospitalized elderly population. A total of 28 participants were included and allocated to either protein supplementation or placebo supplementation following resistance training for 12 weeks (2 days/week). Physical function (lower and upper body strength, aerobic capacity and the Short Physical Performance Battery (SPPB) test), mini nutritional assessment (MNA) and body composition (Dual X-ray Absorptiometry) were assessed at baseline and after 12 weeks of resistance training. Both groups showed improvements in physical function after the intervention (p < 0.01), but there were no further effects for the protein group (p > 0.05). Muscle mass did not improve after resistance training in either group (p > 0.05). In conclusion, 12 weeks of resistance training are enough to improve physical function in a post-hospitalized elderly population with no further benefits for the protein-supplemented group.

ACS Style

Maria Amasene; Ariadna Besga; Iñaki Echeverria; Miriam Urquiza; Jonatan R. Ruiz; Ana Rodriguez-Larrad; Mikel Aldamiz; Pilar Anaut; Jon Irazusta; Idoia Labayen. Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial. Nutrients 2019, 11, 2337 .

AMA Style

Maria Amasene, Ariadna Besga, Iñaki Echeverria, Miriam Urquiza, Jonatan R. Ruiz, Ana Rodriguez-Larrad, Mikel Aldamiz, Pilar Anaut, Jon Irazusta, Idoia Labayen. Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial. Nutrients. 2019; 11 (10):2337.

Chicago/Turabian Style

Maria Amasene; Ariadna Besga; Iñaki Echeverria; Miriam Urquiza; Jonatan R. Ruiz; Ana Rodriguez-Larrad; Mikel Aldamiz; Pilar Anaut; Jon Irazusta; Idoia Labayen. 2019. "Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial." Nutrients 11, no. 10: 2337.

Multicenter study
Published: 27 March 2018 in BMC Geriatrics
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Few studies have simultaneously examined changes in physical, cognitive and emotional performance throughout the aging process. Baseline data from an ongoing experimental randomized study were analyzed. Physical activity, handgrip, the Senior Fitness Test, Trail Making Test A, Rey Auditory-Verbal Learning Test, Quality of Life-Alzheimer's Disease Scale (QoL-AD) and the Goldberg Depression Scale were used to assess study participants. Logistic regression models were applied. ACTRN12616001044415 (04/08/2016). The study enrolled 114 participants with a mean age of 84.9 (standard deviation 6.9) years from ten different nursing homes. After adjusting for age, gender and education level, upper limb muscle strength was found to be associated with Rey Auditory-Verbal Learning Test [EXP(B): 1.16, 95% confidence interval (CI): 1.04-1.30] and QoL-AD [EXP(B): 1.18, 95% CI: 1.06-1.31]. Similarly, the number of steps taken per day was negatively associated with the risk of depression according to the Goldberg Depression Scale [EXP(B): 1.14, 95% CI: 1.000-1.003]. Additional analyses suggest that the factors associated with these variables are different according to the need for using an assistive device for walking. In those participants who used it, upper limb muscle strength remained associated with Rey Auditory-Verbal Learning Test [EXP(B): 1.21, 95% CI: 1.01-1.44] and QoL-AD tests [EXP(B): 1.19, 95% CI: 1.02-1.40]. In those individuals who did not need an assistive device for walking, lower limb muscle strength was associated with Rey Auditory-Verbal Learning Test [EXP(B): 1.35, 95% CI: 1.07-1.69], time spent in light physical activity was associated with QoL-AD test [EXP(B): 1.13, 95% CI: 1.00-1.02], and the number of steps walked per day was negatively associated with the risk of depression according to the Goldberg Depression Scale [EXP(B): 1.27, 95% CI: 1.000-1.004]. Muscle strength and physical activity are factors positively associated with a better performance on the Rey Auditory-Verbal Learning Test, QoL-AD and Goldberg Depression Scale in older adults with mild to moderate cognitive impairment living in nursing homes. These associations appeared to differ according to the use of an assistive device for walking. Our findings support the need for the implementation of interventions directed to increase the strength and physical activity of individuals living in nursing homes to promote physical, cognitive and emotional benefits. ACTRN12616001044415 (04/08/2016).

ACS Style

Haritz Arrieta; Chloe Rezola-Pardo; Iñaki Echeverría; Miren Iturburu; Susana María Gil; José Javier Yanguas; Jon Irazusta; Ana Rodriguez-Larrad. Physical activity and fitness are associated with verbal memory, quality of life and depression among nursing home residents: preliminary data of a randomized controlled trial. BMC Geriatrics 2018, 18, 80 .

AMA Style

Haritz Arrieta, Chloe Rezola-Pardo, Iñaki Echeverría, Miren Iturburu, Susana María Gil, José Javier Yanguas, Jon Irazusta, Ana Rodriguez-Larrad. Physical activity and fitness are associated with verbal memory, quality of life and depression among nursing home residents: preliminary data of a randomized controlled trial. BMC Geriatrics. 2018; 18 (1):80.

Chicago/Turabian Style

Haritz Arrieta; Chloe Rezola-Pardo; Iñaki Echeverría; Miren Iturburu; Susana María Gil; José Javier Yanguas; Jon Irazusta; Ana Rodriguez-Larrad. 2018. "Physical activity and fitness are associated with verbal memory, quality of life and depression among nursing home residents: preliminary data of a randomized controlled trial." BMC Geriatrics 18, no. 1: 80.

Multicenter study
Published: 01 March 2018 in Experimental Gerontology
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To investigate the impact of a multicomponent exercise program on anthropometry, physical function, and physical activity on older adults living in long-term nursing homes (LTNH), we conducted a randomized controlled trial involving 112 participants aged 84.9 ± 6.9 years. Participants were randomly assigned to an intervention (IG) or control group (CG). The IG participated in a 3-month multicomponent exercise intervention focused on strength, balance, stretching exercises, and walking recommendations. Subjects in the CG participated in routine activities. Analyses of outcome parameters were performed in the entire sample and in two subgroups, classified according to participants' physical function score at baseline. The group-by-time interaction, favoring the IG, was significant for the entire sample and for the participants in the low physical function subgroup for the following parameters: waist circumference, 30-s chair-stand, arm-curl, 8-ft timed up-and-go, SPPB score, gait speed, and Berg scale (p < .05). In participants with higher physical function at baseline, significant group-by-time interaction was observed in the SPPB score and Berg scale (p < .05). When differences were analyzed within groups, the IG maintained or improved in all assessed parameters, while participants in the CG showed a marked decline. Our study showed that a multicomponent exercise program is effective for older people living in LTNH. This is especially relevant in those with lower physical function scores. The lower efficacy of the program in participants with better function might be due to the insufficient exercise demands of our intervention for more fit residents. Future studies should analyze the effects of programs with higher intensities in older people with intermediate to high physical function.

ACS Style

Haritz Arrieta; Chloe Rezola-Pardo; Idoia Zarrazquin; Iñaki Echeverria; Jose Javier Yanguas; Miren Iturburu; Susana Maria Gil; Ana Rodriguez-Larrad; Jon Irazusta. A multicomponent exercise program improves physical function in long-term nursing home residents: A randomized controlled trial. Experimental Gerontology 2018, 103, 94 -100.

AMA Style

Haritz Arrieta, Chloe Rezola-Pardo, Idoia Zarrazquin, Iñaki Echeverria, Jose Javier Yanguas, Miren Iturburu, Susana Maria Gil, Ana Rodriguez-Larrad, Jon Irazusta. A multicomponent exercise program improves physical function in long-term nursing home residents: A randomized controlled trial. Experimental Gerontology. 2018; 103 ():94-100.

Chicago/Turabian Style

Haritz Arrieta; Chloe Rezola-Pardo; Idoia Zarrazquin; Iñaki Echeverria; Jose Javier Yanguas; Miren Iturburu; Susana Maria Gil; Ana Rodriguez-Larrad; Jon Irazusta. 2018. "A multicomponent exercise program improves physical function in long-term nursing home residents: A randomized controlled trial." Experimental Gerontology 103, no. : 94-100.