Abstract
Background
in October 2018, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) updated their original definition of sarcopenia to reflect the scientific and clinical ...evidence that has accumulated over the last decade.
Objective
to determine the prevalence of sarcopenia in a large group of community-dwelling older adults using the EWGSOP2 definition and algorithm.
Design
a cross-sectional study.
Setting
the nationwide Korean Frailty and Aging Cohort Study (KFACS).
Subjects
a total of 2,099 ambulatory community-dwelling older adults, aged 70–84 years (mean age, 75.9 ± 4.0 years; 49.8% women) who were enrolled in the KFACS.
Methods
physical function was assessed by handgrip strength, usual gait speed, the five-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. Appendicular skeletal muscle mass (ASM) was measured by dual-energy X-ray absorptiometry.
Results
according to the criteria of the EWGSOP2, the sarcopenia indicators of combined low muscle strength and low muscle quantity were present in 4.6–14.5% of men and 6.7–14.4% of women. The severe sarcopenia indicators of combined low muscle strength, low muscle quantity and low physical performance were present in 0.3–2.2% of men and 0.2–6.2% of women. Using the clinical algorithm with SARC-F as a screening tool, the prevalence of probable sarcopenia (2.2%), confirmed sarcopenia (1.4%) and severe sarcopenia (0.8%) was low.
Conclusions
the prevalence of sarcopenia among community-dwelling older individuals varied depending on which components of the revised EWGSOP2 definition were used, such as the tools used to measure muscle strength and the ASM indicators for low muscle mass.
Aim
To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people.
Methods
A total of 25 out of 1192 ...community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mini‐Mental State Examination. Physical function measures included calf circumference, Timed Up and Go (TUG) and usual walking speed. Interviews were carried out to assess Council on Nutrition Appetite Questionnaire (CNAQ); chronic diseases including hypertension, diabetes and falls; as well as physical frailty, defined as having three of five criteria: muscle weakness, slowness, exhaustion, low activity and weight loss.
Results
The prevalence of cognitive frailty was 2.1%. Participants with cognitive frailty had significantly reduced Mini‐Mental State Examination and calf circumference; and higher instrumental activities of daily living disability and falls. Old age (OR 1.151, 95% CI 1.053–1.257), fall history (OR 3.577, 95% CI 1.381–9.263), having four or more chronic diseases (OR 7.419, 95% CI 2.117–26.005) and slower TUG (OR 1.234, 95% CI 1.041–1.462) were significantly associated with cognitive frailty, whereas greater calf circumference (OR 0.748, 95% CI 0.625–0.895) and CNAQ (OR 0.736, 95% CI 0.628–0.8631) had protective effects. Old age (OR 1.132, 95% CI 1.002–1.280), hospitalization (OR 10.090, 95% CI 2.554–39.854), having four or more chronic diseases (OR 5.120, 95% CI 1.113–23.557) and slower TUG (OR 1.394, 95% CI 1.167–1.665) were significantly associated with cognitive frailty‐related falls, whereas CNAQ (OR 0.704, 0.571–0.868) had protective effects.
Conclusions
Age, chronic disease, TUG and CNAQ were significantly associated with cognitive frailty and cognitive frailty‐related falls. The TUG and CNAQ have the greatest potential for improvement by intervention or lifestyle change. Further research is necessary to determine the efficacy of positive changes in these factors for symptomatic improvements. Geriatr Gerontol Int 2019; 19: 647–653.
This study is to explore a state of the art in metaverse service that is an emerging issue in applying it to the healthcare industry. The purpose of this study is to provide applicable strategic ...scenarios for effective metaverse service planning and implementation in healthcare settings. This study is focused on metaverse service as a business model. Thus, related literatures of metaverse service are reviewed in various aspects in healthcare industry. An exploratory approach is used to analyze current qualitative data characterizing healthcare metaverse service business positions and derive applicable strategies from business trends of current metaverse services. Several cases are examined based on the data obtained from various sources of healthcare and other related industries. This study synthesizes finding results and suggests applicable strategies of metaverse service in the healthcare industry. This study will facilitate strategic decision-making and policy-making processes to pursue a business opportunity development through an application of a metaverse service in healthcare and similar settings.
•A new hybrid method to integrate deep neural networks with multiple financial time series models is proposed.•Combines the LSTM model with various generalized autoregressive conditional ...heteroskedasticity (GARCH)-type models.•Compared performance of the proposed hybrid LSTM models with that of existing methodologies.
Volatility plays crucial roles in financial markets, such as in derivative pricing, portfolio risk management, and hedging strategies. Therefore, accurate prediction of volatility is critical. We propose a new hybrid long short-term memory (LSTM) model to forecast stock price volatility that combines the LSTM model with various generalized autoregressive conditional heteroscedasticity (GARCH)-type models. We use KOSPI 200 index data to discover proposed hybrid models that combine an LSTM with one to three GARCH-type models. In addition, we compare their performance with existing methodologies by analyzing single models, such as the GARCH, exponential GARCH, exponentially weighted moving average, a deep feedforward neural network (DFN), and the LSTM, as well as the hybrid DFN models combining a DFN with one GARCH-type model. Their performance is compared with that of the proposed hybrid LSTM models. We discover that GEW-LSTM, a proposed hybrid model combining the LSTM model with three GARCH-type models, has the lowest prediction errors in terms of mean absolute error (MAE), mean squared error (MSE), heteroscedasticity adjusted MAE (HMAE), and heteroscedasticity adjusted MSE (HMSE). The MAE of GEW-LSTM is 0.0107, which is 37.2% less than that of the E-DFN (0.017), the model combining EGARCH and DFN and the best model among those existing. In addition, the GEW-LSTM has 57.3%, 24.7%, and 48% smaller MSE, HMAE, and HMSE, respectively. The first contribution of this study is its hybrid LSTM model that combines excellent sequential pattern learning with improved prediction performance in stock market volatility. Second, our proposed model markedly enhances prediction performance of the existing literature by combining a neural network model with multiple econometric models rather than only a single econometric model. Finally, the proposed methodology can be extended to various fields as an integrated model combining time-series and neural network models as well as forecasting stock market volatility.
Oxygen vacancies have been treated as an important material engineering tool to enhance catalytic performance; for instance, oxygen vacancies suppress charge recombination at the Schottky interface, ...and thus, the photocurrent can be improved. In this regard, the gradient distribution of oxygen vacancies in n‐type metal oxides produces the ideal band structure for minimizing e−/h+ recombination by efficient hole extraction; however, its achievement remains a daunting challenge. Here, a photoelectrochemical (PEC)‐driven “self‐purification” process is suggested, which can effectively generate a gradient distribution of oxygen vacancies in the thickness range of ≈9.5 nm. As a result, a charge transport efficiency of >95% can be achieved by efficient hole migration from the photoanode to the electrolyte. This unique protocol is expected to provide an advanced metal oxide photocatalyst and photoelectrochemical electrode that exhibit superior photocatalytic performance with enhanced charge separation.
A photoelectrochemical (PEC)‐driven “self‐purification” approach is presented for the formation of an oxygen vacancy gradient by reconstructing the disorder overlayer from a TiO2 nanowire photoanode under long‐term PEC operation. The prepared ΔVo‐TiO2 possesses a gradient distribution of oxygen vacancies at a thickness of ≈9.5 nm, and exhibits an ≈95% charge transport efficiency.
Sarcopenia and cognitive impairment may share common risk factors and pathophysiological pathways. We examined the association between impairments in specific cognitive domains and sarcopenia (and ...its defining components) in community-dwelling older adults. We analyzed 1887 patients who underwent cognitive function tests and dual-energy X-ray absorptiometry from the baseline data of adults aged 70-84 years obtained from the Korean Frailty and Aging Cohort Study. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson's disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio OR 1.76, 95% confidence interval CI 1.04-2.99) and slow gait speed (OR 2.58, 95% CI 1.34-4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05-3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.
•Men and women undergo different body composition changes during aging.•Older men have larger skeletal muscle mass, while older women have larger fat mass.•Muscles and fats play different roles ...depending on volume and regional distribution.•Muscle mass is more favorable for function, BMD, falls, and cognitive function in men than in women.•Fat mass is more favorable for BMD, metabolism, and cognitive function in women than in men.
Aging causes changes in body composition, in which differences in the distribution and amount of fat and muscle tissue affect the development of various diseases according to sex. We conducted a systemic review of the literature and examined the relationship between body composition differences and related health conditions or diseases in older men and women.
Three different electronic databases (MEDLINE, Web of Science, and Embase) were used to find articles from 2000 until March 2022. Information on the study design characteristics, setting, measure of body composition, and health outcomes was extracted.
A total of 217 articles were retrieved, and 28 studies met the inclusion criteria. The included studies showed that older men have larger skeletal muscle mass (sMM) than women, while older women have larger fat mass (FM) than men. sMM has a favorable effect on physical performance, bone density, metabolism, cognitive function, and mortality in both men and women; however, the effects of sMM in women are less significant and even negligible compared to those in men. FM is significantly unfavorable for physical performance in women but sometimes favorable or unfavorable for glucose level and cognitive and lung function according to location. FM in men is usually less important for function, bone density, glucose level, and cognitive function than in women.
Changes in muscle and fat distribution according to aging and their correlation with health outcomes differ according to sex. Muscle mass may not always be favorable, and fat mass may not always be unfavorable in older adults.
Frailty is a common geriatric condition due to aging and defined as a decline in strength and a decrease in the physiologic ability to maintain the homeostasis. Vitamin B12 (B12), water-soluble ...vitamins, are a cofactor in DNA synthesis and involved in the metabolism of every cell in the human body, including the central nervous system. Demyelination neuromuscular symptoms observed in the peripheral nervous system, along with signs of significant damage to nerve fibers, often cause weakness, numbness in distal limbs, impaired balance, gait ataxia, and even physical frailty. In this cross-sectional study, we aimed to investigate the relationship between frailty and B12 level in community-dwelling Korean older adults.Using the data from the Korean Frailty and Aging Cohort Study, 2938 participants (1400 men and 1538 women) were recruited in this study. To evaluate frailty, we compared the frail group and not-frail group based on the modified Korean version of the cardiovascular health study frailty index developed by Fried. SARC-F is used to screen for sarcopenia. The short physical performance battery (SPPB) timed up and go (TUG) test and activities-specific balance confidence scale used to evaluate the physical function and fall risk of participants. B12 concentrations were classified into clinically relevant categories: insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). Linear and logistic regression analyses were used to evaluate the relationship between frailty and B12 levels.The mean age of the frail group was 77.8 (standard deviation = 3.7) years, while that of the not-frail group was 76.7 (SD = 4.0); of which the frail group's mean age was significantly high. In the unadjusted model, frailty was highly prevalent in the B12 insufficient group (odds ratio = 1.298). In the model fully adjusted for demographic data and comorbidities, these associations were attenuated. The B12 sufficiency group showed better total SPPB and TUG test scores. However, they were not statistically significant in the fully adjusted model.In this cross-sectional study, low B12 increased the incidence of frailty and affected physical performance, but it does not increase the incidence of frailty when considering the confounding factors. Frailty is caused by several factors rather than 1 factor, and B12 is one of these factors.
Optimistic orientation is linked to several benefits, including better-coping skills, lower stress levels, and better physical health. This study aimed to identify whether optimistic orientation is ...associated with physical frailty and whether it is related to each component of physical frailty.
We conducted a cross-sectional analysis of 2019 survey data from the Korean Frailty and Aging Cohort Study, which included 1203 participants aged 70–84 years. Frailty was defined using the Fried frailty phenotype and optimistic orientation was assessed using the Life Orientation Test-Revised.
Optimistic orientation and frailty were negatively correlated (r = −0.214, p < 0.001). After adjusting for several variables, the relationship between optimistic orientation and physical frailty was only significant in women (odds ratio OR = 2.960, 95 % confidence interval CI:2 1.375–6.371). Regarding the relationship with the five components of the physical frailty phenotype, the least optimistic women were more exhausted (OR = 1.829, 95 % CI: 1.224–2.732) and weaker (OR = 1.955, 95 % CI: 1.197–3.192) after adjusting for age, body mass index, alcohol consumption, smoking, education, marital status, social activity, living alone, family income, cognitive state, nutritional status, comorbidity, and depression.
Optimistic orientation was negatively associated with physical frailty only in women. Among the components of physical frailty, exhaustion and weakness are associated with optimistic orientation in women.
•Optimistic orientation was associated with physical frailty only in Korean older women.•Exhaustion and weakness were associated with optimistic women.
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