Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of ...muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m
in men and <5.4 kg/m
in women; and bioimpedance, <7.0 kg/m
in men and <5.7 kg/m
in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
Frailty renders older individuals more prone to adverse health outcomes. Little has been reported about the transitions between the different frailty states. We attempted to examine the rate of these ...transitions and their associated factors.
We recruited 3018 Chinese community-living adults 65 years or older. Frailty status was classified according to the Fried criteria in 2 visits 2 years apart. Demographic data, medical conditions, hospitalizations, and cognition were recorded. Rates of transitions and associated factors were studied.
At baseline, 850 (48.7%) men and 884 (52.6%) women were prefrail. Among these, 23.4% men and 26.6% women improved after 2 years; 11.1% of men and 6.6% of women worsened. More men than women (P < .001) deteriorated into frailty. Hospitalizations, older age, previous stroke, lower cognition, and osteoarthritis were risk factors for decline among prefrail participants. Having diabetes was associated with 50% lower chance of improvement in women. Among the robust, older age and previous cancer, hospitalizations, chronic lung diseases, and stroke were risk factors for worsening. Higher socioeconomic status was protective. Previous stroke reduced the chance of improvement by 78% in frail men. Only younger age was associated with improvement in frail women.
Women were less likely to decline in frailty status than men. Hospitalizations, older age, previous stroke, lower cognitive function, diabetes, and osteoarthritis were associated with worsening or less improvement. Older age, previous cancer, hospitalizations, lung diseases, and stroke were risk factors for worsening in the robust and higher socioeconomic status was protective.
Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the ...association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis), handgrip strength (<26 kg for men and <18 kg for women), and usual gait speed (<0.8 m/s). However, a number of challenges remained to be solved in the future. Asia is made up of a great number of ethnicities. The majority of currently available studies have been published from eastern Asia, therefore, more studies of sarcopenia in south, southeastern, and western Asia should be promoted. On the other hand, most Asian studies have been conducted in a cross-sectional design and few longitudinal studies have not necessarily collected the commonly used outcome indicators as other reports from Western countries. Nevertheless, the AWGS consensus report is believed to promote more Asian sarcopenia research, and most important of all, to focus on sarcopenia intervention studies and the implementation of sarcopenia in clinical practice to improve health care outcomes of older people in the communities and the healthcare settings in Asia.
Zn
1 -
x
Mn
x
O nanoparticles have been synthesized by hydrothermal technique. The doping concentration of Mn can reach up to 9 at% without precipitation or secondary phase, confirmed by electron ...spin resonance (ESR) and synchrotron X-ray diffraction (XRD). Room-temperature ferromagnetism is observed in the as-prepared nanoparticles. However, the room-temperature ferromagnetism disappears after post-annealing in either argon or air atmosphere, indicating the importance of post-treatment for nanostructured magnetic semiconductors.
Early cognitive deficits commonly seen in older people have not been well defined and managed in primary care. The objectives are (1) to develop and validate a new risk score to estimate the risk of ...dementia in Chinese older population; and (2) to evaluate the use of risk score in conjunction with cognitive screening in detecting early cognitive deficits in community older people.
A development cohort of 306 cognitive healthy older adults aged 60 or above were followed for 6 years. A CARS was constructed using the estimated coefficients of risk factors associated with dementia at follow up. Validation was carried out in another five-year cohort of 383 older adults. The usefulness of CARS in detecting early cognitive deficits was evaluated.
Risk factors include older age, male gender, low level of education, poorly controlled diabetes, prolonged sleep latency, fewer mind body or light exercise, loneliness, and being apolipoprotein e4 carriers. A cutoff of CARS at -1.3 had a sensitivity of 83.9% and a specificity of 75.4% to predict dementia. The area under curve was 82.5% in the development cohort. Early cognitive deficits were characterized by impaired retention (p <.001, 95% CI 0.2-0.9) and attention (p =.012, 95% CI 0.1-0.8).
The CARS can be used as a standard risk assessment of dementia or in conjunction with a computerized cognitive screening to evaluate a full cognitive profile for detecting early cognitive deficits. The result put forward the integration of risk algorithm into smart healthcare system to provide personalized lifestyle interventions.
Aims
Studies about sarcopenia in Asia are fewer, and started later than in Europe and America. We attempted to examine the decline in muscle mass, grip strength and gait speed in a cohort of older ...Chinese prospectively over 4 years.
Methods
We recruited 4000 community‐living Chinese older than 64 years, and measured their appendicular skeletal mass (ASM) by dual‐energy X‐ray absorptiometry, grip strength, and gait speed at baseline and after 2 years. Muscle mass and gait speed were additionally measured after 4 years.
Results
After 4 years, 3018 participants completed all the measurements. The annualized decline in grip strength (−0.798 kg/year vs −1.239 kg/year) and gait speed (−0.019 m/s/year vs – 0.025 m/s/year) was faster in women than in men. Muscle mass was relatively preserved in comparison with grip strength and gait speed. The percentage loss of ASM in 4 years was −1.59% and −2.02% in men and women, respectively. The percentage decline in gait speed after 4 years was −8.2% in men and −9.0% in women. However, the decline in grip strength was more rapid, particularly in women, which was −10.0% in 2 years and less so in men, −3.85% in 2 years.
Conclusion
Compared with black people and white people, the older Chinese have less muscle mass, weaker grip strength and slower gait speed. Although the rate of loss of ASM was modest, the decline in gait speed was rapid and the decline in grip strength was particularly fast in older Chinese women. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 76–84.
Aim
We examined the incidence and the reversibility of sarcopenia and their associated factors over a 4‐year period using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria.
...Methods
A total of 4000 community‐dwelling older adults aged ≥65 years were evaluated for which detailed information regarding demographics, socioeconomic, medical history, lifestyle, and clinical factors were documented at baseline, 2 years, and 4 years later. Sarcopenia was defined according to the EWGSOP algorithm. Incident sarcopenia and its reversibility were documented at each follow‐up year, and related to possible factors.
Results
At baseline, of the 4000 participants, 361 (9.0%) had sarcopenia. Between baseline and 2‐year follow‐up, 6.0% of the participants without sarcopenia at baseline had developed sarcopenia, and 18.8% of the initially sarcopenic participants had reverted to normal. Between baseline and 4‐year follow‐up, the corresponding figures were 6.3% and 14.1%, respectively. The average annual incidence over 4 years was 3.1%. After multivariate adjustments, older age, female sex, presence of chronic obstructive pulmonary disease, presence of stroke, higher physical activity levels, presence of instrumental activities of daily living impairments, and lower body mass index were associated with incident sarcopenia, whereas younger age, female sex, higher body mass index and absence of instrumental activities of daily living impairments, but not physical activity, were associated with its reversibility. Protein and vitamin D intake were not significantly associated with sarcopenia incidence or its reversibility.
Conclusion
Sarcopenia incidence increases with age, but is potentially reversible in a Chinese elderly population. High body mass index is protective against sarcopenia incidence and its reversibility. Increasing physical activity and maintaining a healthy weight could be beneficial in the prevention of sarcopenia. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 15–28.
The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rising in the West, but little is known in Asia. This study elucidated changes in the incidence ...and HPV-positive portion of OPSCC in Hong Kong. Data from population-based cancer registry were used to analyze the incidence of OPSCC in association with other head and neck cancers. Archived tumor tissues were tested for HPV. From 1986 to 2020, there was a marked decrease in the incidence of nasopharyngeal and laryngeal cancers, but a persistent increase in OPSCC from 36 cases in 1986 to 116 cases in 2020. The average positive rate for high-risk HPV was 36.1% (112/310) among OPSCC diagnosed in 2010-2020. The HPV-positive rate in recent years was significantly higher than earlier cases (tonsil SCC: 64.7% (55/85) in 2016-2020 vs. 40.4% (19/47) in 2010-2015,
= 0.007). Patients with HPV-positive tonsil cancers were significantly younger than those negative (mean SD: 58.9 9.9 vs. 64.3 13.3 years,
= 0.006), but no significant difference was observed between genders. A persistent increase in the incidence of oropharyngeal cancer over the last few decades was observed in Hong Kong, which can be explained by the remarkable increase in HPV-positive tonsil cancers.
The magnetism reflectometer at the SNS has passed the phase of commissioning and is in operation for users. The high power of the neutron source demands that special attention be paid to the ...optimization of the background in order to be able to measure the two-dimensional maps of reflected and scattered intensities with polarized neutrons in a broad range of momentum transfer. It implies an effective separation of the magnetic and non-magnetic reflectivity, off-specular scattering and the grazing incidence SANS in a high range of momentum transfer. Therefore the polarizing and the analyzing efficiencies are of particular importance on this time-of-flight instrument. At the beginning of July 2008 the world's first
3He neutron analyzer with on-line pump-up polarization was successfully installed and the tests with a magnetic multilayer film showing a strong off-specular spin-flip scattering were made. The performance of the instrument is under constant improvement in order to make it an effective and optimal instrument for the applications in nanosciences.
The objective of this paper is to investigate a unique type of entrepreneurship in women handicraft entrepreneurs. Data were collected from six women handicraft entrepreneurs by using in-depth ...interviews. Born after the 1980s, they strive for survival in a highly competitive marketplace. They are all passion-driven entrepreneurs. They have to engage in other activities (ranging from teaching handicraft classes to working in another full-time job) to financially support and sustain their handicraft work. It was found that challenges include high rental rates in the city, long product development processes, small market sizes, and insufficient knowledge in digital marketing. Almost all of them are skillful, innovative, and passionate on the artistic side, but reactive and passive on the business side. Measures were suggested to empower such women entrepreneurs in view of the United Nations’ Sustainable Development Goals.
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