Evidence suggests an association between sarcopenia and impaired respiratory function; however, longitudinal population-based data on the relationship between sarcopenia, its individual components, and peak expiratory flow (PEF) decline remain limited. This study aimed to investigate the cross-sectional and longitudinal associations of sarcopenia and its components with PEF measures among middle-aged and older Chinese adults. Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cross-sectional associations between sarcopenia and PEF measures were examined using multivariable logistic and linear regression models. Longitudinal associations between baseline sarcopenia and subsequent PEF decline were evaluated using multivariable logistic regression models. A total of 9452 participants were included in the cross-sectional analysis. Compared with participants without sarcopenia, those with sarcopenia and severe sarcopenia had higher odds of severe airflow limitation (SAL) (OR = 1.41, 95

[This corrects the article DOI: 10.3389/fendo.2026.1711060.].

ObjectiveTo evaluate the associations of the hemoglobin-albumin-lymphocyte-platelet (HALP) score with baseline physical-cognitive comorbidity, incident physical-cognitive comorbidity, and all-cause mortality using two independent cohorts.MethodsData were derived from the West China Health and Aging Trend (WCHAT) cohort and the UK Biobank (UKB). Participants aged ≥50 years with available laboratory, covariate, and functional data were included. Physical-cognitive comorbidity was defined as the coexistence of low grip strength and cognitive impairment. Multivariable logistic regression was used for cross-sectional analyses in both cohorts. Cox proportional hazards models were used to examine incident physical-cognitive comorbidity in WCHAT and all-cause mortality among participants with baseline comorbidity in UKB. Continuous-variable, subgroup, sensitivity, and restricted cubic spline analyses were additionally performed, and an exploratory incidence analysis was conducted in UKB participants without baseline comorbidity.ResultsA total of 5,957 participants in WCHAT and 101,655 participants in UKB were included in the baseline analyses. In both cohorts, higher HALP scores were associated with a lower risk of baseline physical-cognitive comorbidity. In the fully adjusted models, the odds ratio comparing Quartile 4 (Q4) with Quartile 1 (Q1) was 0.79 (95% CI: 0.62–0.99) in WCHAT and 0.77 (95% CI: 0.66–0.89) in UKB. In WCHAT, among 2,782 participants free of comorbidity at baseline, 330 incident events occurred, and higher HALP was associated with lower incident risk (Q4 vs. Q1: HR = 0.70, 95% CI: 0.52–0.94; per 1-SD increase: HR = 0.88, 95% CI: 0.79–0.99). In UKB, among 1,393 participants with baseline comorbidity, 227 deaths occurred, and higher HALP was associated with lower all-cause mortality (Q4 vs. Q1: HR = 0.65, 95% CI: 0.45–0.93; per 1-SD increase: HR = 0.80, 95% CI: 0.70–0.92). Findings were generally consistent in subgroup and sensitivity analyses, whereas time-dependent ROC-AUC analysis showed limited discrimination of the HALP-only model.ConclusionHigher HALP scores were associated with lower risks of baseline and incident physical-cognitive comorbidity and with better survival among participants with baseline physical-cognitive comorbidity. HALP may provide complementary information for immune-nutritional risk assessment, but it should not be interpreted as an independent predictive tool.

Frailty is a highly prevalent clinical syndrome among the elderly population, defined by diminished physiological reserve and heightened susceptibility to stressors. This condition substantially increases the risk of falls, disability, and mortality. As a dynamic adaptive capacity enabling individuals to cope with internal and external stressors, physical resilience is closely intertwined with the onset, progression, and outcome of frailty. In this review, we systematically synthesize the conceptual dimensions of physical resilience and comprehensively dissect the physiological and pathological mechanisms through which it modulates the frailty trajectory—spanning cellular and molecular pathways, tissue and organ function, and systemic crosstalk. Building on these mechanisms, we summarize the current research evidence supporting multidimensional intervention strategies, including exercise, nutrition, and psychological interventions. The primary objective of this work is to outline future research directions and provide a theoretical foundation as well as practical implications for delaying or ameliorating frailty via enhancing physical resilience.

OBJECTIVE:Previous studies have shown that thyroid function is associated with metabolic syndrome (MetS), but this association remains poorly understood in older adults. This study aimed to explore the relationships between thyroid hormone levels and sensitivity with MetS and its components in older adults. METHODS:The 2018 baseline data of the West China Health and Aging Trends study were used. MetS was diagnosed according to the International Diabetes Federation definition. Central thyroid hormone sensitivity was assessed by the TSH Index (TSHI), Thyrotrophic T4 Resistance Index (TT4RI), Thyroid Feedback Quantile-based Index (TFQI), and Parametric TFQI (PTFQI). Peripheral thyroid hormone sensitivity was assessed by the FT3 to FT4 ratio (FT3/FT4 ratio). RESULTS:A total of 3796 participants were included. The prevalence of MetS was 40.31%. High FT3 levels and FT3/FT4 ratios were associated with abdominal obesity and hypertension; decreased FT3 levels were associated with hyperglycemia, hypertriglyceridemia and low HDL-C; low FT4 levels were associated with abdominal obesity and hypertriglyceridemia; increased TSH, TSHI and TT4RI levels were associated with hypertriglyceridemia and hypertension; and increased TFQI and PTFQI were associated with hypertension (p < 0.05, for all). Increased FT3 (OR = 1.13, 95% CI: 1.05-1.22), TSH (OR = 1.12, 95% CI: 1.04-1.20), TSHI (OR = 1.09, 95% CI: 1.01-1.17), TT4RI (OR = 1.09, 95% CI: 1.01-1.16), FT3/FT4 (OR = 1.25, 95% CI: 1.16-1.35) and low FT4 (OR = 0.87, 95% CI: 0.81-0.94) were associated with MetS. CONCLUSION:Thyroid hormone levels are correlated with MetS and its components. Reduced central thyroid hormone sensitivity and increased peripheral thyroid hormone sensitivity are risk factors for MetS in older adults.

Diabetic foot (DF) and sarcopenia are common complications in individuals with diabetes and are linked through a bidirectional and mutually reinforcing relationship. From a pathophysiological perspective, insulin resistance disrupts skeletal muscle metabolism, while diabetic neuropathy and peripheral arterial disease compromise muscle function and mobility, increasing susceptibility to DF. Persistent low-grade inflammation further promotes muscle wasting and worsens glycemic dysregulation, establishing a self-perpetuating cycle. The presence of sarcopenia is associated with a two- to three fold increased risk of DF and is linked to poorer outcomes, including delayed wound healing and a higher likelihood of amputation. In turn, disability and reduced mobility caused by DF accelerate muscle disuse and atrophy. Integrated management strategies, encompassing resistance training, adequate protein intake, optimized glycemic control, and proactive foot care, are essential to interrupt this cycle. Although emerging pharmacological agents that enhance muscle anabolism show promise, further clinical validation is required. A multidisciplinary approach is necessary to curb the reciprocal progression of these conditions and to improve clinical outcomes in affected patients.

Background:Sarcopenia not only leads to impaired physical function but also may be associated with changes in sleep and mental health as individuals age. Research on the relationships between sleep disorders, anxiety, and depression and adult-onset sarcopenia is limited, however, with no reports of the associations between them and different severity of sarcopenia. The objective of this research endeavor is to investigate the associations between sarcopenia and sleep disturbances, anxiety, as well as depression, within a multi-ethnic population in western China. Method:We conducted a cross-sectional study consisting of 4,500 participants from the WCHAT study. The diagnostic method recommended by the Asian Working Group for Sarcopenia in 2019 was used to screen for sarcopenia. The Pittsburgh Sleep Quality Index (PSQI), the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the 15-item Geriatric Depression Scale (GDS-15) were used to assess sleep quality, anxiety, and depression, respectively. The relationships among sleep, anxiety, depression, and the different sarcopenia subgroups were evaluated by using multivariate regression models. In addition, subgroup of gender analysis were performed. Results:Among the 4,500 participants surveyed in the western region of China, 408 (9.06%) were diagnosed with sarcopenia and 618 (13.73%) with severe sarcopenia. A total of 2,515 individuals (55.88%) had poor sleep quality, while 842 (18.71%) suffered from anxiety, and 1,045 (23.22%) had depression. Good sleeping quality were negatively associated with severe sarcopenia (OR: 0.80, 95%CI 0.66-0.97) in model 1, whereas depression was positively associated with severe sarcopenia in three models (model 1: OR: 1.39, 95%CI 1.13-1.71; model 2: OR: 1.46, 95%CI 1.16-1.85; model 3: OR: 1.43, 95%CI 1.13-1.81). However, anxiety status was not associated with sarcopenia in our study. Conclusion:It was found that good sleep quality were negatively associated with severe sarcopenia, and depression was positively associated with severe sarcopenia. These findings suggested that early intervention in sleep quality and depression may be one of the effective strategies to delay or reduce the severity of sarcopenia. Clinical trial registration:https://www.chictr.org.cn/, identifier ChiCTR1800018895.

The skeletal muscle is an important organ for movement and metabolism in human body, and its physiological aging underlies the occurrence of muscle atrophy and sarcopenia. China has the largest aging population in the world and is facing a grand challenge with how to prevent and treat skeletal muscle aging-related diseases. To address this difficult problem, the Aging Biomarker Consortium (ABC) of China has reached an expert consensus on biomarkers of skeletal muscle aging by synthesizing literatures and insights from scientists and clinicians. This consensus attempts to provide a comprehensive assessment of biomarkers associated with skeletal muscle aging, and proposes a systematic framework to classify them into three dimensions: functional, structural, and humoral. Within each dimension, the experts recommend clinically relevant biomarkers for skeletal muscle aging. This consensus aims to lay the foundation for future research on skeletal muscle aging, facilitating precise prediction, diagnosis, and treatment of skeletal muscle aging and sarcopenia. It is anticipated to make significant contributions to healthy aging of skeletal muscle in the elderly population in China and around the world as well.

OBJECTIVES:This study aimed to develop and validate a game-based digital cognitive assessment tool integrating gaming scenarios and Chinese cultural elements (IGD-CAT) to screen for mild cognitive impairment (MCI) in China, and to assess its concurrent and discriminative validity. DESIGN:A cross-sectional methodological study was conducted to develop and validate the IGD-CAT. SETTING AND PARTICIPANTS:A total of 218 participants were recruited from community and hospital settings between July 2023 and February 2024. All participants underwent traditional cognitive assessments, followed by IGD-CAT administration, and were classified into either normal cognition (NC) or MCI groups. METHODS:A theoretical framework was established through a literature review, expert panel, and Delphi survey. The IGD-CAT was then developed through medical-engineering collaboration. Concurrent validity was evaluated by correlating IGD-CAT scores with Montreal Cognitive Assessment (MoCA) results. A random forest model was developed to assess the discriminatory validity of IGD-CAT in screening individuals with MCI. RESULTS:The IGD-CAT comprises 14 tasks assessing 7 cognitive domains: time orientation, attention, memory, language, calculation, visuospatial abilities, and executive function. Among 196 participants (mean age 63.6 ± 5.81 years), 93 were classified as MCI and 103 as NC. Task scores showed significant positive correlations with MoCA (r = 0.140-0.387), whereas completion times correlated negatively (r = -0.476 to -0.168). The total IGD-CAT score correlated with MoCA (r = 0.529, P < .001), and total time correlated negatively (r = -0.549, P < .001), indicating that higher scores and shorter completion times were associated with better cognitive performance. The random forest model demonstrated strong classification performance, with 89.65% sensitivity, 96.55% specificity, and an area under the curve of 0.96. CONCLUSIONS AND IMPLICATIONS:The IGD-CAT assesses a comprehensive range of cognitive domains, is time efficient, and features an age-friendly design. With high sensitivity, specificity, and accuracy, the IGD-CAT is well-suited for implementation in primary health care settings, communities, hospitals, and home environments.

BackgroundIn 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched a consensus on the diagnostic methods for sarcopenic obesity (SO). The study aimed to identify the prevalence and diagnostic agreement of SO using different diagnostic methods in a cohort of subjects from West China aged at least 50 years old.MethodsA large multi-ethnic sample of 4,155 participants from the West China Health and Aging Trend (WCHAT) study was analyzed. SO was defined according to the newly published consensus of the ESPEN/EASO. Furthermore, SO was diagnosed as a combination of sarcopenia and obesity. The criteria established by the Asian Working Group for Sarcopenia 2019 (AWGS2019) were used to define sarcopenia. Obesity was defined by four widely used indicators: percent of body fat (PBF), visceral fat area (VFA), waist circumference (WC), and body mass index (BMI). Cohen’s kappa was used to analyze the diagnostic agreement of the above five diagnostic methods.ResultsA total of 4,155 participants were part of the study, including 1,499 men (63.76 ± 8.23 years) and 2,656 women (61.61 ± 8.20 years). The prevalence of SO was 0.63–7.22% with different diagnostic methods. The diagnosis agreement of five diagnostic methods was poor-to-good (κ: 0.06–0.67). The consensus by the ESPEN/EASO had the poorest agreement with other methods (κ: 0.06–0.32). AWGS+VFA had the best agreement with AWGS+WC (κ = 0.67), and consensus by the ESPEN/EASO had the best agreement with AWGS+ PBF (κ = 0.32).ConclusionThe prevalence and diagnostic agreement of SO varies considerably between different diagnostic methods. AWGS+WC has the highest diagnostic rate in the diagnosis of SO, whereas AWGS+BMI has the lowest. AWGS+VFA has a relatively good diagnostic agreement with other diagnostic methods, while the consensus of the ESPEN/EASO has a poor diagnostic agreement. AWGS+PBF may be suitable for the alternative diagnosis of the 2022 ESPEN/EASO.

Background Sarcopenia not only leads to impaired physical function but may also be associated with changes in sleep and mental health as individuals age. Research on the relationship between sleep, anxiety, and depression and adultonset sarcopenia is limited; however, there are no reports indicating the relationship between them and the different groups of sarcopenia. The aim of this study is to explore the correlation between sarcopenia (diagnosed sarcopenia, severe sarcopenia) and sleep, anxiety, and depression in different groups in the multiethnic region of western China based on the 2019 Asian sarcopenia diagnostic criteria. Methods The diagnostic method recommended by the Asian Working Group for Sarcopenia in 2019 was used to screen for sarcopenia. The population in the multiethnic region of western China included in this study underwent bioelectrical impedance analysis to classify sarcopenia into the diagnosed sarcopenia and severe sarcopenia groups, while also recording other data for analysis. The Pittsburgh Sleep Quality Index, the 7-item Generalized Anxiety Disorder Questionnaire, and the 15-item geriatric depression scale were used to assess the sleep quality, anxiety, and depression status of participants, respectively. Multiple logistic regression multivariate analysis was used to determine the relationship among sleep, anxiety, depression, and the different types of sarcopenia. Results Among the 4500 participants surveyed in the western region of China, 408 (9.06%) were identified as having myasthenia gravis and 618 (13.73%) as having severe myasthenia gravis, whereas 2015 individuals (44.78%) had poor sleep quality, 842 (18.71%) had anxiety, and 1045 (23.22%) had depression. Sleep abnormalities were associated with severe sarcopenia (odds ratio [OR]: 0.717, 95% confidence interval [CI] 0.550–0.934), whereas depression was associated with diagnosed sarcopenia (OR: 1.289, 95%CI 1.032–1.608) and severe sarcopenia (OR: 1.622, 95%CI 1.032–1.608). Conclusion The western region of China is a multiethnic area with 44.78% of participants > 50 years of age experiencing poor sleep quality, 18.71% suffering from anxiety, and 23.22% experiencing depression. It may be possible to delay or reduce the severity of sarcopenia by early intervention in improving sleep quality and alleviating depression. Clinical trial number : ChiCTR1800018895

AbstractMuscle atrophy, characterized by the loss of muscle mass and function, is a hallmark of sarcopenia and cachexia, frequently associated with aging, malignant tumors, chronic heart failure, and malnutrition. Moreover, it poses significant challenges to human health, leading to increased frailty, reduced quality of life, and heightened mortality risks. Despite extensive research on sarcopenia and cachexia, consensus in their assessment remains elusive, with inconsistent conclusions regarding their molecular mechanisms. Muscle atrophy models are crucial tools for advancing research in this field. Currently, animal models of muscle atrophy used for clinical and basic scientific studies are induced through various methods, including aging, genetic editing, nutritional modification, exercise, chronic wasting diseases, and drug administration. Muscle atrophy models also include in vitro and small organism models. Despite their value, each of these models has certain limitations. This review focuses on the limitations and diverse applications of muscle atrophy models to understand sarcopenia and cachexia, and encourage their rational use in future research, therefore deepening the understanding of underlying pathophysiological mechanisms, and ultimately advancing the exploration of therapeutic strategies for sarcopenia and cachexia.

Objectives The association between sarcopenia severity and fall history remains under-researched at present. Accordingly, this study was developed to evaluate the relationship between sarcopenic status and prior fall events in a multiethnic group of older community-dwelling adults in Western China.Design A retrospective survey study, the data comes from the West China Health and Aging Trend study.Setting The study was based in Western China.Participants In total, this retrospective analysis incorporated data from 2719 older adults (59.2% women).Primary and secondary outcome measures Grip strength, gait speed and skeletal muscle mass index values were analysed for all participants, and the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 consensus criteria were leveraged to assess sarcopenia status in these individuals. Prior fall history was defined by any incidents in which an individual unintentionally came to rest on the floor within the past year. The association between sarcopenia status and fall history was examined through a binary logistic regression approach, with p<0.05 as the threshold for significance.Results Using the AWGS2014 and AWGS2019 diagnostic criteria, of the individuals included in this study cohort 1851 (68.1%) were free of sarcopenia, 160 (5.9%) and 56 (2.1%) showed only muscle-mass loss, 322 (11.8%) and 267 (9.8%) exhibited non-severe sarcopenia and the remaining 386 (14.2%) and 545 (20.0%) exhibited severe sarcopenia, respectively. Previous fall events were reported for 14.8% of study cohort members. After full adjustment for potential confounders, a significant link between severe sarcopenia diagnosed by the AWGS2014 diagnostic criteria and fall history was observed (OR 1.397, 95% CI 1.029 to 1.896, p=0.032), while the AWGS2019 diagnostic criteria did not (OR 1.29, 95% CI 0.982 to 1.694, p=0.068).Conclusions Severe sarcopenia, as defined per the AWGS2014 criteria, was associated with a significantly higher risk of falls in this multiethnic cohort of older adults from Western China, while the AWGS2019 diagnostic criteria did not. However, this relationship was not observed for individuals who experienced muscle mass loss or had non-severe sarcopenia, according to both the AWGS2014 and AWGS2019 diagnostic criteria.

Introduction: Although the relationship between the number of teeth and frailty has been extensively studied, the mediating role of nutrition status in the association between the number of teeth and frailty remains to be clarified. Methods: A number of 6,664 participants lived in the communities of West China were analyzed in our study. Physical frailty was determined based on the phenotype established by Fried. Nutrition status was evaluated using the Mini Nutrition Assessment-Short Form (MNA-SF) scale. Multiple linear regression was employed to evaluate the direct relationships between the number of teeth, nutrition, and frailty. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition status in the relationship between the number of teeth and frailty. Results: Among the 6,664 participants aged over 50 years old, the prevalence of frailty was 6.2%. Multiple linear regression analysis showed a significant total relationship between the number of teeth (beta = -0.359, 95% CI: -0.473 to -0.244, p < 0.001) and frailty. After adjusting for MNA-SF scores, the relationship between the number of teeth and frailty remained significant (beta = -0.327, 95% CI: -0.443 to -0.211, p < 0.001), indicating a partial mediating effect of nutrition. Mediation analysis verified that nutrition partially mediated the relationship between the number of teeth and frailty (indirect effect estimate = -0.0121, bootstrap 95% CI: -0.0151 to -0.0092; direct effect estimate = -0.0874, bootstrap 95% CI: -0.1086 to -0.0678) in the fully adjusted model. This mediating effect occurred through influencing weight loss, low level of physical activity, and debility. SEM framework pathway analysis confirmed the association between the number of teeth, nutrition, and frailty. Conclusions: Our findings demonstrated that frailty was correlated with the number of teeth and poorer nutritional status, with nutrition partially mediating the correlation between the number of teeth and frailty. Our results supported early nutritional evaluation and intervention in oral health to decrease the risk of frailty.

Purpose: The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults. Methods: This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia. Results: Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41–0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58–0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52–0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48–0.98) was associated with a lower risk of sarcopenia. Conclusion: Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.

随着人口老龄化加剧,为实现健康老龄化的目标,全球对年龄相关疾病及衰老的研究投入不断增加,以探索安全有效的衰老干预措施.本文对衰老及衰老干预(包括干细胞干预、微生物群干预、炎症干预、表观遗传学干预及代谢干预)的研究进展进行综述,为研究衰老并最终通过干预延缓衰老提供参考.

课堂教学模式直接影响学生的学习效果,基于研究生的培养目标,传统教育模式不适用于研究生教学.本文对基于"互联网+"的尝试教学法在高校,尤其是研究生教学中的应用效果和现状进行研究综述,探讨尝试教学法在临床医学教学实践中的优势,并提出如何将"互联网+"与尝试教学法相结合应用,为推动新时代教育改革创新,提升临床医学研究生教学质量提供理论参考与依据.

Frailty and sarcopenia are age-related diseases, and exhibit a concomitant relationship, as they share many common clinical features and etiological factors. Transitions within frailty status would be influenced by the presence of sarcopenia. Investigating their association to devise efficacious intervention and management strategies for geriatric patients is imperative, given their potentially unfavorable outcomes. In this study, the literature on sarcopenia and frailty was screened in the Web of Science core collection database over the past 30 years to ascertain the link between them through bibliometric analysis and the exploration of disease-related molecular pathways within the GeneCards and OMIM databases was conducted. Per inclusion and exclusion criteria, 3889 literature sources were selected for subsequent analysis. Keywords, including “cirrhosis” and “postoperative complications,” represent the current and potential future research trends and focal points in this field. Moreover, 63 common potential targets between the two diseases were identified. Their pathogenesis involved cellular aging and endocrine metabolism regulation pathways, including AMPK, cell senescence, and the endocrine resistance pathway. This study identified an intimate correlation between frailty and sarcopenia in pathogenesis, prevention, and treatment measures, establishing a foundation for exploring shared prevention and treatment strategies for these two disorders.