Background Sarcopenic obesity (SO) is characterized by excess adiposity and reduced muscle mass and function. In 2022, the Sarcopenic Obesity Global Leadership Initiative (SOGLI) proposed a diagnostic algorithm to standardize SO identification by integrating screening, diagnostic assessment, and staging. Aim This review evaluates the application of the SOGLI algorithm, identifying strengths, limitations, and potential areas for refinement. Methods A narrative review with systematic citation tracking was conducted (April 2022- August 2025). Literature searches in PubMed, Scopus, and Web of Science identified original studies in adults (≥18 years) explicitly using the SOGLI algorithm. Data on screening, diagnostic tools, staging, prevalence, and comorbidities were synthesized. Results Seventy-two studies applied the SOGLI algorithm, showing heterogeneous approaches across clinical settings. For obesity screening, about half used both body mass index and waist circumference, while sarcopenia screening tools were less frequently reported. For SO diagnosis, bioelectrical impedance analysis was the most common method for body composition assessment, while muscle function was predominantly assessed via hand-grip strength. SO staging was reported in 19% of studies, most often as Stage II. Application of the algorithm consistently confirmed associations between SO and chronic disease burden, functional decline, and increased mortality. Conclusions The SOGLI algorithm represents a major advance, with 72 studies adopting it in two years. Some inconsistencies in screening and staging suggest opportunities for refinement. These findings support its validity, while further standardization and integration of novel biomarkers could enhance its clinical effectiveness.

Sarcopenia is a progressive muscle disease characterized by loss of skeletal muscle mass and strength, commonly associated with ageing and chronic diseases. Type 2 diabetes mellitus (T2DM) accelerates its development through insulin resistance, chronic inflammation, oxidative stress, and hyperglycaemia. Sarcopenia may worsen diabetes-related outcomes, including increased risk of falls, functional decline, reduced quality of life, and impaired metabolic control. Despite its clinical impact, sarcopenia remains underdiagnosed in people with diabetes, particularly in those with high body mass index and excess adiposity. This paper reviews appropriate and sensitive methodologies for screening and diagnosing sarcopenia in people with diabetes. A structured expert consensus was conducted in two phases, informed by a targeted PubMed literature review and discussions with an international multidisciplinary panel. The consensus informed the development of a clinically applicable algorithm. The proposed approach integrates screening, diagnosis, staging, and management of sarcopenia, including exercise and muscle-targeted nutritional interventions, to improve clinical care. Sarcopenia is an under-recognised complication of diabetes requiring systematic assessment. This consensus provides an integrated algorithm combining functional, nutritional, and metabolic evaluation to guide personalised management.

To evaluate the validity, reliability, and diagnostic accuracy of the InGrip digital dynamometer compared with the Jamar hydraulic model in community-dwelling older adults. The InGrip device showed excellent correlation and agreement with the Jamar dynamometer, with high intra- and inter-rater reliability. It demonstrated outstanding diagnostic performance with sex-specific cutoff values closely aligned with EWGSOP2 criteria. The InGrip digital dynamometer is a valid, reliable, and clinically useful alternative to the Jamar for assessing handgrip strength in older adults. Handgrip strength is essential for diagnosing sarcopenia and assessing muscle function in older adults. The Jamar hydraulic dynamometer, backed by strong clinical and epidemiological data, is widely used; however, weight and calibration requirements may limit use. Digital models such as InGrip offer stable calibration and ergonomic design. This study aimed to validate accuracy, reliability, and diagnostic performance of InGrip versus the Jamar. A cross-sectional, randomized, single-center study of 415 community-dwelling older adults (mean age: 75.3 ± 6.5 years). Handgrip strength was measured with both devices per the Southampton protocol. Correlation and agreement (Bland–Altman, ICC) between InGrip and the reference dynamometer (Jamar) were analyzed, and diagnostic capacity via ROC curves, estimating sensitivity, specificity, and predictive values for low handgrip strength per EWGSOP2 criteria. The InGrip dynamometer showed strong correlation with the Jamar dynamometer (r = 0.95) and excellent agreement (ICC = 0.94), intra-observer (ICC = 0.96), and inter-observer (ICC = 0.96), with a mean bias of − 0.37 kg and limits of agreement from – 4.45 to 3.72 kg. Its diagnostic capacity was high (AUC women = 0.968; AUC men = 0.982). Optimal cutoffs were ≤ 18 kg for women (sensitivity = 92.6

To explore the reasons behind the choice of Geriatric Medicine as a specialty among medical residents. Interest in Geriatric Medicine is shaped by both personal factors and elements directly related to the specialty and the characteristics of the older adult population. Training in Geriatrics, encompassing both theoretical and practical components, appears to help reframe the complexity of geriatric patients as a stimulating aspect of the field. Promoting a comprehensive education in Geriatric Medicine during medical training may increase the appeal of the specialty as a career path. To examine the most common factors influencing the selection of Geriatric Medicine as a specialty among medical residents, and to assess whether receiving specific exposure to Geriatric Medicine during training influences these factors. A qualitative descriptive study was carried out using intentional sampling, involving anonymous completion of a questionnaire distributed to accredited Spanish Geriatric Medicine teaching units during the 2023/2024 academic year. A total of 129 medical residents participated in the survey. Eighty-nine per cent were already familiar with the specialty and 46

BACKGROUND AND AIM:To evaluate the association between sarcopenia and metabolic syndrome. PATIENTS AND METHODS:A case-control study. SETTING:Geriatric Care Clinic of Metepec (México). INCLUSION CRITERIA:Outpatients with physical and mental independence to perform daily living activities (DLA). EXCLUSION CRITERIA:Physical or mental disability requiring assistance from a carer, active cancer, cardiopathies and renal disease. PATIENTS:124 participants (59.6% women) aged over 60 years (mean age 69.7 years, standard deviation±6.5 years). MEASUREMENTS:62 with sarcopenia according to the EGWSOP 2019 definition. Hypertension, diabetes, adiposity and dyslipidaemia were assessed, and the prevalence and odds ratio (OR) of metabolic syndrome in cases and controls were calculated. RESULTS:Participants with sarcopenia were more likely to be female (80% vs. 41.8%), with no major differences from controls in other characteristics. 46.7% of participants were obese and 25.8% in both groups met diagnostic criteria for the metabolic syndrome; of the items defining the metabolic syndrome, only hypertension, obesity grade II and central obesity were associated with the presence of sarcopenia (OR 2.12; 3.39 and 1.93, respectively, with 95% CI). CONCLUSIONS:We could not confirm an association between sarcopenia and the metabolic syndrome, but with the obesity and hypertension components.

Background/Aims Malnutrition is a common clinical problem causing poor outcomes, including longer hospital stays, complications, functional decline, and mortality. Oral nutritional supplements (ONS) are a key component of medical nutrition therapy for patients who cannot meet their nutritional needs through diet alone. Despite their proven effectiveness, ONS use in practice remains inconsistent due to the lack of comprehensive, practice-based, and internationally validated guidelines. In 2023, the Turkish Clinical Enteral and Parenteral Nutrition Society (KEPAN) developed a national consensus report to address this gap. To enhance international validity and applicability, this study aimed to validate and refine those recommendations through a global Delphi process involving multidisciplinary experts. Methods A two-round modified Delphi study was conducted between February 2023 and March 2024. Twenty-two experts from 13 countries and various disciplines (internal medicine, gastroenterology, geriatrics, surgery, family medicine, physiatry, clinical nutrition, dietetics, etc.) rated 22 predefined recommendations using a 5-point Likert scale. Consensus was defined as a median score ≥4 with a 25th percentile ≥4. Expert comments were reviewed and incorporated, and recent international guidelines were used to update the supporting commentaries as well. Results Seventeen recommendations achieved consensus in round 1, and the remaining five in round 2. The final internationally validated set of recommendations covers practical aspects of ONS use including: (1) indications for initiation, dose, timing, and product selection; (2) monitoring strategies, adherence, and management of taste, tolerance, and other common problems; and (3) condition-specific considerations across diabetes, chronic kidney disease, cirrhosis, congestive heart failure, chronic obstructive pulmonary disease, neurological diseases, pressure injuries, surgery, cancer, geriatrics and multimorbidity, as well as guidance on continuation and discontinuation of ONS. The refined recommendations emphasize the food-first principle, individualized decision-making, and multidisciplinary collaboration to optimize person-centered nutritional care. Conclusions This study delivers the first internationally validated, expert-informed recommendations on ONS use, providing a standardized and adaptable framework for global implementation. Familiarity with and application of these recommendations in clinical practice should lead to improved nutritional care, better adherence, enhanced patient outcomes, and more efficient, person-centered use of ONS across several healthcare settings.

This article has been simultaneously published in Journal of the American Geriatrics Society (published by Wiley Periodicals LLC on behalf of The American Geriatrics Society), Age and Ageing (published by Oxford University Press on behalf of British Geriatrics Society), and European Geriatric Medicine (published by Springer on behalf of European Geriatric Medicine Society). All rights reserved. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style.

Los adultos mayores a menudo toman múltiples fármacos y son usuarios frecuentes de centros hospitalarios, sufriendo como consecuencia un mayor riesgo de reacciones adversas a medicamentos (RAM) que el resto de la población. Los estudios epidemiológicos sobre las RAM en los mayores, realizados en las últimas décadas, han tenido resultados heterogéneos en lo referente a incidencia, características clínicas de los eventos y a fármacos causantes de las RAM en los distintos niveles asistenciales.La polifarmacia, multimorbilidad, fragilidad, los cambios fármaco-cinéticos y fármaco-dinámicos asociados a la edad y otros síndromes geriátricos se asocian a un mayor riesgo de RAM.Para prevenirlas, los procesos de revisión de medicación y desprescripción se deben realizar en el marco de una valoración global del mayor, teniendo en cuenta las características clínicas y necesidades específicas de cada nivel asistencial.

This study qualitatively investigates retirement-age adults' perspectives on engaging in health behaviors such as physical activity or a healthy diet, distinguishing facilitators, barriers, goals, and motivations (the two later in line with Self-Determination Theory). Two clinical psychologists conducted four focus groups with Spanish adults around retirement age. We conducted inductive and deductive content analysis. The main facilitators and barriers identified were the presence and absence of social support/social network, mental health, willpower, time, and motivation. Participants reported different types of motivation (e.g., intrinsic motivation in the enjoyment of the activity of exercise or cooking) and goals (intrinsic and extrinsic); except for the goal of health management, which presented both types of motivation, participants regulated intrinsic goals autonomously, and extrinsic ones with controlled motivation. A process of internalizing the source of motivation was identified inductively by participants. Facilitating social networks and addressing mental health issues could aid engagement in health behaviors among this population. Additionally, health management appeared as a significant goal, where autonomous motivation can develop even if the behavior initially arises from controlled motivation or external triggers, such as medical advice.

Background: Introduction: Physical activity is essential in preventing and treating age-related chronic diseases and mortality. Retirement is a key period to promote health behaviours, as individuals restructure their routines. Thus, we aimed to identify effective components and behaviour change techniques (BCTs) in interventions promoting physical activity in retirement-age individuals. Methods: We conducted a meta-analysis. Included studies were randomised controlled trials that (p)targeted retirement-age adults (50-70 years), (i)applied BCTs, (c)had any comparator, and (o)promoted physical activity. Screening, full-text review, and data extraction were conducted independently by at least two reviewers. A multilevel random effects model with three effect sizes was fitted, and meta-regressions tested several moderators. Results: 67 studies (N = 12,147) were included. High risk of bias related to larger effects, so these studies were excluded from the main analyses. While individual effects were often non-significant, the overall pooled effect was small but statistically significant. Predictors varied across effect sizes and included action planning, motivational interviewing, and prompts/cues. Email and website delivery were associated with smaller effect sizes. Conclusions: The effectiveness of lifestyle interventions is heterogeneous and presented small effects; implementing action planning, motivational interviewing, and prompts could improve the effectiveness. However, many BCTs that are not frequently used remain unexplored.

Older adults often take multiple drugs and are high users of hospitals. Consequently, this is associated with an increased risk of adverse drug reactions (ADRs) compared to the general population. Epidemiological studies on ADRs in older adults conducted over recent decades have shown heterogeneous results regarding incidence, clinical characteristics of the events, and causative drugs. Polypharmacy, multimorbidity, frailty, age-related pharmacokinetic and pharmacodynamic changes, and other geriatric syndromes are associated with a higher risk of adverse drug reactions (ADR). Medication review and deprescription processes should be conducted within the framework of a comprehensive assessment of older adults, considering their clinical characteristics and the specific needs of each clinical setting.

BACKGROUND:Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S. METHODS:This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2-3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up. RESULTS:Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3-7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41-0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23-0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34-0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18-0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group. CONCLUSIONS:In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance. TRIAL REGISTRATION:ClinicalTrials.gov NCT02582138.

ABSTRACT Background The Sarcopenia and Quality of Life (SarQoL) questionnaire is recognized as the only disease‐specific patient‐reported outcome measure (PROM) for assessing sarcopenia‐related HRQoL. This systematic review and meta‐analysis aimed to provide a quantitative summary of all evidence reported on the reliability, validity, responsiveness and floor/ceiling effects of SarQoL in older adults. Methods Following PRISMA‐COSMIN guidelines, a systematic search for studies evaluating the psychometric properties of SarQoL (i.e., reliability, validity, responsiveness and floor and ceiling effects) in older people was conducted on MEDLINE (via OVID), PsycINFO, Scopus and EMBASE. Studies published between 2013 and November 2024 using a consensual definition of sarcopenia were included. Study selection and data extraction were made by two independent reviewers. A random‐effects model meta‐analysis was applied. PROSPERO registration: CRD42024546880. Results From 411 studies identified by the search strategy, 25 fulfilled the inclusion criteria, including 4585 community‐dwelling individuals, of which 1311 were diagnosed as sarcopenic. SarQoL demonstrated high reliability (pooled Cronbach's alpha values consistently exceeding 0.80) and excellent test–retest reliability (pooled ICC = 0.98). Construct validity was confirmed with strong convergent correlations (pooled r > 0.54) with related dimensions of generic SF‐36 and EQ‐5D and weaker divergent correlations (pooled r < 0.47). Responsiveness, evaluated in two studies using different methodologies, supported the ability of SarQoL to detect meaningful changes in HRQoL. The certainty of evidence was rated as high for reliability, validity and responsiveness. Conclusion This meta‐analysis consolidates a decade of evidence and confirms the strong psychometric properties of SarQoL, with a high level of evidence.

BACKGROUND:Low muscle strength and sarcopenia are strong predictors of disability. Although multicomponent training (MT) is commonly recommended, its long-term effects remain unclear, and evidence on high-speed resistance training (H-RT) in older women is limited. METHODS:This double-blind randomized trial evaluated the effects of a 32-week intervention, with RT (weeks 1-11) progressing to H-RT (weeks 12-32) vs MT, on muscle strength, body composition, and functional performance. A total of 120 women aged ≥65 years (mean age: 77.0 ± 6.8 years) with low muscle strength (diagnosed with probable sarcopenia according to EWGSOP2) were randomized into H-RT, MT, or a nonexercise control group (CG). RESULTS:Both exercise modalities improved lower-limb physical performance, as assessed by the Five Times Sit-to-Stand Test, compared to women who did not exercise (p < .001), with no significant differences between H-RT and MT (p = .127) (H-RT: -3.2 ± 2.5 s; MT: -2.6 ± 2.5 s vs CG: -0.8 ± 2.1 s). Functional and body composition improvements were seen in both groups. H-RT led to greater improvements in the Timed Up & Go Test (-0.9 ± 1.9 s; p = .007) and waist circumference (-4.5 ± 5.1 cm; p = .010), while MT showed better results in aerobic capacity (Two-minute step test: +19.9 ± 17.2 steps; p = .044). CONCLUSIONS:H-RT is an effective alternative to MT for improving strength, performance, and body composition in older women, with specific benefits. Further studies should confirm its role in preserving intrinsic capacity and preventing sarcopenic obesity.

BACKGROUND:Sarcopenic obesity (SO) is a clinical condition defined by the coexistence of high body fat mass and low muscle function and mass, which increases the risk of adverse health outcomes, including disability and mortality. Early detection and frequent monitoring of SO are essential for preventive interventions and management strategies. The current binary approach for SO diagnosis is limited in capturing the spectrum of SO or its progression over time. The main objective of this study was to develop a continuous SOPi that integrates diagnostic criteria such as muscle function and body composition. We aimed to evaluate the association between SOPi and all-cause mortality, to identify baseline-related factors with SOPi and to assess changes in the SOPi over time. METHODS:Participants from the Rotterdam Study with baseline and follow-up measures of handgrip strength (HGS), dual-energy X-ray absorptiometry-measured appendicular lean mass index (ALM/kg) and body fat percentage (BF%) were included. SOPi was calculated as a sex-specific equation integrating z-scores (Z) of (BF%)-(HGS)-(ALM/kg). Cox regression and multivariable linear regression models were fitted to evaluate mortality risk and associated factors with SOPi, respectively. Subgroup analysis of SOPi changes was performed by linear mixed-effects models. RESULTS:In the total population (n = 5888, age 69.5 ± 9.1 years, BMI 27.5 ± 4.3 kg/m2, 56.8% females) and over the 9.9-year median follow-up period, 1538 (26.1%) participants died. Each standard deviation (SD) increase in sex-specific SOPi was associated with a 10% higher risk of premature death (HR = 1.10 [95%CI: 1.07; 1.13]). Thirteen factors were associated with high SOPi, such as reduced physical activity, higher triglyceride-glucose index, HOMA-IR, systemic inflammation, osteopenia, hypertension, liver steatosis, asthma, coronary heart disease, oral corticosteroid use, lower protein intake, lower quality of life and lower educational status. In participants with obesity, lower physical activity and/or insulin resistance (n = 1682), a significantly higher and faster increase in SOPi was observed compared to participants without these factors (males: β = 2.63 [95%CI: 2.22; 3.03]; females: β = 2.90 [95%CI: 2.58; 3.23]). CONCLUSION:SOPi is a significant predictor of premature death and can identify associated factors, particularly useful among persons at risk of SO. SOPi is higher and increases faster in individuals with specific phenotypes. SOPi integrates prognosis information, which could be used as a risk indicator and for prevention of SO.

Introduction: Sarcopenia is an age-related condition characterised by low muscle mass and function, associated with poorer outcomes. Its prevalence and prognostic role in multiple myeloma (MM) remain unclear, as most studies only consider muscle mass defined by computed tomography (CT) scan and disregard muscle function. This study aimed to describe the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) definition in older patients with MM and to analyse its associations with other geriatric syndromes and survival outcomes. Methods: This is a prospective study of patients aged ≥65 years with newly diagnosed MM who underwent a Comprehensive Geriatric Assessment (CGA), including handgrip strength and gait speed. Their initial positron emission tomography-computed tomography images were evaluated in terms of muscle mass, subcutaneous and visceral adipose tissue at the third lumbar vertebral level (L3). Medical records were reviewed in January 2025 to collect mortality and follow-up data. Results: Of 52 patients included (55.1% women; median age 77.6 ± 5.9 years), 32 (61.5%) had probable sarcopenia (low muscle strength), and four (12.5%) had confirmed sarcopenia (low muscle strength and low muscle mass). No significant differences were found in frailty or malnutrition between sarcopenic and non-sarcopenic participants. Sarcopenic patients had significantly shorter overall survival (OS) compared with non-sarcopenic patients (43.1 vs. 18.0 months, p = 0.001), and low muscle mass was independently associated with poorer survival outcomes (hazard ratio [HR]: 46.8; 95% confidence interval [CI]: 1.9–1,146.9). In contrast, no significant differences were observed for progression-free survival (PFS), although low muscle mass remained significantly associated with an increased risk of progression (HR: 25.34; 95% CI: 1.72–374.27). Conclusion: This is the first study to include both muscle quantity (muscle mass) and function (muscle strength) as the correct approach for sarcopenia evaluation in older patients with MM. Patients with sarcopenia may have reduced OS, and low skeletal muscle mass index was also associated with shorter PFS, but further studies with larger cohorts are needed to confirm its prognostic value.

BACKGROUND AND AIM:Despite advances in research on training and nutritional supplementation, it is largely unknown how micronutrient intake modulates the response to training in older adults. This study investigates the relationship between nutrient intake and response to training in older women at risk of sarcopenia. METHODS:A randomized clinical trial with two parallel groups (high-speed resistance training (H-RT) and multicomponent training (MT)) was conducted over a 32-week intervention involving 80 older women at risk of sarcopenia (mean age: 77.36 ± 6.71 years). A food frequency questionnaire was administered to assess whether nutrient intake influenced strength outcomes measured by the Five Times Sit-to-Stand Test (5STS) and other functional variables. RESULTS:Significant improvements in the five times sit to stand test (5STS) were observed in both groups post-intervention (p < 0.001), with no significant differences between them (p = 0.127), suggesting comparable effectiveness. In both groups, lower levels of vitamin B12 (H-RT: rp = -0.52; MT: rp = -0.50) and vitamin D (H-RT: rp = -0.55; MT: rp = -0.69) were associated with worse 5STS performance. Additionally, in the H-RT group, lower levels of vitamin E (rp = -0.36), magnesium (rp = -0.48), iron (rp = -0.43), and potassium (rp = -0.47) were also correlated with poorer performance. CONCLUSIONS:The results indicate that improvements in strength are related to micronutrient sufficiency rather than macronutrient sufficiency. Deficiencies in vitamin D and B12 negatively impacted muscle strength gains in both H-RT and MT, while vitamin E, potassium, magnesium, and iron influenced H-RT outcomes. The lesser effect of micronutrient deficiencies on MT suggests it may be more suitable for individuals with mild deficiencies, as it requires fewer specific nutrients for muscle strength. REGISTRATION:The study is registered at ClinicalTrials.gov under the identifier NCT05870046.