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many multi-faced environmental and medical factors that can con-
tribute to the worsening of sarcopenia-based frailty. Therefore, we
investigated the association of various contributing factors, including
three categories (social engagement, nutrition and physical activity),
with frailty.
Methods:
A Japanese large-scale longitudinal study,
“
Kashiwa study
”
,
was based on data randomly selected community-dwelling older
adults (aged 65
–
94, Ave 73) who participated in Kashiwa city, Japan.
Results:
The fault of all three categories significantly deteriorated
odds ratio (OR; 3.5) of risk of sarcopenia compared to the complete
attainment of three categories (OR; 1.0 as reference). Intriguingly,
using validation of hypothesis model by structural equation modeling,
we found that social disengagement affected subsequent unbalanced
diet, oral dysfunction and inadequate physical activity, leading to
sarcopenia even in the early-stage.
Key conclusions:
Our data suggest that the importance of the TRINITY,
social engagement, nutrition (i.e., dietary intake and dental/oral
management) and physical activity, in comprehensive assessment
and effectively preventive approach for sarcopenia-base frailty.
Therefore, as a new population approach, we have already developed
the community system to carry out the very simple health-checkup
conducted by
“
the healthy elderly citizen supporters
”
to prevent
multi-dimensional frailty. We first have to let the elderly in the
community know the fundamental concept of
“
chew well, eat well,
move well, and participate highly in society!
”
from the earlier stages,
consequently leading to their behavior modification.
P-343
Relationship between sarcopenia and metabolic syndrome
G. Bahat
1
, F. Tufan
1
, C. Kilic
1
, B.
İ
lhan
1
, A. Tufan
2
, M.A. Karan
1
.
1
Department of Internal Medicine, Division of Geriatrics, Istanbul
University, Istanbul Medical School,
2
Department of Internal Medicine,
Division of Geriatrics, Marmara University, Istanbul, Turkey
Objectives:
Sarcopenia is a prevalent problem in the older population
that is commonly considered for its well known adverse functional
associations. Cardiovascular diseases and metabolic syndrome are
also significant problems whose prevalence dramatically increase
with age and remain the main cause of mortality in older adults. These
two entities have recently been suggested to be inter-related and
significant evidence has accumulated. Previous studies showed
conflicting results which may depend on the differences in method-
ology assessing sarcopenia. In this study, we aimed to investigate the
association between sarcopenia and metabolic syndrome components
in terms of different sarcopenia methodologies.
Methods:
Community dwelling older outpatients were prospectively
recruited from the geriatrics outpatient clinics of a university hospital
for assessing hand grip strength and gait speed. Body compositionwas
assessed by bioimpedance analysis. Muscle strength was assessed
measuring hand grip strength with a Jamar hand dynamometer. We
used Turkish population cut-off points according to Baumgartner,
Janssen and FNIHa-b definitions while assessing sarcopenia. The
cut-off thresholds for muscle mass were defined as the mean-2SD of
the values of the young reference study population. Low muscle mass
was defined as followings according to Baumgartner, Janssen and
FNIHa-b, respectively: appendicular muscle mass/height
2
(kg/m
2
),
skeletal muscle mass/total body weight*100 (%), muscle mass/body-
mass-index (kg/m
2
). Hypertension (HT), diabetes mellitus (DM) and
increased waist circumference (IWC) (Male
–
Female >=102 cm vs
88 cm, respectively) were used as the components of metabolic-
syndrome.
Results:
Total of 970 community-dwelling outpatients between 60
and 99 years of age. 303 (31.2%) were male and 667 (68.8%) were
female. Mean age was 75 ± 7.2 years. N = 19 (%2), n = 449 (%46,2),
n = 601 (%61,9), n = 178 (%18,3) of total had lower-muscle-mass
according to Baumgartner, Janssen and FNIHa-b, respectively.
N = 309 (%31.8) had lower gait speed, 363 (%37.4) had lower muscle
strength, 479 (%49.3) had decreased muscle functionality. Sarcopenia
prevalences were 11 (%1,2), 220 (%22,6), 315 (%32,4), 106 (%10,9)
according to Baumgartner, Janssen and FNIHa-b, respectively.
Prevalences of HT, DM, increased WC were 25.3%, 75%, 65.6% respec-
tively. In chi-square analyses, lower-muscle-mass was associated with
increased HT and WC according to Janssen and FNIHa methodo-
logy (p < 0.05), while associated with only increased WC according to
FNIHb methodology (p < 0.001). According to Baumgartner method-
ology there was reverse-association between lower-muscle-mass and
increased HT (p = 0.055) and WC (p < 0.001). In functional parameters
only decreased gait speed was associated with increased WC in MS
components (p = 0.03). According to Janssen methodology increased
HT and WC were associated with sarcopenia (p = 0.04 and p < 0.001,
respectively) while FNIHa-b methodology was associated with only
increased WC (p < 0.001). Baumgartner methodology showed that
sarcopenia is reverse associated with increased WC (p = 0.001). There
was no association between DM and lower-muscle-mass, gait speed,
muscle strength and sarcopenia.
Conclusion:
We observed that relationship between sarcopenia and
MS depends on the kind of definition in sarcopenia. It seems that
Janssen methodology has the highest prediction value in terms of MS
in older population.
P-344
Epidemiology of qualitative gait abnormalities of neurologic type
in well-functioning older adults without neurological diseases
G. Carrizo
1,2
, M. Inzitari
2,3
, A.L. Rosso
4
, J. Verghese
5
, A.B. Newman
4
,
L.M. Pérez
2,3
, S. Studenski
6
, C. Rosano
4
.
1
Parc Sanitari Pere Virgili,
2
Vall d
’
Hebrón University Hospital,
3
Universitat Autonoma de Barcelona,
Barcelona, Spain;
4
University of Pittsburgh, PA,
5
Albert Einstein College of
Medicine, NY,
6
National Institute on Aging, MD, USA
Introduction:
Gait abnormalities are common in older community-
dwellers. These abnormalities, in particular if characterized by
neurological features, are associated with outcomes such as disability,
falls, incident dementia and death. Few data are available about the
epidemiology of neurological qualitative gait abnormalities (NQGA) in
the community. We assessed the prevalence of NQGA and its subtypes
in a cohort of relatively healthy, well-functioning older community-
dwellers.
Methods:
Cross-sectional analysis of the Healthy Brain Project, which
enrolled community-dwelling older adults without previous, psycho-
logical or neurological illnesses. For gait evaluation, after standardized
instructions and a visual demonstration, subjects were asked to walk
back and forth between two lines 1,5 m apart at usual pace, to turn in
place and to walk in tandem. Applying standardized and validated
readings of video-records, based on the qualitative classification of
gait proposed by Verghese et al., a trained geriatrician defined NQGA,
and, in association with neurological exam data, determined subtypes
(unsteady, ataxic, neurophatic, frontal, parkisonian, hemiparetic,
spastic). Abnormalities of gait of non-neurological type (attributable
to rheumatologic, cardio-respiratory reasons etc.), were excluded as
NQGA.
Results:
In our sample of 183 participants (mean age + SD = 83,2 + 2,6
years, 55,2% women, 58% caucasian), 52 (28%) had abnormal gait.
Unsteady gait (37%) was the most frequent subtype followed by hemi-
paretic (15%), neuropathic (14%), parkinsonian (12%), frontal (10%),
ataxic (10%) and spastic gait (2%).
Key conclusions:
In our sample of community-dwelling older adults
without clinical neurological diseases, almost one third showed
neurological abnormalities of gait. Specific subtypes, associated with
incident dementia in previous research, were the most prevalent.
P-345
Association of qualitative gait abnormalities of neurologic type
with clinical characteristics, in well-functioning older adults
without neurological diseases
M. Inzitari
1,2
, G. Carrizo
2,3
, A.L. Rosso
4
, L.M. Pérez
1,2
, J. Verghese
5
,
A. B. Newman
4
, S. Studenski
6
, C. Rosano
4
.
1
Parc Sanitari Pere Virgili,
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S120