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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.


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.


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.


Relationship between sarcopenia and metabolic syndrome

G. Bahat


, F. Tufan


, C. Kilic


, B.




, A. Tufan


, M.A. Karan




Department of Internal Medicine, Division of Geriatrics, Istanbul

University, Istanbul Medical School,


Department of Internal Medicine,

Division of Geriatrics, Marmara University, Istanbul, Turkey


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.


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





skeletal muscle mass/total body weight*100 (%), muscle mass/body-

mass-index (kg/m


). 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-



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.


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.


Epidemiology of qualitative gait abnormalities of neurologic type

in well-functioning older adults without neurological diseases

G. Carrizo


, M. Inzitari


, A.L. Rosso


, J. Verghese


, A.B. Newman



L.M. Pérez


, S. Studenski


, C. Rosano




Parc Sanitari Pere Virgili,


Vall d

Hebrón University Hospital,


Universitat Autonoma de Barcelona,

Barcelona, Spain;


University of Pittsburgh, PA,


Albert Einstein College of

Medicine, NY,


National Institute on Aging, MD, USA


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-



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



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.


Association of qualitative gait abnormalities of neurologic type

with clinical characteristics, in well-functioning older adults

without neurological diseases

M. Inzitari


, G. Carrizo


, A.L. Rosso


, L.M. Pérez


, J. Verghese



A. B. Newman


, S. Studenski


, C. Rosano




Parc Sanitari Pere Virgili,

Poster presentations / European Geriatric Medicine 7S1 (2016) S29