Laetitia Lengelé

Background: Low grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited. Aim: We examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors. Methods: Participants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4–6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell’s Concordance Index (C-index). Results: Mean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed. Conclusions: Grip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.

Background: Weight and appetite regulation have been associated with the expression and secretion of ATPase inhibitory factor 1 (IF1) and growth differentiation factor-15 (GDF-15), 2 potential biomarkers for age-related mitochondrial dysfunction. The aim was to explore the associations between these biomarkers and nutritional variables in the Multidomain Alzheimer Preventive Trial study. Methods: IF1 and GDF-15 plasma levels were quantified at 1-year follow-up. The nutritional status was measured using the Mini Nutritional Assessment (MNA) score variation between baseline and 1- and 2-year visits; appetite loss was extracted from the MNA. Bodyweight was measured every 6 months until the third year and then yearly until the fifth year of follow-up, and weight loss was established if the loss was greater than 5% or 10% within the past 6 or 12 months, respectively. Bidirectional associations of IF1 and GDF-15 levels with malnutrition, appetite, and weight loss were examined. The interactions between individual IF1 and GDF-15 with sex were explored. Results: Four hundred and forty-eight participants had MNA data and 1 045 had weight loss data. All the associations between IF1 levels and the MNA score, appetite loss, and weight loss were nonsignificant. Higher GDF-15 levels were cross-sectionally associated with appetite loss at the first year of follow-up, and the GDF-15 highest quartile was associated with nearly 80% higher risks of weight loss over 4 years. Interactions between IF1 and GDF-15 levels, and between these 2 markers and sex were not significantly associated with the outcomes. Conclusions: GDF-15 plasma levels were related to key malnutrition criteria.

Background Considering their prevalence and burden, information on the sensory impairment etiology is essential. Links between nutrition and sensory impairment through inflammation have been suggested. Although the decline in sensory capacities is age-related, few research included a geriatric population. Aims Exploring the associations of nutrition with sensory capacities and test inflammation as a mediator among cognitively and physically impaired older adults. Methods Cross-sectional data from the COGFRAIL cohort, including 164 participants with no hearing aid and 20 participants wearing no visual aid. Hearing was evaluated using the Hearing Handicap Inventory for the Elderly-screening version (on 40 points, the lower the better), and the Monoyer chart (one to ten out of ten points, the higher the better), and the Parinaud scale (from 1.5, the best, to 28 points, the worst) assessed distant and near vision, respectively. Dietary intake was assessed through a diet history interview and inflammation was measured by the C-Reactive Protein level. Multivariate linear regressions were performed and Structural Equation Modeling (SEM) framework was used to explore the potential mediation effect of inflammation on the diet-hearing relationships. Results None of the nutrients was significantly associated with hearing acuity in the regressions or the SEM model. Regarding vision, a higher intake of saturated fatty acids was related to lower long-distance visual acuity, and greater Omega-3 consumption was associated with better near-vision capacity. Discussion No nutrient was associated with hearing capacity and relationships between fatty acids quality and vision acuity were suggested. Conclusion These exploratory results require further investigations.

Objectives : Nutrition is a modifiable factor that may influence biochemical pathways associated with age-related body composition and physical function changes. This study aimed to describe dietary patterns and their relationships with body composition, physical performance, and grip strength according to age and sex. Design : Cross-sectional study. Setting : The data were collected in either the Clinical Research Center (CRC) of the Gérontopôle of the Centre Hospitalier Universitaire (CHU) of Toulouse or in participant’s home for those who were unable to come to the research facilities. Participants : 470 (63% female) participants of the INSPIRE-T cohort, from 20 to 93 years old. Measurements : The “Mediterranean-like” (i.e., plant-based foods, dairy), “Animal products” (i.e., meat, processed meat, butter, refined starch), and “Sugar and fast food” (i.e., ultra-processed and sugary foods) dietary patterns were extracted by principal component analysis. Total and trunk fat mass indexes (FMI, kg/m²), and total and appendicular lean mass indexes (LMI, kg/m²) were assessed by DXA. Physical performance comprised gait speed (m/sec), chair rise (sec), the Short Physical Performance Battery test (/12 points), and handgrip strength (kg) was assessed. The associations were explored through multivariate linear regressions by sex and age groups: ≥20 to <50, ≥50 to <65, and ≥65 years. Results : In middle-aged women, greater adherence to the “Animal products” diet was associated with higher total and appendicular LMI, whether higher intake of “Sugar and fast food” resulted in worse physical performance. In middle-aged men, the “Mediterranean-like” diet was associated with lower total and trunk FMI, and total and appendicular LMI. Greater compliance with the “Animal products” diet was related to lower strength. Higher “Sugar and fast food” diet intake was associated with greater total and trunk FMI, and slower gait speed. Body composition did not mediate these relationships. Conclusion : Men were more prone to have less healthy food intake in all age groups. Diets composed of sugary foods, fast foods, and processed meat were associated with higher fat mass and poorer physical performance and strength.

Background: GAMotion is a giant physical activity board game intended to improve levels of physical activity and a broader array of physical and psychological outcomes among nursing home residents. Objective: The aim of the present study is to develop and validate new balance, flexibility, muscle strength, and walking exercises to be included in GAMotion. Methods: A two-step design combining the Focus group and Delphi method was conducted among healthcare professionals divided into two independent samples of experts. The first sample was asked to develop exercises during a focus group. The second sample participated in a two-round Ranking-type Delphi method. During the first round, the participants were asked to rate the exercises developed during the focus group on a four-point Likert scale (from 1: not adapted at all to 4: very adapted). The exercises that did not reach consensus were removed (consensus established: median ≥ 3 on the Likert scale and at least 75% of experts rating the exercises as « adapted » or « very adapted »). During the second round, it was asked to rank the exercises selected at the end of the first round from most suitable to least suitable. Results: The Focus group developed nine balance, twelve flexibility, twelve strength, and nine walking exercises. Following the first round of the Delphi method, two exercises in each category did not reach a consensus and were then removed. In the second round, the remaining seven balance, ten flexibility, ten strength, and seven walking exercises were ranked by the experts, and this classification allowed us to determine the four most suitable exercises from each category to be included in the GAMotion. Conclusion: A consensus-based approach among healthcare professionals allowed us to contribute to the development of new exercises to promote physical activity in nursing homes. These validated exercises can be included in the GAMotion board game.

Background The identification of coronavirus disease 2019 (COVID-19) risk factors is requested to implement prevention strategies. Aim To explore the associations between the COVID-19 incidence and malnutrition, sarcopenia, and frailty, identified as potential risk factors in previous cross-sectional studies. Methods Malnutrition, sarcopenia, and frailty were assessed at the last available follow-up from the Sarcopenia and Physical Impairments with Advancing Age (SarcoPhAge) cohort (i.e., the fifth year that ended in 2019) according to the Mini-Nutritional Assessment short-form, the European Working Group on Sarcopenia in Older People (EWGSOP2), and the Fried criteria, respectively. Information regarding the COVID-19 was gathered by phone calls interviews in April 2021 to measure its self-declared incidence. Adjusted Cox regressions and Kaplan–Meier curves were performed. Results The present study included 241 participants [median age 75.6 (73.0–80.6) years, 63.1% women]. Among them, 27 participants (11.2%) developed the non-fatal Covid-19. No significant increased risks of COVID-19 were observed in patients with malnutrition [adjusted HR 1.14 (0.26–5.07)] and sarcopenia [adjusted HR 1.25 (0.35–4.42)]. Nevertheless, the incidence of COVID-19 was significantly higher in frail (44.4%) than in robust participants (8.5%) [Adjusted HR 7.01 (2.69–18.25)], which was confirmed by the Kaplan–Meier curves (p < 0.001). Among the frailty syndrome components, a low physical activity level was the only one significantly associated with an increased risk of COVID-19 [adjusted HR 5.18 (1.37–19.54)]. Conclusion Despite some limitations in the methodology of this study (i.e., limited sample size, COVID-19 incidence self-reported and not assessed systematically using objective measurements) requiring careful consideration, an increased risk to develop COVID-19 was observed in the presence of the frailty syndrome. Further investigations are needed to elaborate on our findings.