Wei-Syun Hung

Background: Preserving physical function and sleep health is vital for healthy aging. While poor sleep correlates with sarcopenia risk, the specific relationships between sleep quality and individual diagnostic criteria remain unclear. This study investigated associations between sleep quality and sarcopenia components to identify independent physiological predictors in the elderly population. Methods: Data from 468 healthy, non-frail older adults(aged ≥ 60 years) were analyzed. Sarcopenia was defined by 2019 AWGS criteria, including assessments of handgrip strength, gait speed, and muscle mass via bioelectrical impedance analysis (BIA). Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI), with a score>5 indicating poor sleep. Results: A total of 196 participants(41.9%)had poor sleep quality, exhibiting significantly lower handgrip strength(p=0.030), slower gait speed(p=0.005), and reduced muscle mass(p=0.019)compared to those with good sleep quality. PSQI scores were significantly higher in the low gait speed group than in the normal group(7.03 vs. 5.61, p=0.004). PSQI correlated negatively with handgrip strength(r=-0.139, p=0.003), gait speed(r=-0.148, p=0.002). In multivariable linear regression, walking speed(β =-0.100, p=0.042) was identified as independent predictors of PSQI levels, alongside with insomnia, anxiety, depressive symptoms, and tea consumption. Conclusion: Poor sleep quality is significantly associated with diminished physical performance in healthy older adults. Specifically, walking speed is an independent physiological marker associated with sleep quality, suggesting that reduced physical mobility may be an early clinical indicator of poor sleep in the elderly population, independent of a formal sarcopenia diagnosis.

Background: Sarcopenia is a progressive skeletal muscle disorder associated with adverse outcomes. Although the association between sarcopenia and quality of life (QoL) has been discussed, the specific relationship between different stages of sarcopenia severity—particularly distinguishing between muscle mass loss and functional impairment—and health-related quality of life (HRQoL) remains unclear. Method: This cross-sectional study enrolled 100 elderly participants from a geriatric outpatient clinic. Participants were categorized into four groups (normal, possible sarcopenia, sarcopenia and severe sarcopenia) based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. HRQoL was assessed using the Short-Form 36-Item (SF-36) questionnaire. Result: The severe sarcopenia group was significantly older and had lower calf circumference compared to the normal group. Notably, the possible sarcopenia group presented with the highest body mass index and body fat percentage, resembling a “dynapenic obesity” phenotype. In terms of QoL, participants with confirmed sarcopenia did not exhibit significant differences compared to the normal group. However, the severe sarcopenia group demonstrated significantly lower scores across almost all SF-36 domains compared to the normal group. Multivariate linear regression analysis revealed that severe sarcopenia was independently and significantly negatively associated with multiple QoL domains, including physical functioning, general health and vitality. Additionally, age, social activity and body fat were identified as independent correlates of specific QoL domains. Conclusions: Our findings suggest a non-linear relationship between sarcopenia and HRQoL. A comprehensive decline in HRQoL is strongly linked to the severity of sarcopenia (functional impairment) rather than the diagnosis of muscle mass loss alone. These results highlight the clinical importance of preserving physical performance and suggest that categorizing different severities of sarcopenia and stage-specific management strategies are necessary to improve quality of life in older adults.

Introduction: Pneumocystis jirovecii pneumonia(PCP) is a potentially life-threatening opportunistic infection. Recent study demonstrated poor prognosis and higher mortality rate in non-HIV patient, associated risk factor included cytomegalovirus(CMV) co-infection. We aimed to investigate the manifestation and outcomes of concomitant PJP and CMV infection in non-HIV, critically ill patients. Method: We had retrospectively collected patients with all adult patients who admitted to intensive care unit(ICU) and diagnosed with PCP infection from January 2017 and December 2022. The data were retrieved from the Chang Gung Research Database, including clinical manifestations, comorbidities and mortality. Result: A total of 1597 adult patients who admitted in ICU with mechanical ventilator use having bronchoalveolar lavage (BAL) evaluation were enrolled. There 289 patients had PCP infection (18%). Among them, 26 patients had concomitant CMV infection, while there were 28 patients in the non-PCP infection group had CMV infection (19.7% versus 6.7%). Increased incidence of septic shock was noticed in CMV co-infection group (26.9% vs. 5.7%, p= 0.004). There was no difference between APACHE II score and PaO2/FiO2 ratio among them. In-patient mortality was significantly higher in PCP with CMV co-infection group (33.3% vs. 11.1%, P=0.002). Conclusions: Concomitant CMV infection was common in non-HIV, critically ill patient with PCP infection, and was associated worse outcome. Early recognition and treatment may improve outcomes.