Yuri Onishi

Aim: Sarcopenia increases the risk of long‐term care, disease development, and mortality in older adults. It is also a risk factor for cardiovascular disease and vice versa. Using cross‐sectional and longitudinal cohort study designs, we investigated the association between the carotid intima‐media thickness (CIMT) and sarcopenia in older adults. Methods: Data were extracted from the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Using data from Wave 3 of the SONIC participants, we examined the association between CIMT and sarcopenia using cross‐sectional analysis and the association between CIMT at baseline and sarcopenia status 3 years later (Wave 4) in a longitudinal study. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 guidelines. Results: The cross‐sectional study included 735 participants (347 males, mean age: 76.0 ± 0.9 years); the longitudinal study included 498 participants (247 males, mean age: 75.9 ± 0.9 years). In the cross‐sectional study, 130 (17.7%) participants had sarcopenia; multiple logistic regression analysis revealed an odds ratio (OR) of 1.55 (95% confidence interval [CI]: 1.15–2.07) for sarcopenia for every 1 mm increase in the maximum CIMT. In the longitudinal study, 100 participants (20.1%) had sarcopenia at Wave 4. Multiple logistic regression analysis revealed an OR of 1.63 for sarcopenia (95% CI: 1.13–2.36) for each 1 mm increase from the baseline maximum CIMT. Conclusion: CIMT was associated with sarcopenia. These results help clarify the pathophysiology of sarcopenia and the possible use of the CIMT as a marker to identify individuals at high risk of sarcopenia.

Aim: To investigate the impact of preoperative exercise and nutritional interventions on postoperative complications, physical function, and activities of daily living ( ADL ) 1 year postoperatively in frail older patients with gastrointestinal cancer. Methods: This single‐center, randomized controlled trial enrolled 62 patients aged ≥ 70 years scheduled to undergo elective surgery for gastrointestinal cancer with decreased grip strength or walking speed between October 2017 and December 2022. Participants were randomly assigned to control ( n = 33) and intervention ( n = 29) groups; the latter performed resistance exercises and consumed amino acid‐containing jelly daily at home for 14 days. All participants were followed‐up for 1 year. Results: After exclusion, 27 and 18 patients were enrolled in the control and intervention groups, respectively. The average age was 80.4 years, and 37.8% were male. Postoperative complications were observed in 51.9% and 44.4% of the control and intervention groups, respectively (95% confidence interval [CI] 0.62–2.19), with postoperative delirium observed in 25.9% and 33.3%, respectively (95% CI 0.31–1.94). There were no significant inter‐group differences in grip strength, walking speed, or skeletal muscle index. However, the intervention group showed superior knee extension strength maintenance (preoperatively: 100.2% ± 18.3% vs. 119.1% ± 68.8%, p = 0.19; discharge: 86.7% ± 22.0% vs. 119.3% ± 72.0%, p = 0.044), and lower rates of decreased ADLs or death 1 year postoperatively (42.3% vs. 23.5%; RR 0.56, 95% CI 0.08–1.92). Conclusions: This 14‐day preoperative exercise and nutritional intervention program did not significantly reduce postoperative complications in frail older patients with gastrointestinal cancer; however, it aided in maintaining knee extension strength at discharge.

Aim: Vitamin D (VD) affects skeletal muscles. The high prevalence of VD deficiency in Japan may lead to decreased skeletal muscle mass and strength, increasing the prevalence of sarcopenia. Therefore, we aimed to investigate the association between serum VD levels and skeletal muscle indices in a Japanese community‐dwelling older population. Methods: We extracted data from the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. We analyzed the data for participants in the 70s and 90s age groups. Skeletal mass index (SMI) using bioimpedance analysis, grip strength, walking speed, and serum VD levels using 25‐hydroxyvitamin D [25(OH)D] were measured. Results: We analyzed the data of 310 participants in their 70s and 48 in their 90s. Mean serum 25(OH)D levels were 21.6 ± 5.0 ng/mL in the 70s group and 23.4 ± 9.1 ng/mL in the 90s group. In the 70s group, serum 25(OH)D levels correlated with SMI ( r = 0.21, P < 0.0001) and grip strength ( r = 0.30, P < 0.0001). Serum 25(OH)D levels were independently associated with SMI after adjusting for sex, body mass index, and serum albumin levels. In the 90s group, serum 25(OH)D levels were correlated with SMI ( r = 0.29, P = 0.049) and grip strength ( r = 0.34, P = 0.018). However, the multivariate analysis showed no independent association between SMI, grip strength, and serum 25(OH)D levels. Conclusion: In a cross‐sectional analysis of an older population, serum VD levels were associated with SMI and grip strength, and this association was more pronounced in the 70s group than in the 90s group. Our results suggest that serum VD levels maintain skeletal muscle mass and grip strength. Geriatr Gerontol Int 2024; 24: 898–903 .