Öz
Amaç
Bu çalışmanın amacı, yaşlı hastalarda sarkopeni varlığını değerlendirmek ve bunun vücut kompozisyonu, beslenme durumu, kas kuvveti ve fiziksel performans ile ilişkisini incelemektir.
Gereç ve Yöntem
Kesitsel olarak planlanan bu çalışmaya, Haziran 2018 ile Haziran 2019 tarihleri arasında bir üniversite hastanesinin fiziksel tıp ve rehabilitasyon polikliniğine başvuran 60 yaş ve üzeri hastalar dahil edilmiştir. Katılımcıların demografik ve antropometrik verileri kaydedilmiştir. Sarkopeni taraması SARC-F anketi (skor ≥4) ile yapılmış; kas kütlesi, biyoyelektrik impedans analizi ile değerlendirilmiştir. Fonksiyonel parametreler el kavrama kuvveti, 4 metrelik yürüme hızı testi, sandalyeden otur-kalk testi, denge testleri ve kısa fiziksel performans bataryası ile ölçülmüştür. Beslenme durumu, mini nutrisyonel değerlendirme tam formu ile değerlendirilmiş; fiziksel aktivite düzeyi ise yaşlılar için fiziksel aktivite ölçeğinin Türkçe versiyonu kullanılarak belirlenmiştir.
Bulgular
Sarkopeni prevalansı genel olarak %41,0 olarak saptanmış olup, cinsiyetler arasında anlamlı bir fark bulunmamıştır. SARC-F skorları, özellikle denge ve sandalyeden kalkma testi performansı olmak üzere, çeşitli fiziksel performans ölçütleriyle anlamlı ilişki göstermiştir. Lojistik regresyon analizinde, daha iyi denge ve sandalyeden otur-kalk testi performansının yüksek SARC-F skoru ile ters orantılı olduğu; daha yüksek vücut kitle indeksinin ise yüksek SARC-F skoru ile ilişkili olduğu bulunmuştur.
Sonuçlar
SARC-F anketi, sarkopeninin temel özelliklerini belirlemede etkili olmakla birlikte, tek başına tanısal bir araç olarak kullanımı sınırlıdır. Kesin tanı için kas kütlesi ve kas kuvveti değerlendirmelerini içeren kapsamlı bir yaklaşım önerilmektedir.
Anahtar Kelimeler: Anahtar kelimeler: Vücut kompozisyonu, geriatri, beslenme değerlendirmesi, fiziksel performans, sarkopeni
Kaynakça
Marzetti E, Calvani R, Tosato M, Cesari M, Di Bari M, Cherubini A, et al. Sarcopenia: an overview. Aging Clin Exp Res. 2017;29:11-7.
Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127(5 Suppl):990S-1S.
Sayer AA, Cruz-Jentoft A. Sarcopenia definition, diagnosis and treatment: consensus is growing. Age Ageing. 2022;51:afac220.
Chang KV, Hsu TH, Wu WT, Huang KC, Han DS. Association between sarcopenia and cognitive impairment: a systematic review and meta-analysis. J Am Med Dir Assoc. 2016;17: 1164.e7-1164.e15.
Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, et al. Sarcopenia and Cardiovascular Diseases. Circulation. 2023;147:1534-53.
Kara M, Kara O, Ceran Y, Kaymak B, Kaya TC, Citir BN, et al. SARcopenia assessment in hypertension the SARAH study. Am J Phys Med Rehab. 2023;102:130-6.
Kara Ö, Kara M, Kaymak B, Kaya TC, Çitir BN, Durmus ME, et al. Homing in on cognition with cross-sectional analysis of sarcopenia-related measurements: the SARCOG study. Aging Clin Exp Res. 2022;34:2149-54.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16-31.
Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc. 2011;12:249-56.
Nishikawa H, Asai A, Fukunishi S, Takeuchi T, Goto M, Ogura T, et al. Screening tools for sarcopenia. In Vivo. 2021;35:3001-9.
Malmstrom TK, Morley JE. SARC-F: A Simple Questionnaire to Rapidly Diagnose Sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-2.
Bahat G, Yilmaz O, Kiliç C, Oren MM, Karan MA. Performance of Sarc-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging. 2018;22:898-903.
Evans WJ, Guralnik J, Cawthon P, Appleby J, Landi F, Clarke L, et al. Sarcopenia: no consensus, no diagnostic criteria, and no approved indication—How did we get here? GeroScience. 2023.
McLean RR, Kiel DP. Developing consensus criteria for sarcopenia: an update. J Bone Miner Res. 2015;30:588-92.
Kondoh H, Kameda M. Metabolites in aging and aging-relevant diseases: frailty, sarcopenia and cognitive decline. Geriatr Gerontol Int. 2023.
Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopeni. 2022;13:86-99.
Ozkok S, Oren MM, Aydin CO, Ozalp H, Kilic C, Koc Y, et al. Clinical validation of SARC-F by proxy as a practical tool to evaluate sarcopenia in dependent older adults. J Geriatr Oncol. 2023;14:101630.
Bahat G, Tufan A, Kilic C, Öztürk S, Akpinar TS, Kose M, et al. Cut-off points for weight and body mass index adjusted bioimpedance analysis measurements of muscle mass. Aging Clin Exp Res. 2019;31:935-42.
Bahat G, Tufan F, Bahat Z, Aydin Y, Tufan A, Akpinar TS, et al. Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly. Aging Male. 2013;16:67-72.
Sacar DE, Kilic C, Oren MM, Erdogan T, Ozkok S, Aydin CO, et al. Probable sarcopenia: associations with common geriatric syndromes and comorbidities in Turkish geriatric patients from a university hospital. Eur Geriatr Med. 2022;13:1299-308.
Bahat G, Aydin CO, Tufan A, Karan MA, Cruz-Jentoft AJ. Muscle strength cutoff values calculated from the young reference population to evaluate sarcopenia in Turkish population. Aging Clin Exp Res. 2021;33:2879-82.
Bauer JM, Verlaan S, Bautmans I, Brandt K, Donini LM, Maggio M, et al. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015;16:740-7.
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. 1988.
Organization WH. Measuring obesity: classification and description of anthropometric data. Copenhagen: WHO. 1989;133.
Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40:423-9.
Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69:547-58.
Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7:28-36.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85-94.
Lauretani F, Ticinesi A, Gionti L, Prati B, Nouvenne A, Tana C, et al. Short-physical performance battery (SPPB) score is associated with falls in older outpatients. Aging Clin Exp Res. 2019;31:1435-42.
Fritz S, Lusardi M. White paper: “walking speed: the sixth vital sign”. J Geriatr Phys Ther. 2009;32:46-9.
Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med. 2002;18:737-57.
Ayvat E, Kilinc M, Kirdi N. The Turkish version of the Physical Activity Scale for theElderly (PASE): its cultural adaptation, validation, and reliability. Turkish Journal of Medical Sciences. 2017;47:908-15.
Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Research Notes. 2011;4:1-5.
Alcazar J, Losa-Reyna J, Rodriguez-Lopez C, Alfaro-Acha A, Rodriguez-Mañas L, Ara I, et al. The sit-to-stand muscle power test: an easy, inexpensive and portable procedure to assess muscle power in older people. Exp Gerontol. 2018;112:38-43.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412-23.
Barbosa-Silva TG, Menezes AM, Bielemann RM, Malmstrom TK, Gonzalez MC. Enhancing SARC-F: improving sarcopenia screening in the clinical practice. J Am Med Dir Assoc. 2016;17:1136-41.
Ishihara Y, Kusakabe T, Yasoda A, Kitamura T, Nanba K, Tsuiki M, et al. Comparison of the utility of SARC-F, SARC-CalF, and calf circumference as screening tools for sarcopenia in patients with osteoporosis. PLoS One. 2024;19:e0310401.
Chen L-K, Woo J, Assantachai P, Auyeung T-W, Chou M-Y, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21:300-7.e2.
Lin Y-L, Wang C-H, Tsai J-P, Chen C-T, Chen Y-H, Hung S-C, et al. A comparison of SARC-F, calf circumference, and their combination for sarcopenia screening among patients undergoing peritoneal dialysis. Nutrients. 2022;14:923.
Zhuang M, Wang L, He X, Ma L, Song Y, Chen N. Prevalence of sarcopenic obesity: comparison of different diagnostic criteria and exploration of optimal screening methods. BMC Geriatrics. 2024;24:799.
Marín Baselga R, Teigell-Muñoz FJ, Porcel JM, Ramos Lázaro J, García Rubio S. Ultrasound for body composition assessment: a narrative review. Intern Emerg Med. 2025;20:23-34.
Dogan Y, Kara M, Culha MA, Ozcakar L, Kaymak B. The relationship between vitamin D deficiency, body composition, and physical/cognitive functions. Arch Osteoporos. 2022;17:66.
