Association between depression and incident dementia: Longitudinal findings from the share study.

BACKGROUND: The association between depression and dementia is still unclear, particularly regarding depression as a potential risk factor preceding dementia. Therefore, we aimed to verify if the presence of depression at baseline may increase the risk of dementia and cognitive impairment during 15 years of follow-up in the SHARE (Survey of Health, Aging and Retirement in Europe) study. METHODS: Depressive symptoms were defined using the EURO-D, with a score ≥4 indicative of depression. Incident dementia was ascertained using self-reported data and caregivers' information, cognitive impairment using objective cognitive tests. Cox regression analysis, adjusted for 10 baseline confounders, was run and hazard ratios (HRs), with their 95% confidence intervals, were estimated. RESULTS: In total 22,789 participants were included in the present analysis (mean age 64.2 years) and were predominantly female. The prevalence of depression at baseline was 24.9%. Over 15 years of follow-up, the onset of dementia occurred a median 2 years earlier in people with depression compared to those without. Depression at the baseline significantly increased the risk of dementia in the overall sample (HR = 1.74; 95% CI: 1.54-1.95) and the risk of cognitive impairment (HR = 1.15; 95% CI: 1.06-1.25). For dementia, the association was stronger in people less than 60 years (HR = 2.07; 95% CI: 1.42-3.02) than in participants aged ≥80 years (HR = 1.47; 95% CI: 1.14-1.91). A similar trend was observed for cognitive impairment. Among the single items of the EURO-D, loss of concentration was the strongest individual variable predicting the onset of dementia. CONCLUSIONS: Depression increased the risk of dementia and cognitive impairment, particularly in younger adults, whereas loss of concentration was the strongest individual predicting variable of dementia. These findings demonstrate the need for early detection of depression for preventing future cognitive worsening.

Osteosarcopenia increases the risk of mortality: a systematic review and meta-analysis of prospective observational studies.

BACKGROUND & AIMS: Osteosarcopenia is a recently recognized geriatric syndrome. The association between osteosarcopenia and mortality risk is still largely underexplored. In this systematic review with meta-analysis of prospective cohort studies, we aimed to explore whether osteosarcopenia could be associated with a higher mortality risk. METHODS: Several databases were searched from the inception to 16th February 2024 for prospective cohort studies dealing with osteosarcopenia and mortality. We calculated the mortality risk in osteosarcopenia vs. controls using the most adjusted estimate available and summarized the data as risk ratios (RRs) with their 95% confidence intervals (CIs). A random-effect model was considered for all analyses. RESULTS: Among 231 studies initially considered, nine articles were included after exclusions for a total of 14,429 participants (mean age: 70 years; 64.5% females). The weighted prevalence of osteosarcopenia was 12.72%. Over a mean follow-up of 6.6 years and after adjusting for a mean of four covariates, osteosarcopenia was associated with approximately 53% increased risk of mortality (RR: 1.53; 95% CI: 1.28-1.78). After accounting for publication bias, the re-calculated RR was 1.48 (95%CI: 1.23-1.72). The quality of the studies was generally good, as determined by the Newcastle Ottawa Scale. CONCLUSIONS: Osteosarcopenia was significantly linked with an increased risk of mortality in older people, indicating the need to consider the presence of osteoporosis in patients with sarcopenia, and vice versa, since the combination of these two conditions typical of older people may lead to further complications, such as mortality.

Vitamin D and Risk of Incident Type 2 Diabetes in Older Adults: An Updated Systematic Review and Meta-Analysis.

Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50-60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017.

Sarcopenic obesity and health outcomes: An umbrella review of systematic reviews with meta-analysis.

Many studies support the idea that sarcopenic obesity (SO) could be considered a potential risk factor for negative health outcomes. These results have been inconsistent, and no umbrella reviews exist regarding this topic. Several databases until November 2023 were searched for systematic reviews with meta-analysis of observational studies (cross-sectional, case-control and prospective). For each association, random-effects summary effect sizes with correspondent 95% confidence intervals (CIs) were evaluated using the GRADE tool. Among the 213 papers initially screened, nine systematic reviews with meta-analysis were included, for a total of 384 710 participants. In cross-sectional and case-control studies, 30 different outcomes were analysed, and 18 were statistically significant. In any population addressed in cross-sectional and case-control studies, compared with non-SO, SO increased the prevalence of cognitive impairment (k = 3; odds ratio [OR] = 3.46; 95% CI: 2.24-5.32; high certainty of evidence), coronary artery disease (k = 2; OR = 2.48; 95% CI: 1.85-3.31) and dyslipidaemia (k = 3; OR = 2.50; 95% CI: 1.51-4.15). When compared with sarcopenia or obesity, the results were conflicting. In prospective studies, the association between SO-compared with non-SO-and other negative outcomes was supported by low/very low certainty of evidence and limited to a few conditions. Besides, no comparison with sarcopenia or obesity was provided. Finally, only a few studies have considered muscle function/physical performance in the diagnostic workup. SO could be considered a risk factor only for a few conditions, with the literature mainly based on cross-sectional and case-control studies. Future studies with clear definitions of SO are needed for quantifying the importance of SO-particularly when compared with the presence of only sarcopenia or obesity-and the weight of muscle function/physical performance in its definition.

Mild cognitive impairment predicts the onset of Sarcopenia: a longitudinal analysis from the English Longitudinal Study on Ageing.

BACKGROUND: Mild cognitive impairment (MCI) and sarcopenia are two common conditions in older people. It is not widely known if MCI could predict the onset of sarcopenia. Therefore, we aimed to investigate whether MCI could predict the occurrence of sarcopenia in a population of older adults. METHODS: In the ELSA (English Longitudinal Study on Ageing), MCI was defined as the absence of dementia, preserved functional capacity and low performance in three objective cognitive tests. Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index during follow-up. The longitudinal association between MCI at the baseline and incident sarcopenia was assessed using a multivariable logistic regression model, reporting the data as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: 3,106 participants (mean age of 63.1 years; 55.3% males) were included. People with MCI reported significantly lower mean handgrip strength values and Skeletal Mass Index (SMI), as well as a higher prevalence of obesity at baseline. At baseline, 729 people had MCI and during the ten years follow-up period, 12.1% of the initial population included had sarcopenia. On multivariate analysis, adjusted for 18 potential confounders, the presence of MCI (OR = 1.236; 95%CI: 1.090-1.596, p = 0.01) significantly predicted the onset of sarcopenia during follow-up. CONCLUSION: The presence of MCI at baseline was associated with a higher incidence of sarcopenia at ten-years follow-up, demonstrating a likely role of MCI as a predictor of the onset of sarcopenia in older people.

Clinical prognostic factors for older people: A systematic review and meta-analysis.

OBJECTIVE: To explore the accuracy and precision of prognostic tools used in older people in predicting mortality, hospitalization, and nursing home admission across different settings and timings. DESIGN: Systematic review and meta-analysis of prospective and retrospective studies. DATA SOURCES: A systematic search from database inception until 01st February 2023 was run in Medline, Embase, Cinhal, Cochrane Library. ELIGIBILITY CRITERIA: Studies were eligible if they reported accuracy (area under the curve [AUC]) and/or precision (C-index) for the prognostic index in relation to any of the following outcomes: mortality, hospitalization, and nursing home admission. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data. Data were pooled using a random effects model. The risk of bias was assessed with the Quality in Prognosis Studies (QUIPS) tool. If more than three studies for the same setting and time were available, a meta-analysis was performed and evaluated using the GRADE tool; other data were reported descriptively. RESULTS: Among 16,082 studies initially considered, 159 studies with a total of 2398856 older people (mean age: 78 years) were included. The majority of the studies was carried out in hospital or medical wards. In the community setting, only two tools (Health Assessment Tool and the Multidimensional Prognostic Index, MPI) had good precision for long-term mortality. In emergency department setting, Barthel Index had an excellent accuracy in predicting short-term mortality. In medical wards, the MPI had a moderate certainty of the evidence in predicting short-term mortality (13 studies; 11,787 patients; AUC=0.79 and 4 studies; 3915 patients; C-index=0.82). Similar findings were available for MPI when considering longer follow-up periods. When considering nursing home and surgical wards, the literature was limited. The risk of bias was generally acceptable; observed bias was mainly owing to attrition and confounding. CONCLUSIONS: Several tools are used to predict poor prognosis in geriatric patients, but only those derived from a multidimensional evaluation have the characteristics of precision and accuracy.

Interventions to prevent and treat delirium: An umbrella review of randomized controlled trials.

Delirium is a common condition across different settings and populations. The interventions for preventing and managing this condition are still poorly known. The aim of this umbrella review is to synthesize and grade all preventative and therapeutic interventions for delirium. We searched five databases from database inception up to March 15th, 2023 and we included meta-analyses of randomized controlled trials (RCTs) to decrease the risk of/the severity of delirium. From 1959 records after deduplication, we included 59 systematic reviews with meta-analyses, providing 110 meta-analytic estimates across populations, interventions, outcomes, settings, and age groups (485 unique RCTs, 172,045 participants). In surgery setting, for preventing delirium, high GRADE evidence supported dexmedetomidine (RR=0.53; 95%CI: 0.46-0.67, k=13, N=3988) and comprehensive geriatric assessment (OR=0.46; 95%CI=0.32-0.67, k=3, N=496) in older adults, dexmedetomidine in adults (RR=0.33, 95%CI=0.24-0.45, k=7, N=1974), A2-adrenergic agonists after induction of anesthesia (OR= 0.28, 95%CI= 0.19-0.40, k=10, N=669) in children. High certainty evidence did not support melatonergic agents in older adults for delirium prevention. Moderate certainty supported the effect of dexmedetomidine in adults and children (k=4), various non-pharmacological interventions in adults and older people (k=4), second-generation antipsychotics in adults and mixed age groups (k=3), EEG-guided anesthesia in adults (k=2), mixed pharmacological interventions (k=1), five other specific pharmacological interventions in children (k=1 each). In conclusion, our work indicates that effective treatments to prevent delirium differ across populations, settings, and age groups. Results inform future guidelines to prevent or treat delirium, accounting for safety and costs of interventions. More research is needed in non-surgical settings.

Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis.

BACKGROUND: Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of importance, but actual diagnostic criteria have some limitations. In this systematic review and meta-analysis, we aimed to find the most accurate markers that can discriminate patients with DLB versus AD, in MCI stage. METHODS: We searched several databases up to 17 August 2023 including studies comparing markers that may distinguish DLB-MCI from AD-MCI. We reported data regarding sensitivity, specificity, and the area under the curves (AUCs) with their 95% confidence intervals (CIs). RESULTS: Among 2219 articles initially screened, eight case-control studies and one cohort study were included for a total of 832 outpatients with MCI. The accuracy of cerebrospinal fluid (CSF) markers was the highest among the markers considered (AUC > 0.90 for the CSF markers), with the AUC of CSF Aß42/Aß40 of 0.94. The accuracy for clinical symptom scales was very good (AUC = 0.93), as evaluated in three studies. Although limited to one study, the accuracy of FDG-PET (cingulate island sign ratio) was very good (AUC = 0.95) in discriminating DLB from AD in MCI, while the accuracy of SPECT markers and EEG frequencies was variable. CONCLUSIONS: Few studies have assessed the accuracy of biomarkers and clinical tools to distinguish DLB from AD at the MCI stage. While results are promising for CSF markers, FDG-PET and clinical symptoms scales, more studies, particularly with a prospective design, are needed to evaluate their accuracy and clinical usefulness. CLINICAL TRIAL REGISTRATION: Prospero (CRD42023422600).

Telecoaching as a new training method for elderly people: a systematic review.

BACKGROUND: The numerous restrictive measures implemented during the recent COVID-19 pandemic have reduced the levels of physical activity (PA) carried out by elderly people and telecoaching (TC) could be a training method to maintain the recommended levels of PA. In fact, TC uses information and digital communications technologies, such as computers and mobile devices, to access training services remotely. Thus, this study aimed to systematically review the scientific literature to verify the application, efficacy, and safety of TC training programs. METHODS: PubMed, Scopus, and Web of Sciences databases were used for this review, and randomized controlled trials analyzing TC training programs for elderly people were included. Only articles written in English and published in the last decade were considered. RESULTS: 3 articles were included in the qualitative synthesis including 194 elderly people. The sample size ranged from 12 to 117 and the TC training program from 8 to 12 weeks. The TC training programs were applied to elderly people with metabolic diseases and respiratory diseases. TC training program was effective in elderly people with metabolic diseases while the benefits for respiratory diseases have yet to be clarified. CONCLUSION: TC seems to be a safe, effective, and injury-free training method, despite its limited application in elderly population. Future studies should better investigate this training method in elderly people in order to evaluate the effectiveness in a wider range of diseases.

Magnesium and the Hallmarks of Aging.

Magnesium is an essential ion in the human body that regulates numerous physiological and pathological processes. Magnesium deficiency is very common in old age. Age-related chronic diseases and the aging process itself are frequently associated with low-grade chronic inflammation, called 'inflammaging'. Because chronic magnesium insufficiency has been linked to excessive generation of inflammatory markers and free radicals, inducing a chronic inflammatory state, we formerly hypothesized that magnesium inadequacy may be considered among the intermediaries helping us explain the link between inflammaging and aging-associated diseases. We show in this review evidence of the relationship of magnesium with all the hallmarks of aging (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, disabled autophagy, dysbiosis, and chronic inflammation), which may positively affect the human healthspan. It is feasible to hypothesize that maintaining an optimal balance of magnesium during one's life course may turn out to be a safe and economical strategy contributing to the promotion of healthy aging. Future well-designed studies are necessary to further explore this hypothesis.

The link between spirituality and longevity.

We are facing an inverted demographic pyramid with continuously growing aged populations around the world. However, the advances that prolong physical life not always contemplate its psychological and social dimensions. Longevity is a complex outcome influenced by a wide range of factors, including genetics, lifestyle choices, access to healthcare, socio-economic conditions, and other environmental factors. These factors have been generally considered in the compelling research that seeks the determinants of longevity, particularly those concerning personal lifestyle choices, socioeconomic conditions, and molecular mechanisms proposed to mediate these effects. Nonetheless, fundamental aspects that can affect health and well-being, such as spirituality and religiosity, have been somehow left aside despite numerous epidemiological studies showing that higher levels of spirituality/religiosity are associated with lower risk of mortality, even after adjusting for relevant confounders. Because spirituality/religiosity are dimensions of great value for patients, overlooking them can leave them with feelings of neglect and lack of connection with the health system and with the clinicians in charge of their care. Integrating spirituality and religiosity assessment and intervention programs into clinical care can help each person obtain better and complete well-being and also allowing clinicians to achieve the highest standards of health with holistic, person-centered care. The present narrative review aims to explore the available evidence of a relationship between spirituality/religiosity and longevity and discusses the possible mechanisms that can help explain such relationship.

Prevalence of sarcopenia in Africa: a systematic review and meta-analysis of observational studies.

BACKGROUND: Existing literature suggests that sarcopenia is a highly prevalent condition in older people. However, most studies to date reporting data on its prevalence have been mainly carried out in Western countries, while data on sarcopenia in Africa is scarce. With this systematic review and meta-analysis, we aimed to determine the prevalence of sarcopenia in African countries and to explore potential factors that could explain higher or lower prevalence of this condition in Africa. METHODS: Major databases for studies reporting data on sarcopenia in African countries were searched from inception to June 2023. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of sarcopenia in Africa, applying a random effect model. Several sensitivity and meta-regression analyses were run. RESULTS: Among 147 articles initially screened, six articles (with seven cohorts) including a total of 10,656 participants were included. Mean age of participants was 66.9 years, and the majority were female (58.1%). The weighted prevalence of sarcopenia in the selected countries of Africa was 25.72% (95%CI: 18.90-32.55). This outcome was characterized by a high heterogeneity (I2 = 99%) and by publication bias. Among the factors investigated, sarcopenia was lower when assessed using only one anthropometric measure, or in South Africa. CONCLUSION: Sarcopenia is a prevalent condition in Africa and thus research regarding this topic is a public health priority. Future studies that cover African countries for which data are not available and using standardized criteria are needed.

Dietary Patterns and Healthy or Unhealthy Aging.

BACKGROUND: The aging process is complex, comprising various contributing factors influencing late-life conditions and eventual occurrence of chronic diseases that generate high financial and human costs. These factors include genetic proneness, lifestyle conducted throughout life, environmental conditions, as well as dietary aspects, among others, all together modulating precise pathways linked to aging, making longevity a multidimensional event. SUMMARY: Compelling evidence support the concept that nutritional determinants have major impact on the risk of age-associated non-communicable diseases as well as mortality. Nutrition research has turned in recent years from considering isolated nutrients or foods to focusing on combinations of foods in dietary patterns in relation to their associations with health outcomes. This narrative review focuses attention on dietary patterns that may contribute to healthy or unhealthy aging and longevity with examples of traditional dietary patterns associated with healthy longevity and reviewing the association of healthy plant-based and unhealthy ultra-processed diets with frailty, a condition that may be considered a hallmark of unhealthy aging. KEY MESSAGE: There is currently accumulated evidence confirming the key role that dietary patterns mainly of plant origin may exert in modifying the risk of age-associated chronic diseases and healthy longevity. These types of dietary models, unlike those in which the use of ultra-processed food is frequent, are associated with a reduced risk of frailty and, consequently, with healthy aging.

Sarcopenia using muscle mass prediction model and cognitive impairment: A longitudinal analysis from the English longitudinal study on ageing.

BACKGROUND: Literature on the association between sarcopenia and cognitive impairment is largely unclear and mainly limited to non-European populations. Therefore, the aim of this study is to explore if the presence of sarcopenia at the baseline could increase the risk of cognitive impairment in a large cohort of older people participating to the English Longitudinal Study of Ageing (ELSA), over ten years of follow-up. METHODS: Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index at the baseline, using a muscle mass prediction model; cognitive function was evaluated in the ELSA through several tests. The results are reported in the whole sample adjusted for potential baseline confounders and after matching sarcopenic and non-sarcopenic participants with a propensity score. RESULTS: 2738 people (mean age: 68.7 years, 54.4% males) were included. During the ten years of follow-up, sarcopenia was associated with significantly lower scores in memory (p < 0.001), verbal fluency (p < 0.001), immediate word recall (p <0.001), delayed word recall (p = 0.018), and in recall summary score (p < 0.001). After adjusting for eight potential confounders, the presence of sarcopenia was significantly associated with poor verbal fluency (odds ratio, OR= 1.417, 95% confidence intervals, CI= 1.181-1.700) and in propensity-score matched analyses (OR=1.272, 95%CI= 1.071- 1.511). CONCLUSIONS AND IMPLICATIONS: Sarcopenia was found to be associated with a significantly higher incidence of poor cognitive status in a large population of elderly people followed up for 10 years, suggesting it may be an important potential risk factor for dementia.

Spirituality and heart failure: a systematic review.

OBJECTIVES: Heart failure (HF) is a frequent chronic disease with disturbing symptoms and complex treatments, associated with depression and lower quality of life. Some studies have shown that spirituality and religiosity may be relevant in these patients. We aimed to systematically review the medical literature on spirituality and religiosity in patients with HF. METHODS: Major databases for studies investigating the effect of spirituality and religiosity in people affected by HF were searched from inception until 26th April 2023. Studies with clear definition of spirituality or religiosity, validated diagnosis of HF, and reporting outcomes of interest (i.e., incidence of mortality, cardiovascular outcomes, and quality of life) were included. RESULTS: Among 810 non-duplicate records, we screened the full texts of 25 works. After excluding 18 studies, we included 7 studies (3 observational and 4 interventional) comprising 1234 HF patients followed up over a median of 3 months. Definitions of spirituality and religiosity were heterogeneous among the studies. The intervention studies showed improvements in quality-of-life parameters, some cardiovascular outcomes, or mortality, and the observational studies showed significant associations with these outcomes. CONCLUSIONS: Despite the extreme heterogeneity of the populations included, of the definition of spirituality and religiosity, and of the interventions in the few studies that included it, all the studies reported some positive associations with the outcomes examined. Spirituality/religiosity is an aspect not generally taken into account in the usual practice of medicine and can potentially contribute to improving the conditions of patients with HF, a chronic disease with unfavorable prognosis.

Less favourable food consumption ratings in the Five-Color Nutri-Score are associated with incident frailty in older adults.

BACKGROUND: The Nutri-Score front-of-package labelling classifies food products according to their nutritional quality, so healthier food choices are easier when shopping. This study prospectively assesses the association of a diet rated according to the Nutri-Score system and incident frailty in community-dwelling older adults. METHODS: Cohort study with 1,875 individuals aged ≥60 recruited during 2008-2010 in Spain. At baseline, food consumption was assessed using a validated dietary history. Food was categorised into five Nutri-Score labels (A/green-best quality; B, C, D, E/red-worst quality) utilising an algorithm established in 2017 and currently in use. For each participant, a Five-Color Nutri-Score Dietary Index (5-CNS DI) in grams per day per kilogram was calculated. The 5-CNS DI sums up the grams per day of food consumed times their corresponding nutritional quality value (from A rated as 1 to E rated as 5) and divided by weight in kilograms. From baseline to December 2012, incident frailty was ascertained based on Fried's criteria. Statistical analyses were performed with logistic regression adjusted for main confounders. RESULTS: After a mean follow-up of 3.5 years, 136 cases of frailty were identified. The multivariable-adjusted odds ratios (95% confidence interval) of incident frailty across increasing quartiles of the 5-CNS DI were 1, 1.51 (0.86-2.68), 1.56 (0.82-2.98) and 2.32 (1.12-4.79); P-trend = 0.033. The risk of frailty increased by 28% (3-58%) with a 10-unit increment in this dietary index. Similar results were found with the Nutri-Score algorithm modified in 2022. CONCLUSIONS: consumption of a diet with less favourable Nutri-Score ratings doubles the risk of frailty among community-dwelling older adults.

Magnesium-An Ion with Multiple Invaluable Actions, Often Insufficiently Supplied: From In Vitro to Clinical Research.

Magnesium (Mg) is a key ion for numerous metabolic processes, being a cofactor of over 600 enzymes involved in cell metabolism and multiple biological processes [...].

Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing.

BACKGROUND: Dynapenic abdominal obesity (DAO) (i.e., impairment in muscle strength and high waist circumference) is gaining interest, as it is associated with several important adverse health outcomes. However, the association between DAO and multimorbidity is largely unclear. Thus, the aim of the present study was to investigate the association between DAO at baseline and new onset multimorbidity over ten years of follow-up. METHODS: People participating in the English Longitudinal Study of Ageing were included. DAO was defined as waist circumference > 102 cm in men and > 88 cm in women, and a concomitant presence of dynapenia (handgrip strength defined as < 27 kg for men and < 16 kg for women). Multimorbidity was defined as having two or more chronic conditions. The association between DAO and incident multimorbidity was assessed using a multivariable logistic regression analysis, reporting the data as odds ratios (ORs) and their 95% confidence intervals (CIs). RESULTS: Overall, 3302 participants (mean age: 63.4 years, males: 50.3%) without multimorbidity at baseline were followed-up for ten years. After adjusting for several variables, compared to participants without dynapenia nor abdominal obesity, the presence of abdominal obesity (OR = 1.505; 95%CI: 1.272-1.780; p < 0.0001) and DAO (OR = 1.671; 95%CI: 1.201-2.325; p = 0.002) significantly increased the risk of multimorbidity. Compared to no dynapenia nor abdominal obesity, DAO was associated with significantly higher risk for arthritis and diabetes. CONCLUSIONS: DAO was significantly associated with a higher risk of incident multimorbidity, over 10 years of follow-up. The results of our study suggest that addressing DAO can potentially decrease risk for multimorbidity.

Dynapenic abdominal obesity and susceptibility to fall: a prospective analysis of the Osteoarthritis Initiative.

Background: The prediction of the risk of falling remains a challenge in geriatric medicine and the identification of new potential reversible risk factors is a public health priority. In this study, we aim to investigate the association between DAO (dynapenic abdominal obesity) and incident falls in a large sample of people with knee OA (osteoarthritis) or at high risk for this condition, over 8 years of follow-up. Methods: DAO was defined using a waist circumference more than 102 cm in men and 88 cm in women and a concomitant presence of dynapenia, defined as a time over 15 s in the five times chair stands time. Falls, during follow-up, were recorded using self-reported information in the previous year. A logistic binary regression analysis was run, adjusted for potential confounders at the baseline, reporting the data as odds ratios (ORs) with their 95% confidence intervals (CIs). Results: Overall, 3,844 subjects were included, majority of whom had abdominal obesity. Across the 8 years of follow-up, 2,695 participants fell vs. 1,149 not reporting any fall. Taking those without DAO as reference, the presence of only dynapenia was not associated with risk of falls (OR = 1.18;95%CI: 0.73-1.91; p = 0.50), whilst the presence of abdominal obesity (OR = 1.30; 95%CI: 1.09-1.56; p = 0.004) and DAO (OR = 1.31; 95%CI:1.01-1.73; p = 0.04) were significantly associated with a higher risk of incident falls. Conclusion: DAO significantly increased risk of falls as well as the presence of abdominal obesity.

Magnesium in Kidney Function and Disease-Implications for Aging and Sex-A Narrative Review.

Magnesium (Mg) has a vital role in the human body, and the kidney is a key organ in the metabolism and excretion of this cation. The objective of this work is to compile the available evidence regarding the role that Mg plays in health and disease, with a special focus on the elderly population with chronic kidney disease (CKD) and the eventual sex differences. A narrative review was carried out by executing an exhaustive search in the PubMed, Scopus, and Cochrane databases. Ten studies were found in which the role of Mg and sex was evaluated in elderly patients with CKD in the last 10 years (2012-2022). The progression of CKD leads to alterations in mineral metabolism, which worsen as the disease progresses. Mg can be used as a coadjuvant in the treatment of CKD patients to improve glomerular filtration, but its use in clinical applications needs to be further characterized. In conclusion, there's a need for well-designed prospective clinical trials to advise and standardize Mg supplementation in daily clinical practice, taking age and sex into consideration.