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Decreased Basal Metabolic Rate Can Be an Objective Marker for Sarcopenia and Frailty in Older Males.
Journal of the American Medical Directors Association 2018 August 17
OBJECTIVES: The aim of this study is to demonstrate the ability of the basal metabolic rate (BMR) to detect frailty and sarcopenia in older males.
SETTING AND PARTICIPANTS: A total of 305 male patients undergoing comprehensive geriatric assessment were included in the study.
MEASURES: The frailty status was assessed with the Fried criteria. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criteria. BMR is calculated by bioimpedance analysis. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of BMR in detecting sarcopenia.
RESULTS: The mean age was 74.52 ± 7.51 years. Among the patients in the sample, 95 (31.1%) had sarcopenia and 55 (18%) had frailty. Patients who had a BMR <1612 kcal/d had a higher frequency of frailty than those who had a BMR ≥1612 kcal/d (67.3 vs 32.7, P < .001). Results were similar for sarcopenia (77.9 vs 22.1, P < .001). When BMR was divided by body surface area (BSA), BMR/BSA with a cut-off of 874 kcal/m2 had a sensitivity of 80% and a specificity of 68%, and the AUC was 0.82 for BMR/BSA, in diagnosing sarcopenia (P < .01). The participants without sarcopenia had a higher BMR/BSA for the unadjusted (OR = 8.00, 95% CI 4.52-14.19, P < .001) and adjusted analyses (OR = 6.60, 95% CI 3.52-12.38, P < .001).
CONCLUSIONS: Older male patients with sarcopenia and frailty have a higher BMR reduction. Therefore, it should be kept in mind that patients with low BMR should alert us to screen sarcopenia and frailty. BMR/BSA may play a role in objective screening to detect sarcopenia in older males.
SETTING AND PARTICIPANTS: A total of 305 male patients undergoing comprehensive geriatric assessment were included in the study.
MEASURES: The frailty status was assessed with the Fried criteria. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criteria. BMR is calculated by bioimpedance analysis. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of BMR in detecting sarcopenia.
RESULTS: The mean age was 74.52 ± 7.51 years. Among the patients in the sample, 95 (31.1%) had sarcopenia and 55 (18%) had frailty. Patients who had a BMR <1612 kcal/d had a higher frequency of frailty than those who had a BMR ≥1612 kcal/d (67.3 vs 32.7, P < .001). Results were similar for sarcopenia (77.9 vs 22.1, P < .001). When BMR was divided by body surface area (BSA), BMR/BSA with a cut-off of 874 kcal/m2 had a sensitivity of 80% and a specificity of 68%, and the AUC was 0.82 for BMR/BSA, in diagnosing sarcopenia (P < .01). The participants without sarcopenia had a higher BMR/BSA for the unadjusted (OR = 8.00, 95% CI 4.52-14.19, P < .001) and adjusted analyses (OR = 6.60, 95% CI 3.52-12.38, P < .001).
CONCLUSIONS: Older male patients with sarcopenia and frailty have a higher BMR reduction. Therefore, it should be kept in mind that patients with low BMR should alert us to screen sarcopenia and frailty. BMR/BSA may play a role in objective screening to detect sarcopenia in older males.
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