Assessment of the involutive sarcopenia severity in gender groups of elderly patients as a predictive screening method of active longevity

BACKGROUND. Progressive limitation of life activity with aging is largely associated with the development of sarcopenia, a geriatric syndrome characterized by decreased muscle strength and mass, requiring timely correction to maintain functional independence and quality of life in older people.

OBJECTIVE: to assess the severity of sarcopenia in older men and women to assess their potential for achieving active longevity.

MATERIALS AND METHODS. The object of the study was a random sample of 120 patients (30 men and women of elderly and senile age, mean age - (77.3 ± 2.5) years) who went to the medical prevention departments of polyclinics in Kursk to undergo annual medical examination. Kursk to undergo annual medical examination. All patients were evaluated by carpal dynamometry to judge whether the muscle strength of both arms was preserved or decreased, and the strength index (SI) was calculated, reflecting its percentage relation to body weight. A brief questionnaire was administered to the study participants using the SARC-F screening questionnaire to determine the individual probability of SP development in points, indirectly reducing the potential for achieving active longevity.

Statistical analysis of the results was carried out by descriptive statistics methods; normality of distribution was established by the Shapiro-Wilk test at p < 0.01; reliability of differences between the studied indicators was assessed by Student's test at p < 0.05. The strength and direction of the relationship between the studied characteristics was determined on the basis of the Pearson correlation coefficient.

RESULTS. Screening assessment with the SARC-F questionnaire revealed probable SP in 64% of the respondents, and in 36% of the examined patients - its absence. In elderly women, self-assessed SP was significantly higher than in men of similar age ((5.5 ± 0.4) points vs. (4.60 ± 0.25) points; p < 0.05). The left and right hand dynamometry values in women were (10.7 ± 1.5) kg and (12.8 ± 1.6) kg, respectively, while in their male peers they were significantly higher: (26.3 ± 2.4) kg and (27.5 ± 2.7) kg, respectively (p < 0.001). The SI in women was significantly lower than in men ((14.6 ± 2.2) % vs. (25.2 ± 2.1) %; p < 0.001), which indirectly confirmed the more pronounced degree of their physical limitations and, consequently, their greater need for assistance.

The expression of SP in the elderly subgroup, assessed by the questionnaire method in points, was found at a higher level than in the elderly group; no gender differences were revealed. According to the results of dynamometry, left and right arm strength in women was significantly lower than in men ((4.3 ± 1.2) kg vs. (16.2 ± 1.5) kg and (6.1 ± 1.3) kg vs. (19.3 ± 2.1) kg, respectively), as well as SI ((5.5 ± 1.4) % vs. (18.7 ± 2.0) %) (p < 0.001).

Comparison of SI values between subgroups of elderly and elderly patients confirmed similar differences (p < 0.001) in favor of younger patients.

In the group of men and women over 75 years of age, strong inverse correlations were found between the SP index and dynamometry (r = -0.70 and r = -0.63; p < 0.01), indicating a significantly pronounced relationship between age-related changes in the muscular system and limitations of vital activity. In representatives of the elderly group, these correlations were smaller (r = -0.43 and r = -0.38; p < 0.05), which may serve as a predictor of relative compensation for the functional decline in muscle strength with moderately pronounced structural changes in them against the background of aging, thereby indicating the preservation of the potential to achieve active longevity, provided that the optimal diet and exercise regimen is followed.

CONCLUSION. The greatest severity of involutional sarcopenia, established in elderly women, confirms a higher probability of developing their functional dependence, serves as a predictor of a high risk of adverse medical and social consequences. Measures aimed at slowing the development and progression of age-associated sarcopenia will serve as the basis for achieving both individual and population-wide active longevity.