Slowing phenotype in geriatric patients with sarcopenia, sarcopenic obesity and dyspnea

The slowing phenotype, which is widespread among geriatric patients, is a variant of unhealthy aging that conceptually links the physical, cognitive, and emotional status of the patient. The development of simple and accessible diagnostic algorithms and further study of this phenotype are of paramount importance for understanding the mechanisms of its progression and developing the most effective therapeutic strategies for correction.

OBJECTIVE: to study the prevalence of cognitive dysfunction (CD), depression, and the slowing phenotype among patients with sarcopenia and sarcopenic obesity (SO) and to assess the clinical and functional relationships between these clinical manifestations and dyspnea in the study cohort.

MATERIALS AND METHODS. In a cross-sectional observational study of 227 geriatric patients divided into four comparative groups (with sarcopenia, with SO, with obesity without sarcopenia, control group without sarcopenia and obesity), the frequency of CD, depression, dyspnea, and the slowing phenotype was studied. The McNaught and Kane scale was used to identify cognitive impairment. Depression was assessed using the Geriatric Depression Scale (GDS-15). The Modified Medical Research Council (mMRC) and Borg scales were used to interpret the severity of dyspnea.

RESULTS. The mean age of the study participants was (76.48 ± 6.94) years, with a predominance of female subjects (73.57 %). Among patients with sarcopenia and sarcopenic obesity, the greatest number of individuals with cognitive deficit, depression, and the slowing phenotype were identified. Patients with dyspnoea were found to be numerically and more severely predominant in the sarcopenic obesity and non-sarcopenic obesity groups. Statistically significant relationships were established between sarcopenia and cognitive dysfunction (c² = 27.34; p < 0.001; С = 0.38 — average relationship), and between sarcopenia and depression (c² = 10.82; p = 0.002; С = 0.24 — average relationship). The present study found a statistically significant correlation between dyspnoea and depression (r = 0.20; p = 0.049), fatigue (r = 0.33; p = 0.008) and average relationship with obesity (c² = 7.85;  p = 0.006; C = 0.27). Conversely, obesity was not associated with cognitive dysfunction or depression.

CONCLUSION.  Among patients with sarcopenia and sarcopenic obesity, there is a high frequency of cognitive dysfunction, depression, and the slowing phenotype, which represents the most unfavorable prognostic variant of aging. Indirectly, dyspnea in such patients can aggravate the condition due to the negative impact on fatigue, physical function, and depression.

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