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Background: Poor sleep quality may contribute to sarcopenia, but evidence remains sparse. This retrospective cross-sectional study investigated the association between subjective sleep quality and probable sarcopenia in a cohort of community-dwelling older adults enrolled in the Longevity Check-Up 8+ study. Methods: Participants were asked about their sleep quality over the past month, with four possible options (“very good”, “quite good”, “quite bad”, very bad”). For the analysis, participants were grouped into good or bad sleep quality categories. Probable sarcopenia was operationalized according to handgrip strength values < 27 kg for men and

Objective: This study investigated the effects of dual-task resistance training (RT) and detraining on physical function, cognitive capacity, lipid profile, renal function, oxidative stress markers, and chronic inflammation of institutionalized older adults. Methods: The study involved 11 older adults (83.09 ± 8.1 years) residing in a long-term care institution, spanning 42 weeks with assessments at weeks 1, 14–15, 28, and 42. The initial 12 weeks following the first assessment (weeks 2–13) served as a baseline, during which participants maintained their routine activities. A dual-task resistance training protocol was implemented from weeks 16 to 27, followed by a detraining period from weeks 29 to 41. Assessments included clinical characteristics, physical function, cognitive ability, blood samples for biochemical parameters, oxidative stress, and chronic inflammation. Results: Dual-task RT significantly enhanced balance (p = 0.027) and 4 m walking speed (p = 0.027) post-training compared to the baseline. It also decreased the completion time for the sit-and-stand test both post-training (p = 0.008) and post-detraining (p = 0.015) relative to baseline. Cognitive ability showed significant improvements (p

Sarcopenia is a prevalent neuromuscular condition among older adults, marked by significant reductions in muscle mass and strength, which result in notable impairments in physical performance. Modifications in lifestyle habits have been frequently highlighted as essential approaches to mitigate the progression of sarcopenia, with a particular focus on protein consumption. Over the past few decades, a wealth of knowledge has emerged, driven by both observational and experimental studies exploring various factors related to protein intake, such as amount, timing, and sources. This review provides a pauca verba overview of these findings, presenting a concise yet informative summary of key insights.

Objectives: The present study examined the associations between the dietary intake of polyunsaturated fatty acids (PUFAs), physical function, and the prevalence of sarcopenia in Italian community-dwelling older adults. Design: Cross-sectional study. Setting: Unconventional settings across Italy (e.g., exhibitions, health promotion campaigns). Participants: Older adults (65+ years) who provided a written informed consent. Methods: Physical function was evaluated according to isometric handgrip strength (IHG) and 5-time sit-to-stand (5STS) performances. Muscle power parameters were estimated based on 5STS values. Sarcopenia was operationalized according to the presence of low physical function (IHG or 5STS) plus low appendicular skeletal muscle mass (ASM), estimated according to calf circumference. A 12-item food questionary was used to estimate the dietary intake of PUFAs, which included omega-3 (α-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid) and omega-6 fatty acids. Results: Multiple linear regression results indicate negative and significant associations between the dietary intake of α-linolenic acid and muscle power, and between docosahexaenoic acid consumption and ASM. No significant associations were found between PUFAs-related variables and sarcopenia. Conclusions: Results of the present study indicate that PUFAs-related variables were negatively and significantly associated with physical function and body composition in older adults. Nevertheless, no significant associations were found with sarcopenia. These findings suggest that a more detailed analysis of covariates should be conducted in future investigations that aim to examine the associations between the dietary intake of PUFAs and sarcopenia-related parameters.

Objectives: This study aimed to investigate the effects of resistance training (RT) on knee extensor muscle hypertrophy in adults 65 years and older. Methods: A systematic search was carried out in PubMed, Embase, and Scopus to review randomized controlled trials that assessed the effects of supervised RT on 1) muscle size, 2) fiber area, and 3) leg lean mass (LLM). Random-effects meta-analyses of standardized mean difference (SMD) and raw mean difference (RMD) for LLM were calculated. We performed a meta-regression to examine the interference of age, training volume, and duration on the results related to hypertrophy at muscle and fiber levels. Results: Thirty-two studies were included in the review, and 28 were meta-analyzed. The meta-analysis found a significant effect of RT on muscle size (SMD = 0.34; 95 % CI: 0.16–0.52; p

Sarcopenia is associated with structural, ultrastructural, and molecular abnormalities of skeletal muscle. Mitochondrial dysfunction is a pivotal factor involved in muscle aging and sarcopenia. Mitochondrial bioenergetics are significantly reduced in muscles of older adults which is associated with whole-body aerobic capacity, muscle strength, and physical performance. Transcriptional profiling of muscle samples from older adults also revealed inverse correlations between gene expression patterns of autophagy and mitophagy and muscle volume and physical performance. This is in line with the proposition that mitochondrial quality control (MQC) processes are key to organellar and tissue health. MQC encompasses mitochondrial biogenesis, dynamics, and mitophagy. The latter has recently been included among the hallmarks of aging and alterations in MQC have been associated with chronic sterile inflammation as well as muscle atrophy and dysfunction. Several biomarkers spanning MQC, inflammation, metabolism, intercellular communication, and gut microbiota have been linked to sarcopenia. Findings from these initial studies hold promise to inform geroscience-based research in the field of sarcopenia by offering a plausible biological framework for developing gerotherapeutics and monitoring their effects.

Accurate EEG source localization is crucial for mapping resting-state network dynamics and it plays a key role in estimating source-level functional connectivity. However, EEG source estimation techniques encounter numerous methodological challenges, with a key one being the selection of the regularization parameter in minimum norm estimation. This choice is particularly intricate because the optimal amount of regularization for EEG source estimation may not align with the requirements of EEG connectivityanalysis, highlighting a nuanced trade-off. In this study, we employed a methodological approach to determine the optimal regularization coefficient that yields the most effective reconstruction outcomes across all simulations involving varying signal-to-noise ratios for synthetic EEG signals. To this aim, we considered three resting state networks: the Motor Network, the Visual Network, and the Dorsal Attention Network. The performance was assessed using three metrics, at different regularization parameters: the Region Localization Error, source extension, and source fragmentation. The results were validated using real functional connectivity data. We show that the best estimate of functional connectivity is obtained using 10−2, while 10−1 has to be preferred when source localization only is at target.

Objectives: The study was conducted to explore associations between markers of mitochondrial quality control (MQC) from vastus lateralis muscle biopsies, serum inflammatory markers, and measures of muscle power assessed by two different tools in a sample of older adults. Design: Secondary analysis of data collected in the PeppeR develOpMental ProjecT (PROMPT) at the University of Florida (Gainesville, FL, USA). Methods: Forty-three older adults (n = 20 women) were included in the study. Muscle volume of the calf and thigh was quantified by three-dimensional magnetic resonance imaging. Lower-limb muscle power was estimated using 5-time sit-to-stand (5STS) muscle power equations and isokinetic test. Protein markers of MQC were measured in muscle samples by Western immoblotting (n = 12–23), while type I and II fiber cross-sectional area (CSA) and their proportion were quantified using immunohistochemistry (n = 12). Cytochrome C oxidase enzyme activity was measured spectrophotometrically. Finally, inflammatory markers were quantified in the serum using a multiplex immunoassay (n = 39). Results: Mean age of participants was 78.1 ± 5.5 years, and the average body mass index was 26.2 ± 4.5 kg/m2. Markers of mitochondrial biogenesis (i.e., PGC-1α), mitochondrial import proteins (i.e., cHsp70 and mtHsp70), and type I fiber CSA were significantly associated with muscle power estimated via both 5STS muscle power equations and isokinetic test (p < 0.05). Specific associations were also found according to the muscle power assessment method. 5STS muscle power measures were negatively correlated with ClvCasp3, P-AMPK, T-AMPK, P-p38, GM-CSF, INF-γ, IL1b, IL6, IL8, and TNF-α, whereas positive associations were found with BAX (p < 0.05). In contrast, isokinetic measures were significantly and positively correlated with RIP140, Hsp60, and type II muscle fiber CSA (p < 0.05). Conclusions: Markers of mitochondrial biogenesis (PGC-1α), mitochondrial import proteins (cHsp70 and mtHsp70), and type I muscle fiber CSA were significantly linked to lower-limb muscle power in older adults. These results suggest that muscle power is influenced by mitochondrial signaling. We also found that the relationship between mitochondrial mediators, inflammatory markers, and muscle power varied according to the assessment tool used.

Ageism encompasses the creation of negative stereotypes of aging that culminate in the development of prejudicial thoughts and discriminatory actions against people in advanced age. Stereotypes refer to major characteristics, overgeneralized, not supported by observations, that are created to categorize, simplify, and combine complex characteristics, attributes, and behaviors shared by members of a group into more simplistic categories. Negative aging stereotypes include the assumption that old people are weak, reminiscent, sick, and tired, to quote a few. In early age, these views may generate intergenerational conflicts between young and old people, but they seem to have little effect on other aspects of life. However, in middle-aged and older adults, the presence of negative-self stereotypes of aging are significantly associated with several health parameters, including walking speed, cognitive function, mental health problems, and accumulation of amyloid plaques and neurofibrillary tangles. Furthermore, observational studies found that ageism might be associated with cardiovascular events, obesity, dementia, and death. These harmful effects are possibly mediated by the interaction between ageism and fundamental mechanisms of aging, mainly inflammation. Given the clinical implications of this relationship, the present manuscript provides a critical review of the available literature that examined associations between ageism and health parameters. We also discuss the main possible mechanisms underlying this association, the main limitations of the current literature, candidate strategies to counteract ageism, and directions to future studies. Finally, we provide a critical opinion of the current scenario and its potential adaptability to the clinical practice.

Prabal Kumar,1 Shashikiran Umakanth,2 Emanuele Marzetti,3,4 Sanjay Kalra,5,6 Girish N1 1Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India; 2Department of Medicine, Dr. TMA Pai Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India; 3Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy; 4Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica Del Sacro Cuore, Rome, Italy; 5Department of Endocrinology, Bharti Hospital, Karnal, India; 6University Center for Research & Development, Chandigarh University, Mohali, IndiaCorrespondence: Girish N, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India, Tel +91 9886782114, Email girish.n@manipal.edu; girish_darsana@yahoo.co.inBackground: The prevalence of sarcopenia is concerningly high in long-term care settings (LTCS); yet, no exercise programs specifically targeting older adults living in residential care are available.Objective: The goal of the present study was to co-design and validate a program named Reablement Strategies targeting Sarcopenia (ReStart-S) for older long-term care residents.Design: Cross-sectional study with an exploratory phase.Settings: LTCS in Udupi, Karnataka, India.Participants: Sarcopenic older adults diagnosed using Asian Working Group for Sarcopenia 2019 criteria.Material and Methods: The program was designed using a four-step intervention mapping technique involving systematic progression after completing each step. The steps included 1) identifying the appropriate exercise-based intervention for sarcopenia, 2) determining objectives and expected outcomes, 3) seeking expert views through a Delphi consensus approach, and 4) assessing the feasibility of ReStart-S program among older adults living in LTCS.Results: A comprehensive literature review appraised existing exercise programs for managing sarcopenia. A workshop held with six older adults and one caretaker, decided on morning exercise sessions, recommended 2– 7 days/week. The results of the review and workshop were compiled for the Delphi process that had seven experts from 5 countries, achieving a 71% response rate after four rounds. In the last step, a pilot study on eight LTCS residents, two males and six females with a mean age of 78.3 ± 8.3 years, was conducted and the program was found to be feasible.Conclusion: The ReStart-S program for managing sarcopenia among older adults residing in LTCS incorporates evidence from the literature and the engagement of older adults, caregivers, and experts, making it a contextually appropriate intervention. Our study also provides researchers and healthcare professionals insight into co-designing an intervention program for vulnerable older adults. Finally, the program evaluation indicates that a full-scale trial testing the efficacy of the ReStart-S program is feasible.Keywords: reablement, sarcopenia, intervention mapping, older adults, long-term care settings

Feedback may be considered 'good' according to many of the criteria in the literature whilst still having little or no impact on students' learning in the longer term. Feedback in the context of this paper is defined as the process of learners obtaining information about their work in order to produced improved learning. This comes from tutors, peers, or even self-evaluation. Here we argue for greater prominence for feedback in curriculum design. Clear principles for giving guidance on assessments and feedback at the programme level, which complement those already established and widely used for single assessments, would help curriculum designers consider communication to students about assessments in a broader context. These processes should create a dialogue that aids the students' progression in their learning from one module to the next and encourages the development of autonomous learners. Based on a review of the literature on programme-focused approaches to teaching, assessment and feedback, the current paper delineates the benefits of a programme level approach to communication around assessments and proffers a list of broad principles that will help academics achieve a coherent and developmental approach to feedback.

Background: An age-dependent normative values of calf circumference (CC) has been recently proposed as an accessible proxy for muscle mass. However, its usefulness to estimate sarcopenia has not been assessed. The objectives of the present study were to determine if the substitution of the classical way to assess muscle mass by these values have enough diagnostic accuracy and prognostic value among older adults living in the community. Methods: Data from the Toledo Study of Healthy Ageing (TSHA) were used. CC was measured using an anthropometric tape. We used two age-groups CC cut-off points: the TSHA CC median and the one proposed in the Longevity Check-up 7+ (Lookup 7+) project. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and FNIH criteria standardized for our population (sFNIH). Frailty (according to the Frailty Phenotype and the Frailty Trait Scale-5) and disability (Katz index) were assessed at baseline and follow-up. Mortality and first hospitalization were also recorded. Logistic (incident frailty and worsening disability) and Cox (mortality and hospitalization) regressions were performed. Diagnostic accuracy was assessed through Kappa index, AUCs, positive and negative predictive values. Predictive ability was assessed through AUCs and integrated AUCs (IAUCs). Results: 1531 participants (74.8 ± 5.8 years; 45.6% men) were included in the analysis. Prevalence rates of sarcopenia were 22.7% (sFNIH), 15.0% (FNIH), and 13.9% (EWGSOP2). Using TSHA-based cut-points of CC, the prevalence of sarcopenia was 16.8% (sFNIH), 11.0% (FNIH), and 11.5% (EWGSOP2). According to LC7+-based CC cut-off points, sarcopenia prevalence was 17.6% (sFNIH), 11.9% (FNIH), and 12.4% (EWGSOP2). CC cut-off points showed low-to-moderate agreement (Kappa Index values between 0.49 and 0.69) with appendicular lean mass for the evaluation of sarcopenia. Sarcopenia identified by Lookup 7+ and TSHA CC cut-off points was associated with the adverse events examined, with similar AUCs and IAUCs than original sarcopenia definitions, and were lost after adjustment by baseline frailty, except when the original EWGSOP2 definition was used. Conclusions: Using normalized values of CC as a criteria of muscle mass shows moderate agreement with classical criteria for diagnosing sarcopenia and offer similar predictive value in community-dwelling older adults.

Treatment-Resistant Depression (TRD) poses a substantial health and economic challenge, persisting as a major concern despite decades of extensive research into novel treatment modalities. The considerable heterogeneity in TRD’s clinical manifestations and neurobiological bases has complicated efforts toward effective interventions. Recognizing the need for precise biomarkers to guide treatment choices in TRD, herein we introduce the SelecTool Project. This initiative focuses on developing (WorkPlane 1/WP1) and conducting preliminary validation (WorkPlane 2/WP2) of a computational tool (SelecTool) that integrates clinical data, neurophysiological (EEG) and peripheral (blood sample) biomarkers through a machine-learning framework designed to optimize TRD treatment protocols. The SelecTool project aims to enhance clinical decision-making by enabling the selection of personalized interventions. It leverages multi-modal data analysis to navigate treatment choices towards two validated therapeutic options for TRD: esketamine nasal spray (ESK-NS) and accelerated repetitive Transcranial Magnetic Stimulation (arTMS). In WP1, 100 subjects with TRD will be randomized to receive either ESK-NS or arTMS, with comprehensive evaluations encompassing neurophysiological (EEG), clinical (psychometric scales), and peripheral (blood samples) assessments both at baseline (T0) and one month post-treatment initiation (T1). WP2 will utilize the data collected in WP1 to train the SelecTool algorithm, followed by its application in a second, out-of-sample cohort of 20 TRD subjects, assigning treatments based on the tool’s recommendations. Ultimately, this research seeks to revolutionize the treatment of TRD by employing advanced machine learning strategies and thorough data analysis, aimed at unraveling the complex neurobiological landscape of depression. This effort is expected to provide pivotal insights that will promote the development of more effective and individually tailored treatment strategies, thus addressing a significant void in current TRD management and potentially reducing its profound societal and economic burdens.

Abstract Background Muscle power is associated with health‐related parameters. Simple equations were validated to estimate lower extremity muscle power measures based on the time to complete the five‐repetition sit‐to‐stand test. The present study was conducted to provide lower extremity muscle power estimates and produce centile values in a large and relatively unselected population across a wide age spectrum. Methods Data were from the Longevity Check‐up 7+ (Lookup 7+) project, an ongoing initiative conducted in unconventional settings (e.g., exhibitions, shopping centres and health promotion campaigns) across Italy to foster adoption of healthy lifestyles. Absolute, relative, allometric and specific muscle power measures of the lower extremities were estimated using validated formulas. Cross‐sectional centile and normative values for muscle power measures from 18 to 81+ years were produced for the two sexes. Smoothed normative curves for men and women were constructed using the lambda–mu–sigma method. Results From 1 June 2015 to 31 October 2021, 13 515 participants were enrolled of whom 12 864 were eligible for the present study. Mean age was 55.9 years (standard deviation: 14.8 years; range: 18–98 years), and 7217 (56.%) were women. Absolute, relative, allometric and specific muscle power declined significantly with age. Specific patterns of decline were observed according to sex and muscle power parameter. Absolute muscle power peaked at 41–50 and 31–40 years in men and women, respectively. Afterwards, a decline rate of approximately 12% per decade was observed, regardless of sex. Relative muscle power showed the largest reduction with age, such that it was 40.6% and 46.4% smaller in men and women older than 80, respectively, compared with those aged 18–30 years. Age‐related changes in allometric and specific muscle power measures were similar between men and women. Conclusions Data from the Lookup 7+ project indicate that lower extremity muscle power estimated using simple equations is significantly associated with age. Sex‐specific patterns of decline in absolute and relative muscle power were observed with age. Allometric and specific muscle power declined at a similar rate in men and women.

Abstract Background Wide consensus exists on the notion that low muscle mass is a predictor of negative health‐related events, such as disability, morbidity, and mortality. Indeed, the European Working Group on Sarcopenia in Older People 2 had identified muscle mass as the key component to confirm the diagnosis of sarcopenia. However, the lack of normative values for muscle mass across ages hampers the practical assessment of this important parameter. The aim of the present study was to produce cross‐sectional centile and normative values for calf circumference (a surrogate estimation of muscle mass) across a wide spectrum of ages using a large and unselected sample of community‐dwellers enrolled in the Longevity Check‐up 7+ (Lookup 7+) project. Methods This is a cross‐sectional study using the data of Lookup 7+ project, an ongoing study started in June 2015 and conducted in unconventional settings (i.e., exhibitions, malls, and health promotion campaigns). Candidate participants were considered eligible for enrolment if they were at least 45 years of age and provided written informed consent. Calf circumference was measured using an inextensible but flexible plastic tape in a sitting position with the knee and ankle at a right angle and the feet resting on the floor. Normative values for calf circumference from ages 45 to 80 + years were generated. Results A total of 11 814 participants were enrolled from 1 June 2015 to 30 September 2022. The mean age of participants included in the analyses was 61.8 years (standard deviation; 10.2 years; range: 45–98 years), and 6686 (57%) were women. Normative values for calf circumference were obtained for men and women, stratified by age groups. Accordingly, a calf circumference tape, with colour bands that demarcate the centiles range into which the patient falls, was created and validated. Conclusions Our study established age‐ and gender‐specific centile reference values for calf circumference. The calf circumference tape can be used to easily interpret the assessment in every‐day practice for the early detection of individuals with or at risk of sarcopenia and malnutrition.