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    Relationship between chewing ability and malnutrition, sarcopenia, and frailty in older adults
    (Wiley, 2022) Özsürekçi, Cemile; Kara, Murat; Güngör, Anıl Evrim; Ayçiçek, Gözde Şengül; Çalışkan, Hatice; Dogu, Burcu Balam; Cankurtaran, Mustafa
    Background Several studies reported that impaired nutrition is associated with reduced muscle mass, muscle strength, and physical performance. Chewing ability is essential to maintain balanced oral nutrient intake. The study was designed to define the possible relationship between chewing ability and nutrition-related problems (malnutrition, sarcopenia, and frailty) in a holistic perspective. Methods This cross-sectional study recruited adults aged >= 65 years. All patients were evaluated with comprehensive geriatric assessment. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People criterion. Malnutrition was determined according to body mass index, calf circumference, and Mini Nutritional Assessment short form (MNA-SF). Frailty status was diagnosed with the Clinical Frailty Scale. Masseter and gastrocnemius muscle thicknesses (MTs) were measured via ultrasonography imaging. Oral examinations were carried out by a dentist, and chewing performance was examined with a color-changeable chewing gum. Results Overall, 135 older adults (76 females) were analyzed. Mean +/- SD age was 75.7 +/- 7.2 years; 37.0% of the patients were frail, 3.7% were malnourished, 12.6% were sarcopenic, and 20.0% had poor chewing function. In the poor chewing function group, age and frailty scores were increased and the MNA-SF scores, handgrip strength, skeletal muscle index, and masseter MT were reduced (all P < 0.05). After adjusting for confounders, regression analysis showed that low grip strength and low gastrocnemius MT were independently associated with poor chewing ability. Conclusions Chewing ability was related to sarcopenia. Age and low grip strength in females and low cognitive scores and having low gastrocnemius MT in males were independent variables affecting chewing ability.
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    Ultrasonographic/regional muscle measurements for diagnosing sarcopenia in older adults with and without dementia
    (Tubitak Scientific & Technological Research Council Turkey, 2022) Ülger, Zekeriya; Ayçiçek, Gözde Şengül; Kara, Özgür; Kara, Murat
    Background/aim: Sarcopenia and dementia are growing concerns among older adults that muscle and brain atrophy may cooccur. We aimed to compare the age-related loss of muscle mass by using ultrasound (US), and skeletal muscle mass index (SMI) by bioelectrical impedance analysis in older adults with and without dementia. Materials and methods: A total of 221 older adults aged >= 65 years were included in the study. The diagnosis of sarcopenia was established if low muscle mass according to either SMI or sonographic gastrocnemius (GC) muscle thickness was combined with low grip strength. The diagnosis of dementia was based on the National Institute of Aging and Alzheimer's Association criteria and the major neurocognitive disorder definition in the Diagnostic and Statistical Manual of Mental Disorders-V. Muscle strength was measured by hand dynamometer and physical performance was assessed by 4-meter usual gait speed. Results: There were similar/moderate correlation coefficients between GC muscle thickness and SMI with functional parameters (all p < 0.01). Forty-six patients (20.8%) had dementia, and 21 (45.7%) of them had sarcopenia diagnosed by GC thickness (p < 0.001). Age was older but weight, body mass index, and all sarcopenia-related parameters were lower in dementia patients (all p < 0.01). When clinical variables were taken into binary logistic regression analyses, age [OR = 1.095 (95% CI: 1.028-1.167)], weight [OR = 0.918 (95% CI: 0.887-0.950)], and presence of dementia [OR = 5.109 (95% CI: 2.002-13.033)] were independently associated with sarcopenia diagnosed with GC muscle thickness (all p < 0.05). Conclusion: This study showed that sarcopenia is highly prevalent in older adults with dementia (45.7%) than without dementia (11.4%). Amongst different factors, increased age, having low body weight, and the presence of dementia independently increased the risk of sarcopenia diagnosed by GC muscle thickness (but not diagnosed by SMI) in older adults. Thus, we can evaluate easily and successfully the loss of (regional) muscle mass in dementia patients by using US in outpatient clinics.