Abstract

The association between fatigue and sarcopenia is not well understood, therefore, this study aimed to compare the sarcopenia measures among elderly with mild and severe fatigue and to determine whether fatigue severity is associated with sarcopenia measures. This was a cross-sectional study conducted on201 elderly (age = 68.45±6.30 years). The elderly was classified into either mild or severe fatigue based on the Fatigue Severity Scale (FSS), meanwhile, sarcopenia measures include SARC-F score, muscle mass (ASM/height2), calf circumference (CC), upper (handgrip) and lower limb muscle strength, as well as physical performance (gait speed). Data were analyzed using independent t-tests and logistic regression. The results showed that elderly with severe fatigue were significantly older, with lower muscle strength, and slower gait speed (all p-value <0.05). After adjusting for age, fatigue severity remained significantly associated with SARC-F score (OR = 1.583, 95% CI = 1.262-1.986, p-value = 0.001) and CC (OR = 1.103, 95% CI = 1.014-1.200, p-value = 0.022). Moreover,when the SARC-F score was removed from the regression model, fatigue severity was significantly associated with CC (OR = 1.088, 95% CI = 1.006-1.178, p-value = 0.036) and gait speed (OR = 0.011, 95% CI = 0.001-0.168, p-value = 0.001). Based on the results, fatigue severity is associated with SARC-F score, CC, and gait speed, therefore, interventions targeted at sarcopenia measures is recommended to optimize physical endurance in the elderly.

References

1. Zengarini E, Ruggiero C, Pérez-Zepeda MU, Hoogendijk EO, Vellas B, Mecocci P, Cesari M. Fatigue: relevance and implications in the aging population. Experimental Gerontology. 2015; 70: 78-83.

2. Galland-Decker C, Marques-Vidal P, Vollenweider P. Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey. BMJ Open. 2019; 9 (8): e027070.

3. Soares WJ, Lima CA, Bilton TL, Ferrioli E, Dias RC, Perracini MR. Association among measures of mobility-related disability and self-perceived fatigue among older people: a population-based study. Brazilian Journal of Physical Therapy. 2015; 19 (3): 194-200.

4. Bruyère O, Beaudart C, Ethgen O, Reginster JY, Locquet M. The health economics burden of sarcopenia: a systematic review. Maturitas. 2019; 119: 61-9.

5. Ying-Hsin H, Chih-Kuang L, Ming-Yueh C, Mei-Chen L, Yu-Teh L, Liang-Kung C, et al. Association of cognitive impairment, depressive symptoms and sarcopenia among healthy older men in the veterans retirement community in southern Taiwan: a cross-sectional study. Geriatric and Gerontology International. 2014; 14 Suppl 1: 102-8.

6. Visser M, Schaap LA. Consequences of sarcopenia. Clinics in Geriatric Medicine. 2011; 27 (3): 387-99.

7. Limpawattana P, Kotruchin P, Pongchaiyakul C. Sarcopenia in Asia. Osteoporosis and Sarcopenia. 2015; 1 (2): 92–7.

8. Patino-Hernandez D, David-Pardo DG, Borda MG, Pérez-Zepeda MU, Cano-Gutiérrez C. Association of fatigue with sarcopenia and its elements: a secondary analysis of SABE-Bogotá. Gerontology and Geriatric Medicine. 2017; 3: 1-7.

9. Vlietstra L, Stebbings S, Meredith-Jones K, Abbott JH, Treharne GJ, Waters DL. Sarcopenia in osteoarthritis and rheumatoid arthritis: The association with self-reported fatigue, physical function and obesity. PloS one. 2019; 14 (6): e0217462.

10. Goodwin E, Hawton A, Green C. Using the Fatigue Severity Scale to inform healthcare decision-making in multiple sclerosis: mapping to three quality-adjusted life-year measures (EQ-5D-3L, SF-6D, MSIS8D). Health and Quality of Life Outcomes. 2019; 17 (1): 136.

11. Amtmann D, Bamer AM, Noonan V, Lang N, Kim J, Cook KF. Comparison of the psychometric properties of two fatigue scales in multiple sclerosis. Rehabilitation Psychology. 2012; 57 (2): 159-66.

12. Demirchyan A, Petrosyan V, Thompson ME. Psychometric value of the center for epidemiologic studies depression (CES-D) scale for screening of depressive symptoms in Armenian population. Journal of Affective Disorders. 2011; 133 (3): 489-98.

13. Belza B, Miyawaki CE, Liu M, Aree-Ue S, Fessel M, Minott KR, et al. A systematic review of studies using the multidimensional assessment of fatigue scale. Journal of Nursing Measurement. 2018; 26 (1): 36-74.

14. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirieet Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019; 48 (1): 16-31.

15. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. Journal of the American Medical Directors Association. 2020; 21 (3): 300-7.

16. Department of Statistics Malaysia. Pocket stats quarter; 2020.

17. McCarten JR, Anderson P, Kuskowski MA, McPherson SE, Borson S. Screening for cognitive impairment in an elderly veteran population: acceptability and results using different versions of the Mini-Cog. Journal of American Geriatric Society. 2011; 59 (2): 309-13.

18. Bubel K, Jarek E, Singleton C. Fatigue severity scale. Rehab Measures; 2016.

19. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. Journal of the American Medical Directors Association. 2013; 14 (8): 531-2.

20. Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC Geriatric. 2017; 17 (1): 238.

21. Braden J, Hilgenberg S, Bohannon RW, Ko MS, Hasson S. Gait speed is limited but improves over the course of acute care physical therapy. Journal of Geriatric Physical Therapy. 2012; 35 (3): 140-4.

22. Soyuer T. Fatigue and physical performance in the elderly aged 65 and over living in a nursing home. International Journal of Family & Community Medicine. 2018; 2: 371-3.

23. Wang B, Thapa S, Zhou T, Liu H, Li L, Peng G, Yu S. Cancer-related fatigue and biochemical parameters among cancer patients with different stages of sarcopenia. Supportive Care in Cancer. 2020; 28 (2): 581-8.

24. Neefjes ECW, van den Hurk RM, Blauwhoff-Buskermolen S, van der Vorst MJDL, Becker-Commissaris A, de van der Schueren MAE, et al. Muscle mass as a target to reduce fatigue in patients with advanced cancer. Journal of Cachexia, Sarcopenia and Muscle. 2017; 8 (4): 623- 9.

25. Davis MP, Panikkar R. Sarcopenia associated with chemotherapy and targeted agents for cancer therapy. Annal of Palliative Medicine. 2019; 8 (1): 86-101.

26. Walston JD. Sarcopenia in older adults. Current Opinion in Rheumatology. 2012; 24 (6): 623-7.

27. Kwak SE, Lee JH, Zhang D, Song W. Angiogenesis: focusing on the effects of exercise in aging and cancer. Journal of Exercise Nutrition and Biochemistry. 2018; 22 (3): 21-26.

28. Carroll TJ, Taylor JL, Gandevia SC. Recovery of central and peripheral neuromuscular fatigue after exercise. Journal of Applied Physiology. 2017; 122 (5): 1068-76.

29. Huang YZ, Chang FY, Liu WC, Chuang YF, Chuang LL, Chang YJ. Fatigue and muscle strength involving walking speed in Parkinson's disease: insights for developing rehabilitation strategy for PD. Neural Plasticity. 2017; 1941980.

30. Mänty M, Ekmann A, Thinggaard M, Christensen K, Avlund K. Indoor mobility-related fatigue and muscle strength in nonagenarians: a prospective longitudinal study. Aging Clinical and Experimental Research. 2014; 26 (1): 39-46.

31. Gacesa JZ, Klasnja AV, Grujic NG. Changes in strength, endurance, and fatigue during a resistance-training program for the triceps brachii muscle. Journal of Athletic Training. 2013; 48 (6): 804-9.

32. Vestergaard S, Nayfield SG, Patel KV, Eldadah B, Cesari M, Ferrucci L, et al. Fatigue in a representative population of older persons and its association with functional impairment, functional limitation, and disability. The Journal of Gerontology, Series A: Biological Sciences and Medical Sciences. 2009; 64 (1): 76-82.

33. Wei-Quan L, Meng-Juan J, Jie T, Jia-Ji W, Hui-Shan Z, Le-Xin Y, et al. Factors associated with fatigue among men aged 45 and older: a crosssectional study. International Journal of Environmental Research and Public Health. 2015; 12 (9): 10897-909.

34. Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013; 80 (4): 409-16.

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